Psychoactive Drugs Flashcards
Which of the following are not characteristics of depressants? A Decrease CNS functions B. Raise processing speed C. Cause dizziness D. Lack of coordination
B. Depressants do not generally increase processing speed as they are lower the functions of the brain. Everything else is correct.
How are barbiturates and benzodiazepines similar? How are they different?
Barbiturates/tranquilizers and benzodiazepines are both depressants that function in suppressing the functions of the central nervous system. Both are prescribed to relax a patient or induce sleep, however, barbiturates are no longer used due to the high addiction potential. Barbiturates can also be used as general anesthesia or be used as an anticonvulsant (prevent or reduce the severity of epileptic fits or other convulsions) Benzos are more commonly prescribed as to treat insomnia, anxiety and seizures
Alcohol falls under the psychoactive drug class: depressants. What about alcohol makes it a little odd and doesn’t quite fit the class?
Alcohol has the ability to lower inhibitions, therefore allowing indv to commit to actions that would not normally do, therefore more likely to act on impulses and leads to impaired judgement and reduced self-awareness and self control
Name all drugs that fall under the class of stimulants.
Caffeine - Amphetamines, ex: Adderall Methamphetamines MDMA/ecstasy/mollie Cocaine Nicotine
Along with increased CNS functions, what consequences can come out of stimulants?
Along with the increased HR And BP, stimulants can increase alertness leading to an energetic feeling. However, it can cause jitteriness and even nervousness.
What about nicotine makes it an oddball in the class of stimulants?
Nicotine can cause relaxation, but it can also make a person more alert. [sounds contradicting, but no!]
After a long night out, you and Juan are sitting at a diner and realize that he has an interview in an hour. Still heavily drunk, he insists on sobering up with coffee. What should you tell him?
He should reschedule his interview. Alcohol and coffee does have polar opposite effects, however, they do not cancel one another out as they do not mechanistically function in the same way. Therefore he will simply be a more drunk person.
Besides having the ability to create hallucinations, what other properties does hallucinogens also have? Which other class of psychoactive drugs have the additional characteristics?
Hallucinogens also have the ability to excite or calm the indv as well mirroring stimulants or depressants respectively
Hallucinogens also create a sense of connectedness and can induce intense mood swings in a person.
What is the experience of hallucinogens dependent on?
The exact experiences perceived by an indv, maybe different for another indv because a lot of hallucinogens and their effect are based on indv personalities, where they are, and who they are with.
Opiates/opioids are known for their pain relief. However, what other characteristics can they have to cause them to be potentially classified as another class?
Opiates can depress the CNS as well leading to a decrease in HR and BP. This is why some drugs under this class are in fact classified as depressants instead. HOWEVER!! The mechanism of action is different. Opiates/opioids bind to endorphin receptors while depressants bind to GABA receptors
Which of the following drugs are not opiates? A. Codeine B. Oxycodone C. Barbiturates D. Vicodin
C. Barbiturates. These drugs are a part of depressants and represent the classic definitions of depressants: depress the CNS by decreasing HR, BP, and RR through binding of GABA receptors. [remember, opiatea/opiods also act like depressants as well]
You find a new drug used recreationally among the projects. What properties must this drug contain in order to be classified as an opioid?
It has to be synthetically made to be termed opioids [note: opiates are naturally occurring, though there are used interchangeably; Mneumonic: “at” - n”at”ural - opi”at”es] This new drug has to also depress the central nervous system (therefore decrease HR and BP) and also bind endorphin receptors to create an analgesic effect.
Though psychoactive drugs can be classified based on many things, what are the most common classifications?
There are many drug classifications that can be denoted, therefore not all a single drug can fit nicely into one category as it may share many similar characteristics of different groups. But the most common classifications are:
Legal system
Likelihood of abuse
Biological effect of drugs (classic classification in psych)
What psychoactive classifications (biological effect) does marijuana fall under?
None of the commonly listed ones as it shares characteristics of different ones. Marijuana can cause hallucinations but also it can decrease central nervous systems to cause relaxation.
Alcohol is known to be a disrupter of sleep. Explain why.
Alcohol causes disturbances of REM sleep. This in turn can lead to lack of REM sleep overall and play a role in inhibiting you ability to form memories and new synapses
What negative consequence does both depressants: barbiturate and alcohol share together?
