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NEUR1005 > Drugs of abuse (Prof Dickenson) > Flashcards

Drugs of abuse (Prof Dickenson) Flashcards

1
Q

How would you define drug dependence ?

A

A state, psychological and/or physical
resulting from an interaction between a drug and organism, characterized by a compulsion (periodic or continuous) to experience the psychic effects and/or avoid the discomfort of withdrawal.

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2
Q

What effects do all drugs have in common ?

A

Wish, need, desire and craving (all psychological).

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3
Q

Which drugs systematically lead to withdrawal symptoms ?

A

Depressent drugs: opioids, alcohol etc.

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4
Q

Which drugs can be classed as:

  • depressants ?
  • opiates ?
  • stimulants ?
  • hallucinogens ?
  • inhalants ?
  • cannabis ?
A 
Depressants: alcohol, barbiturates
Opiates: heroin, morphine
Stimulants: amphetamines, cocaine, ecstasy
Hallucinogens: LSD, magic mushrooms
Inhalants: glue, solvents
Cannabis: classed alone
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5
Q

Do opioids cause physical and/or psychological withdrawal symptoms ?

A

Physical and psychological symptoms.

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6
Q

Can all drugs trigger:

  • phsycological dependance ?
  • physical dependance ?
A

Psychological dependence: yes, all drugs can trigger reward and or reinforcement mechanisms
Physical dependence: only depressant drugs can trigger
adaptive mechanisms

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7
Q

How does the Ventral Tegmental Area (VTA) reward system work ?

A

GABAergic neurons naturally inhibit dopaminergic neurons that release dopamine in the cortex.

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8
Q

Where do opioids, alcohol and cannabis act on the VTA ?

A

These drugs inhibit the GABAergic neurons of the VTA, thus increasing the amount of DA released in the cortex.

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9
Q

Where does nicotine act on the VTA ?

A

It stimulates the dopaminergic neurons of the VTA.

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10
Q

How do cocaine and NMDA work ?

A

Cocaine inhibits the reuptake of DA in VTA dopaminergic neurons. while NMDA causes DA release.

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11
Q

What are the typical characteristics of withdrawal systems ?

A

Withdrawal symptoms are opposite to the acute effects of the drug: if the drug is a depressant (e.g. heroin or alcohol), it inhibits the NS, which adapts over time to increase overall excitation (receptor up-regulation, NT synthesis, depolarization up, 2nd messengers up, plasticity up). When the drugs is removed, the body is in a naturally over-excited state.

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12
Q

What are the acute effects of heroin ?

A
  • Pain relief
  • Reflexes down
  • Secretions down
  • Temperature down
  • Constipation
  • Cough down
  • Anxiety down
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13
Q

What are the withdrawal effects of heroin ?

A
  • Aches and pains
  • Kick the habit
  • Tears, runny nose
  • Fever - cold turkey
  • Diarrhea
  • Coughing
  • Panicky
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14
Q

What were the treatments in the past for heroin dependency ?

What about today ?

A

Past: aversion therapy
Today: substitution therapy –> methadone or naoloxone for opioids

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15
Q

What are the major problems of drug dependence and abuse ?

A

(1) overdose
(2) crime as a result of need to obtain drug
(3) withdrawal symptoms - may be life threatening
(4) retreat from society
(5) acute effects of a particular drug and the chronic pathological effects
(6) AIDS, hepatitis etc. as a result of injections. Injection of tablets.
(7) drug combinations

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16
Q

On what receptors does cannabis act on ?

What types are they and where are they located ?

A
  • inhibitory CB1 and CB2 receptors
  • They both work through slow 2nd messengers
  • Sites of action: spinal and supraspinal
17
Q

How does the receptor coupling for cannabis compare to that of opioids ?

A

It is very weak.

18
Q

What do patients like when they take cannabis ?

A

Analgesia, mood, sedation, amnesia, muscle relaxation –> spinal, cortical and hyppocampal sites of action.
Also increased appetite .

19
Q

What are the effects of stimulants at low doses ?

A 
• Mood amplification 
• Increased energy 
• Insomnia 
• Restlessness - motor 
• Hyperactive ideation 
• Talkativeness 
• Mild anorexia 
• Increased sexual 
interest
20
Q

What are the effects of stimulants at high doses ?

A
  • Irritability, hostility
  • Extreme energy
  • Total insomnia
  • Motor stereotypies
  • Disjointed ideas
  • Rambling
  • Total anorexia
  • Decreased sexual interest
21
Q

Where does heroin comme from ?

How does it work ?

A
  • Heroin commes from morphine (juice of the opium poppy).
  • Heroin = diamorphine, enters the brains rapidly and is converted to morphine
  • 4 opioid peptides and 4 ORs known
  • morphine activates MORs, open K+ channels and inhibits NT release
22
Q

How does cocaine work ?

A

By blocking the reuptake and NA and DA (by blocking a presynaptic transporter).

23
Q

What are the consequences of repeated cocaine consumption ?

A
  • Mood, confidence, alert…
  • Dry mouth, palpitations
  • Anxiety and panic
  • Heart failure - bp and heart rate up
  • Cerebral haemorrhage
24
Q

How do amphetamines work ?

A

Amphetamines enter the nerve terminal through uptake and cause NT release (DA, NA, 5-HT).

25
Q

What are the effects of amphetamines ?

A
  • Alert, awake, confident
  • Amphetamine psychosis (DA)
  • Motor problems - chewing (DA)
  • Fatigue
  • Anorexia
26
Q

What are the effects of MDMA/ecstacy ?

A
  • 5HT + DA levels increase
  • energy, calm, empathy, enhanced sense of surroundings/temperature changes
  • 5HT may relate to visual changes etc.
    But autoreceptors may then be activated:
  • reduced release + activity of neurons and synthesis
    of 5HT
    Short term depletion of 5HT..3-4 days of comedown
27
Q

What are the various effects of morphine in:

  • the cortex ?
  • the brainstem ?
  • the spinal chord ?
  • the PNS ?
A
  • Cortex: reward and reduced anxiety
  • Brainstem: analgesia, respiratory depression, nausea and cough
  • Spinal chord: analgesia
  • PNS: constipation
28
Q

Can patients under morphine treatment become dependant ?

A

No, because pain block reward.

29
Q

What are the effects of excessive alcohol consumption ?

A
  • One drug is legal
  • Violence - 35%
  • Criminal damage
  • Brain damage
  • Liver damage
  • CV problems
  • Gastric damage
  • Major dependence
  • 20,000 deaths
  • No medical use
30
Q

What are the effects of cannabis consumption ?

A
  • Benign
  • Apathy
  • Bronchitis
  • Amotivational syndrome
  • Mental problems… ??
  • Minor psych dependence
  • 0 deaths
  • Potential use in pain, cancer and AIDS

NEUR1005 (31 decks)

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