Addictions symposium

Question 1

Tolerance and reward centre responsible for

Answer 1

tolerance - physical dependence

reward centre - psychological craving

Question 2

Tolerance

Answer 2

reduced responsiveness to a drug caused by previous administration

Question 3

Which rugs show tolerance?

Answer 3

BZD, opiates, alcohol, barbiturates

Question 4

dispositional tolerance

Answer 4

less drug reaching active site
increased metabolism and excretion
decreased rate of absorption

Question 5

pharmacological tolerance

Answer 5

site of action less effected by drug

internalisation or down regulation of receptors

Question 6

Why may tolerance lead to withdrawal symptoms?

Answer 6

avoid negative side effects

Question 7

Are the withdrawal symptoms the same or opposite as the effect of the drug?

Answer 7

opposite

Question 8

opioid, barbiturate and cocaine - effect and withdrawal effect

Answer 8

constipation - diarrhoea
anti convulsant - convulsions
increase mood - decrease mood

Question 9

Reward pathway

Answer 9

neurons from VTA - nucleus accumbens - prefrontal cortex

Question 10

What happens when VTA neurons stimulated?

Answer 10

dopamine release

Question 11

Dopamine action

Answer 11

pleasure and reward eg food, sex

Question 12

Examples of drugs tapping into reward system

Answer 12

alcohol, heroin, amphetamine, cocaine

Question 13

2 stimulants

Answer 13

cocaine and amphetamine

Question 14

Early use of cocaine

Answer 14

coca leaves in 1880 - ENT surgery

Question 15

Ingesting cocaine

Answer 15

leaves chewed, cocaine HCL snorted or injected and crack cocaine smoked

Question 16

Effect of cocaine depends on?

Answer 16

dose and rate of entry to brain

Question 17

Rate of entry to brain of cocaine depending on how it is taken

Answer 17

smoking - immediate
inject is 15-30s
snort - 3-5mins

Question 18

cocaine effects

Answer 18

convulsions with resp failure
damage to nose and airways 
toxic confusions
hypertension and CVA 
cardiac arrhythmias and MI
paranoid psychosis 
less appetite and desire for sleep
increased confidence and impaired judgement
increased alertness and energy
stimulant and euphoriant

Question 19

cocaine withdrawal effects

Answer 19

depression 
hyperphagia 
hypersomnia 
irritability 
agitation 
craving

Question 20

Amphetamine

Answer 20

amphetamine sulphate - sniffed, swallowed, inject

Question 21

Effects of amphetamine

Answer 21

similar to cocaine but longer lasting
toxic confusion occasionally with convulsions and death
psychosis

Question 22

Examples of opiates

Answer 22

opium, morphine, heroin, methadone, codeine

Question 23

Heroin effects

Answer 23

analgesia, sleep, euphoria, resp depression, bradycardia, constipation, pinpoint pupils, “rush”

Question 24

side effects of heroin

Answer 24

first time - N&V, headache
medium - phlebitis, anorexia and constipation
long term - tolerance, withdrawal, social and health problems

Question 25

opiate withdrawal

Answer 25

craving, yawning, insomnia, muscle pain, dilated pupils, piloerection

Question 26

Positives of methadone maintenance

Answer 26

decriminalises drug use, reduces IV misuse | normalise life

Question 27

Ecstasy effects

Answer 27

increased talkability, euphoria then calm, 2-4 hours

Question 28

side effects of ecstasy

Answer 28

nausea - dry mouth - dehydration - panic - anxiety - hallucinations - psychosis - increase blood pressure - brain and liver

Question 29

Components of cannabis

Answer 29

THC is psychoactive | cannabinoids in CBD

Question 30

Effects of cannabis

Answer 30

``` relaxing or stimulating euphoriant increase sociability and hilarity increase appetite high dose - anxiety, hallucinations synaesthesia ```

Question 31

ill effects of cannabis

Answer 31

respiratory, toxic confusion, mental illness, psychosis

Question 32

What are novel psychoactive substances?

Answer 32

legal highs

Question 33

Anabolic steroids prescribed in

Answer 33

muscular dystrophy, wasting in AIDS

Question 34

Muscle hypertrophy areas with anabolic steroids

Answer 34

deltoid, pectoralis, trapezius, biceps

Question 35

side effects of anabolic steroids

Answer 35

``` acne, stretch marks, bald feminisation in males and virilisation in females increase cholesterol and HTN premature closure of epiphysis liver disease ```

Question 36

psychological effects of anabolic steroids

Answer 36

roid rage - irritable and anger hypomania and mania depression and suicidal on withdrawal