Both can potentially reduce memory, judgement and concentration. Both do have the ability to reduce anxiety (barbiturates induce sleep while alcohol reduces your inhibitions)
As you assess a new benzodiazepine on the market, you are attempting to recall the mechanism of benzos in the body. What happens once the drug has bound onto its receptor?
Benzo binds to GABA receptors of neurons, leading to activated chloride channels in neurons to open. This leads to more chloride entering the neurons creating a negative membrane. This low membrane potential leads to the neurons resilience in excitation, hence why they are good rxs for sleep or anxiety.
What kind of psychoactive drugs are prescribed for insomnia A Stimulants, Oxycodone B. Depressants, Barbiturates C. Depressants, Benzodiazepines D. Depressants, Alcohol
C. Depressants, Benzodiazepines - Short and intermediate acting benzos are prescribed for insomnia only. Long acting benzodiazepines are Rx for anxiety as it has a longer effect. Historically, tranquilizers/barbiturates were Rx for all of these disorders, however, this class of drugs had very addictive potential, leading to the discontinue and occasional use of it only now
In terms of prescription, what is one diagnosis that both stimulants and depressants can be prescribed to an individual?
Anxiety. Molly/Ecstasy and long acting barbiturates can be Rx to an indv to treat their anxiety
What are endorphins and what mimics these?
Endorphins are the body’s natural pain reducing neurotransmitters. Opiates mimic these neurotransmitters leading to a decreased in perception of pain
What about opiates leads to this class of psychoactive drug to have addictive potentials?
With high doses of opiates, indv will have a sense of euphoria leading to recreational uses
Nicotine and caffeine are both physiologically addictive chemicals. What do they both share in terms of withdrawal symptoms?
Without the substances in the body, users can experience irritability, distractibility, and mood changes (depression for caffeine users and anxiety with nicotine users) They do differ in some symptoms such as caffeine users tend to experience headaches which nicotine users tend to experience insomnia.
How does the neurochemical mechanism of cocaine differ from amphetamine?
Cocaine causes the release of dopamine, serotonin and norepinephrine which amphetamine (and methamphetamine) causes the release of dopamine only. All 3 causes a sense of euphoria
What do most recreational stimulants share in common during the crash stages of substance use?
Cocaine, methamphetamine, and amphetamine all depletes their respective neurotransmitters. Once the effect wears off, the crash is experience, where emotional disturbances (such as irritability and depression) and convulsions/seizures can be experienced by users
How does methamphetamine and amphetamine’s crash signs differ from cocaine?
Though both share many signs of crashing, cocaine’s crash signs include cardiac arrest and respiratory failure while methamphetamine and amphetamine demonstrate insomnia.
What are the difficulties about ecstasy that makes it hard to classify this drug?
It has both stimulant and hallucinogenic properties. As a stimulant, it does raise bodily functions, such as heart rate, blood pressure and temperature. It causes serotonin to be flushed out of neurons which can also lead to damages to these types of neurons. MDMA also has hallucinogenic effects causing one to feel socially connected and intimate with others even as there is nothing in reality that points to it.
Your patient comes in and reports he has been feeling very depressed. Though not an addict, he does use mdma many times a year when he travels to festivals. What do you fear has happened?
The chronic use of MDMA for a number of years may have damaged his serotonergic neurons leading to little or no serotonin compared to his normal levels. This could explain his permanent depressed mood.
What is the relationship of hallucinogens on serotonergic neurons?
Hallucinogens seem to have a pattern of interfering with serotonin transmission. This relationship has an after effect of indv experiencing an artificial sensation not present in the environment.
Those most drugs under the class of hallucinogens do cause some form of hallucination/perception of sensations not present in reality, what forms are specific to LSD?
LSD tends to be visual as opposed to auditory hallucinations.
The active ingredient, THC, in marijuana creates what kind of effect on the body?
This ingredient heightens sense in sounds, colors, tastes, and smells and therefore has been associated as a mild hallucinogen.
What is strange about THC and why its innate properties don’t allow for a cohesive classification?
Even though THC acts as a mild hallucinogen, it also demonstrates very similar roles like a depressant. In this way, it reduces inhibition and relaxes the CNS. This decrease in CNS function ultimately leads to decrease in motor coordination,imparis perpetual skills, and disrupt memory formation (hence why sometimes it can interfer with short term memory recall) These effects are very similar to the effects of alcohol.
