Chapter 9 (key aspects of drug abuse and addiction)

Question 1

Vioxx and Bextra

Answer 1

COX2 inhibitors taken off the market b/c of increased rates of CAD and stroke that were not reported and were covered up

Question 2

Celebrex

Answer 2

only selective COX2 inhibitor left on market b/c they correctly reported increased risk of CAD and stroke

Question 3

NSAIDs and Tylenol

Answer 3

work peripherally as analgesics, but Tylenol does not treat inflammation

Question 4

non-traditional pain relievers

Answer 4

TCAs, CCBs, B-blockers, etc.

Question 5

drug abuse

Answer 5

a behavior that all people are capable of doing; most people have done it whether they know it or not

Question 6

drug addiction

Answer 6

a disease that requires genetic disposition and the volition to activate it

Question 7

many people participate in substance abuse, but…

Answer 7

it is usually short term and people will voluntarily quit

Question 8

alcoholism and drug addictions are…

Answer 8

compulsions characterized by the inability to stop despite the desire to do so and the presence of severe consequences

Question 9

one cannot distinguish between abuse and addiction by the drug effects…

Answer 9

b/c they are the same either way; e.g. alcohol poisoning can occur the first time you drink or after you are addicted

Question 10

to diagnose addiction

Answer 10

look at family history, compulsion (their control over their behavior)
They must be taken drug despite the negative consequences and want to stop

Question 11

genetics of addiction

Answer 11

substance abuse can lead to addiction, but most be genetically predisposed; as confirmed by twin studies and genetic studies revealing protection genes and genes of increased susceptibility
Physiology studies shown initial brain response differences in response to first use of drug from those with addictive potential and people who don’t

Question 12

curing drug addiction focus

Answer 12

don’t focus on drug b/c many addicts can switch to another drug so the behavior should be focused on

Question 13

regardless of drug, the same addiction behavior is present, which is…

Answer 13

people have a need to change the way they feel

Question 14

cocaine and all -caine drugs

Answer 14

shut down nerve transmission of pain impulses by blocking sodium channels

Question 15

methamphetamine

Answer 15

stimulant with similar properties to epinepherine

Question 16

drug addiction features

Answer 16

compulsive thoughts that dwell on using drug, adverse consequences to drug use, and inability to stop on own will
Shame, denial, and compulsion

Question 17

drug addiction requirements

Answer 17

genetic predisposition, desire to abuse drugs to alter the way one feels, and a set of life circumstances
Many people have the genetic predisposition to abuse but never will because they never have the means or opportunity to try the drug

Question 18

stimulant drugs of abuse

Answer 18

amphetamine and cocaine

Question 19

depressant drugs of abuse

Answer 19

alcohol, opioids, and benzodiazepines

Question 20

hallucinogen drugs of abuse

Answer 20

LSD (lysergic acid, or just “acid”), mescaline (derived from peyote plant), and psilocybin in mushrooms (mushroom alkaloids)

Question 21

cannabinoid drugs of abuse

Answer 21

marijuana and hashish

Question 22

inhalant drugs of abuse

Answer 22

nitrous oxide (laughing gas) and solvents like glue, gasoline, and pain thinner

Question 23

most abused drugs

Answer 23

tabacco is one, then alcohol, and marijuana, but most abused Rx drug are Vicodin and benzodiazepines

Question 24

child oxycodone deaths

Answer 24

kids will chew OxyContin instead of swallowing so they get full drug amount all at once instead of extended release and overdose

Question 25

opioids for heart attacks

Answer 25

morphine can be given to treat anxiety and pain because pain and anxiety increase HR which increases O2 demand of heart which makes MI even worse; also morphine is a good venodilator to increase venous capacity and reduce load on heart from less blood it has to move

Question 26

helpful opioid effects

Answer 26

constipation is evident from any opioid, which can be used to treat diarrhea (Lomotil used) they also are used to suppress coughs (codeine used)

Question 27

Lomotil

Answer 27

mild opioid effect used to treat diarrhea; mixed with atropine to prevent abuse

Question 28

unhelpful opioid effects

Answer 28

can trigger addiction cycle in susceptible individuals; development of tolerance, nausea/vomiting, and respiratory depression

Question 29

Antabuse

Answer 29

disulfiram; prevents elimination of acetaldehyde which causes hangover symptoms so ingestion of alcohol causes very quick acting and long-lasting hangover

Question 30

naltrexone with alcoholism

Answer 30

reduces alcohol cravings for people who have quit drinking

Question 31

naltrexone for opioids

Answer 31

antagonizing the mu receptors blocks the effects of heroin or other opioids in the brain so there is no euphoria (no pleasure is produced)

Question 32

naloxone imbedded in opioids

Answer 32

some opioids are made with naloxone in it to prevent crushing tablets and abuse

Question 33

Narcan

Answer 33

naloxone; pure mu rc antagonist used for overdoses b/c it has a very short 1/2 life, so can't be used for maintenance; given by IV

Question 34

detoxification

Answer 34

difficult process with unpleasant physical symptoms for addicts getting off drugs; includes headache, insomnia, nausea Opioids are not usually given unless medically necessary to keep patient out of danger

Question 35

methadone

Answer 35

opioid used to help transition through detox; slowly tapers patients off over a few weeks

Question 36

naltrexone

Answer 36

used in maintenance phase as long-term mu rc antagonist that has long 1/2 life so one can have effects lasting all day and used orally.

Question 37

opioid anti-abuse drugs

Answer 37

Narcan (naloxone) used for emergency overdose treatment methadone is used for detox help if needed for weaning naltrexone used for prophylactic maintenance

Question 38

methadone can be used for detoxification or maintenance

Answer 38

detoxify is for someone who plans on becoming abstinent | maintenance is for someone who plans on using it for the rest of their lives for harm reduction

Question 39

harm reduction

Answer 39

Many mentally ill, poverty stricken addicts are hopelessly stuck in the addiction cycle and will never get out so recovery is not goal Just get daily doses of methadone so they don't need to score heroin during the day to prevent crime and disease (from buying drugs and dirty needles)

Question 40

amphetamines

Answer 40

stimulant; Rx forms are used to treat hyperactivity in children (ADHD)

Question 41

cocaine

Answer 41

highly addictive stimulant (crack is inexpensive yet highly addictive form of drug derived from powdered cocaine)

Question 42

LSD

Answer 42

lysergic acid; acid; has chief ingredient of mescaline

Question 43

cannabinoids

Answer 43

mimic action of similar endogenous substances (endocannabinoids) that bind to cannabinoid receptors in humans

Question 44

tobacco

Answer 44

nicotine inside of it is most common drug of abuse and addiction worldwide

Question 45

Xanax

Answer 45

alprazolam; commonly abused benzodiazepine

Question 46

Valium

Answer 46

diazepam; commonly abused benzodiazepine

Question 47

opioid side effect that causes death in overdose

Answer 47

respiratory depression

Question 48

Suboxone

Answer 48

buprenorphine and naloxone together; starting to replace methadone and naltrexone in clinics for maintenance and detox b/c it offers mixed agonist effects