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YR2 LCRS Pharm > Drugs of Abuse 1 – General/Cannabis > Flashcards

Drugs of Abuse 1 – General/Cannabis Flashcards

1
Q

Generally speaking, how do the drugs of abuse cause the feeling of euphoria?

A

Hijack the mesolimbic dopaminergic pathway – the central reward pathway

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2
Q

Describe the structure of the central reward pathway.

A

Dopaminergic neurones project from the ventral tegmental area to the nucleus accumbens
Dopamine release into the nucleus accumbens stimulates the feeling of euphoria

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3
Q

Put the routes of administration of drugs in order of speed of absorption.

A

Smoking > IV > Snorting > Oral

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4
Q

Why is smoking slightly quicker than IV injections?

A

Smoking delivers drug to alveoli where it easily crosses the alveoli + enters the pulmonary circulation
There is a shorter distance from the pulmonary circulation to the heart + then brain than from the site of IV injection to the heart + then brain

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5
Q

What are the different classes of the drugs of abuse?

A

Narcotics/painkillers e.g. opiate like drugs- heroin
Depressants e.g. alcohol
Stimulant e.g. cocaine, caffeine
Miscellaneous e.g. Ecstasy (mixed properties)

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6
Q

What is an alkaloid?

A

Any class of nitrogenous organic compound of plant origin that has profound physiological actions on humans

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7
Q

What are the active components of the Cannabis sativa plant?

A

Cannabinoids (> 60 in the plant)

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8
Q

What is the most potent cannabinoid in the plant?

A

Delta-9-tetrahydrocannabinol (Delta-9-THC)

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9
Q

What is another important cannabinoid that appears to counteract some of the negative effects of the potent cannabinoid?

A

Cannabidiol

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10
Q

How has cannabis production changed over the last 10-15 years?

A

Increase in amount of 9-THC in the cigarette meaning that there is less cannabidiol
Suggests cannabis production is heading towards being more pro-psychotic

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11
Q

What percentage of smoked cannabis will reach the blood stream?

A

~ 30%

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12
Q

Describe the accumulation of cannabis in the brain following administration.

A

Cannabis levels in the brain rise very quickly after administration but, because the brain is highly perfused, cannabis levels in the brain fall rapidly too

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13
Q

Describe the accumulation of cannabis in fat following administration.

A

Cannabis is very lipid soluble so slowly accumulates in the fat
Thus, will leak from the store in fat for a long time after administration

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14
Q

How long will the effects of cannabis last after smoking a joint?

A

~ 30 days (because of storage in adipocytes)

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15
Q

What is an important metabolite of cannabis?

A

11-hydroxy THC (more potent than Delta-9-THC)

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16
Q

What happens to 11-hydroxy THC once it has been produced?

A

Excreted in bile into GI tract but then undergoes enterohepatic cycling + re-enters blood stream where it can exert its physiological effects
Because of this, plasma Delta-9-THC levels are a poor measure of intoxication

17
Q

Where are the different cannabinoid receptors found?

A

CB1: brain
CB2: peripheral immune cells

18
Q

What type of receptor is the cannabinoid receptor?

A

GPCR: negatively coupled with adenylate cyclase

By reducing cAMP, the cell doesn’t function so well (depresses cell activity)

19
Q

Name one endogenous cannabinoid.

A

Anandamide

20
Q

Describe how cannabis causes euphoria.

A

Cannabis binds CB1 receptors on GABA neurones + inhibits GABA neurones
Thus, remove inhibitory influence of GABA neurones on dopaminergic neurones of the rewards pathway, hence there is increased firing of the dopaminergic neurones –> euphoria

21
Q

What area of the brain does cannabis interact with that is linked to its psychotic effects?

A

Anterior Cingulate Cortex

Hypoactivity in ACC in chronic cannabis users

22
Q

What is the Anterior Cingulate Cortex responsible for?

A

Performance monitoring + behavioural adjustment in order to avoid losses

23
Q

Which part of the brain does cannabis act on to stimulate food intake?

A

Lateral hypothalamus

24
Q

What are the two main groups of neurones that are involved in stimulating appetite?

A

MCH (melanin concentrating hormone) neurones

Orexin neurones

25
Q

What effect does cannabis have on MCH and

Orexin neurones?

A

Cannabis inhibits the inhibitory effect of GABA on MCH neurones, thus leading to increased MCH firing
Also directly stimulates orexin production
This leads to hunger

26
Q

Describe the effect of cannabis on the immune system.

A

Cannabis is a powerful immunosuppressant

CB2 receptor on immune cells so depresses their activity

27
Q

How does cannabis cause memory loss?

A

Inhibits production of BDNF (brain derived neurotrophic factor), which is important in the hippocampus in forming memories
In general, cannabis has a depressant effect on the hippocampus

28
Q

How does cannabis cause impaired psychomotor performance?

A

Depresses the cerebral cortex

29
Q

How does cannabis cause cardiovascular effects?

A

Cannabis acts via the TRPV1 receptor to cause calcium influx

30
Q

What are the cardiovascular effects of cannabis?

A

Activating the TRPV1 receptor leads to calcium influx –> tachycardia

31
Q

In which part of the body does cannabis cause a lot of vasodilation?

A

Conjunctivae (bloodshot eyes)

32
Q

Why is it not possible to overdose on cannabis?

A

There is very low expression of CB1 in the medulla (which is where you find the cardio-respiratory centres)

33
Q

What is the upregulation of cannabinoid receptors pathologically associated with?

A

Obesity

Infertility

34
Q

State 4 drugs that are either cannabinoid agonists or antagonists.

A

Dronabinol: Delta-9-THC
Nabilone: Delta-9-THC
Sativex: Delta-9-THC + cannabidiol
Rimonabant: CB1 antagonist

35
Q

What can cannabinoid receptor agonists be used for?

A

Treatment of nausea due to chemotherapy

36
Q

What is Sativex used for?

A

Analgesic

Treatment for symptom improvement in adult patients with moderate to severe spasticity due to MS

37
Q

What can Rimonabant be used for?

A

Anti-obesity medication (removed from the market because it was shown to cause depression + suicidal thoughts)

38
Q

What can dronabinol and nabilone be used for?

A

Stimulating appetite in AIDS/ Chemotherapy patients

YR2 LCRS Pharm (34 decks)

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