Upon arriving at the ER, you find yourself with a very disoriented patient. He states that he is very nervous for his job interview coming up as they will be doing a drug test. To calm his nerves, he decided to smoked some weed instead of drink as he always does. After consumption he bumped his head when he missed a step going up the stairs. His vitals are WNL, and his CT shows no signs of abnormality. What can you report to him?
Alcohol and THC does share very similar effects however unlike alcohol which is eliminated from the body in a few hours, THC can stay up to a week with the system. This is why long time users can sometimes take less of the substance and achieve the same high. Because of this, he may fail his exam if it is detected in his body.
You are interning your attendee and he prescribes THC for his cancer patient. As a 15 year old, who has had a few relapses, you question whether this is the best choice for a minor. Why may he be prescribing THC on top of her chemo.
Chemotherapy has lots of side effects and nausea is one. THC has the ability to reduce pain and ease nausea and therefore maybe the best alternative to other addictive medication like opioids.
Shadowing a psychologist, you both are interviewing a veteran who has suffered from PTSD with repression. He refuses to open up about his experiences as he sees it as far too hurtful for him, however because of court mandation, he is here. What do you suggest as the next form of therapy?
You can suggest hallucination Rx if he is open to the idea and shows no signs of dependency or drug seeking behavior. Hallucinogens seem to allow people to access painful memories of their past, but in a way that is detached from any strong emotional reactions. Therefore you are able to recall a painful memory and come to terms with it in a way that’s not possible under normal circumstances.
What is homeostasis?
The brain and body’s attempt to work and maintain body functions at a baseline. This is achieved through maintenance of your temperature, heart beat, metabolism, etc.
How is homeostasis disturbed when an individual first consumes mollie
After taking a stimulant, your bodily functions are distorted away from homeostasis. With the substance, you start to experience speeding up the body functions, a sense of energy and changes in mood, such as an increase in self confidence. These changes cause your body and brain to immediately start to counteract these changes to bring your body back to normal levels.
Ritualistic behaviors are often performed with a user, such as smoking at the same place or with specific people at certain times. How does these users’ body react to these behaviors?
Your brain has associated these behaviors and external cues with the use of the substance. Rather than regulating your body only when it has substance, your brain tells your body to get a head start and with increased use, the user will need a higher and higher dose to reach the same level of high.
As a sponsor, you arrive at the hospital to your sponsee to find that she relapsed and overdosed. Police officers found her in a location where you’ve never heard before and with people you don’t know. The doctors assure you that the dose she took is just 1 g, her normal dosage. What may be the cause of her overdose.
Because your sponsee is in a new location, her body did not receive the signals to lower her baseline because she was not committing any ritualistic behaviors associated with her drug consumption. Due to this, the consumption overwhelmed her normal homeostatic baseline resulting in an overdose.
As a sponsor, you arrive at the hospital to your sponsee to find that she relapsed and overdosed. Police officers found her in a location where you’ve never heard before and with people you don’t know. The doctors assure you that the dose she took is just 1 g, her normal dosage. What may be the cause of her overdose.
Because your sponsee is in a new location, her body did not receive the signals to lower her baseline because she was not committing any ritualistic behaviors associated with her drug consumption. Due to this, the consumption overwhelmed her normal homeostatic baseline resulting in an overdose.
Your patient is rushed into the ER after they were released from rehab. Her parents are threatening to have her stay in rehab longer because they argue that she has fallen back into her addiction. Upon viewing her charts, you conclude that this hospitalization was in fact, not from overdose or use, but rather from a crash. Explain this medical phenomenon to her parents
A crash occurs, because there is no substance to counteract the lowered body functions (which results from the body responding to ritualistic behaviors). This may result simply from being in the same environment that she is used to consuming substance. Therefore the best scenario is to remove her from her location where she is unconsciously able to associate her drug habits.
Contrast the rate of of absorption between oral intake vs IV intake.
IV occurs within seconds while oral takes ~30 minutes +/- few minutes. This increase in absorption is due to the fact that substance has to travel through the GI in order to be absorbed by the bloodstream. It is one of the slowest routes of entry.
After a party, you are hanging out with some new friends and they are “shooting”. What potential dangers does this route of intake hold?
Can be very dangerous because it is much more likely to inject bacteria or other harmful toxins besides the drugs. Especially if you are using unsterilized paraphernalia (misc articles, especially the equipment needed for a particular activity)
Contrast the rate of absorption between intravenous and inhalation route of administration.
In textbooks, they are one and the same, however IV can occur as fast as 2-3 seconds, which inhalation takes about 10 seconds. Once consumed through inhalation though, the substance can travel straight to the brain
Compare and contrast transdermal route of administration and intramuscular route of administration.
Both are involved with delivering substance to the body through the skin. However, in transdermal, the substance is delivered through absorption through the skin such as a nicotine patch. Whereas an intramuscular injection is delivering substance through a needle into the muscles.
A nicotine patch can deliver nicotine to the body up to A. 10 seconds B. A few seconds C. several hours D. 30 minutes
Several hours. As a transdermal patch, the concentrations can be very high and can it is released into the bloodstream for several hours
An intramuscular route of administration’s rate of absorption ….
Depends on the substance. Depending on the chemical properties of the drug, this method can deliver drugs to your system very quickly or very gradually.
Halfway through dinner at Ella, a nearby woman starts having an allergic reaction to the shrimp in her sauce. Thinking fast, you rush over to her and find she has an epipen on hand. Where should the injection be delivered? Why?
An epipen is an intramuscular needle, therefore the Needle goes directly into a large muscle like the thigh. Studies have demonstrated that in order to have the most access points to blood vessels, you need to stick the needle into a large muscle
True or False: The rate of absorption of chemicals is dependent on the route of entry solely.
False, it is dependent on both routes of administration as well as the drug’s potential to produce dependence.
At a crime scene you are discovering a variety of substances throughout the house. These samples are rushed into the lab and you find that these are drugs with high potentials, including, but not limited to her
People are more likely to become dependent on drugs that take effect more quickly.
After studying for hours for the MCAT, you reward yourself with a big piece of cake. After one bite you immediately feel lots of gratitude. Where is this sense of accomplishment and reward located within you?
The reward pathway is located in the right side of the brain
What is the role of the hippocampus in the reward pathway?
The hippocampus is responsible for forming memories. Receiving DA input from the VTA allows memory creation of what actions/stimuli that led to this feeling so that the indv can remember for future references
Once the prefrontal cortex receives dopaminergic inputs, what occurs? Why?
The prefrontal receives dopaminergic inputs from the VTA which allows the indv to focus their attention and plan around the feelings of the reward and the action that allows for the reward to occur. This behavior is able to occur as the VTA -< Prefrontal cortex is a portion of the reward pathway.
Where does the VTA send signals to? What is the input for the pathway?
The VTA sends signals to the amygdala, Prefrontal cortex, hippocampus, and the nucleus accumbens. This pathway is first initiated by feelings of pleasure.
This is released when the brain first experiences pleasure… A. Norepinephrine B. Epinephrine C. Serotonin D. Dopamine
D. Dopamine is primarily released from the ventral tegmental area in the midbrain. NE and EPI are ntsr used to communicate between neurons of different pathways, where NE is produced in the pons. Serotonin stabilizes our mood, feelings of well-being, and happiness is released by the raphe nuclei (nih)
When the Ventral Tegmental Area is activated, it sends its signals to many locations. Of the many, contrast the different functions that result when dopamine is sent to the amygdala and the nucleus accumbens.
Both receive Dopamine inputs from the TGA, however differ on emotion process. Amygdala - deals with emotions. Nucleus Accumbens - controls body motor functions. According to sanescohealth, this is the location in which the feelings of pleasure and reward are created.
Components of the mesolimbic pathway include …
VTA, NAac, amygdala, and the hippocampus
Compare and contrast the mesolimbic pathway and the limbic pathway.
Mesolimbic pathway is the dopaminergic reward pathway everyone refers to when discussing addiction. It involves the ventral tegmental area of the midbrain and its connections to the PFC, NAcc, hippocampus, and amygdala (it probably has connections throughout the brain, but these are most relevant).
The limbic system is the set of structures associated with emotion. It involves the hippocampus, hypothalamus, thalamus, amygdala, PFC and other more obscure areas (fornix, septal nuclei, etc).
There’s a lot of overlap since the mesolimbic system is essentially a subdivison of the larger limbic system, but the goal is to understand the dominant purpose of each pathway (pleasure + reward related behavior or emotion/fear).
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