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Drug Dependence Flashcards

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1
Q

Define Addiction

A

Chronic disease characterised by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences

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2
Q

Define Drug Abuse

A

Pattern of drug use in which the users consume the substance in amounts Use methods which are directly/indirectly harmful to themselves or others

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3
Q

Define drug dependence

A

Adaptive state that develops after repeated drug use and which results in withdrawal symptoms upon cessation of drug use

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4
Q

Define Drug Tolerance

A

The diminishing effect of a drug which results after repeated administration at a set dose

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5
Q

Define Psychological dependence

A

Dependence that involves emotional-motivational withdrawal symptoms (e.g. dysphoria, depression, anhedonia, restlessness)

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6
Q

Define physical dependence

A

Dependence that involves significant physical-somatic withdrawal symptoms (e.g. fatigue, nausea, seizures, pain, delirium tremens)

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7
Q

How many admission to hospital with a primary diagnosis of a drug-related mental health and behavioural disorder?

A

6,549

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8
Q

What are class A drugs?

A

Heroin Methadone Cocaine Crack cocaine Ecstasy LSD Magic mushroom

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9
Q

What are class B drugs?

A

Amphetamines Barbiturates Ketamine Methylphenidate Codeine Cannabis

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10
Q

What are class C drugs?

A

Anabolic steroid Benzodiazepine Gamma hydroxybutyrate Gamma butyrolactone Khat

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11
Q

Which drug is deemed most dangerous?

A

Class A

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12
Q

Which drug is thought to have least capacity for harm?

A

Class C

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13
Q

Opiates

A

Agonists at mu opioid receptors

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14
Q

Cocaine

A

DA,NAd and 5-HT uptake systems

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15
Q

Amphetamine

A

Monoaminergic transmission: uptake system; agonist of tract amine-associated receptor 1 (TAAR1)

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16
Q

Ethanol

A

GABA A and NMDA receptors

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17
Q

Nicotine

A

Nicotinic ACH receptors - agonist

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18
Q

Cannabinoids

A

CB1 receptors - agonist

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19
Q

Phencyclidine, ketamine

A

NMDA glutamate receptors - antagonist

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20
Q

Hallucinogens

A

5-HT2A receptors

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21
Q

Barbiturates and benzodiazepine

A

GABA A receptors

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22
Q

Solvents

A

NMDA receptors, nicotinic ACH receptors

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23
Q

Benzodiazepine

A

Drugs that can be abused but have therapeutic value as hypnotics and anxiolytics

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24
Q

What are the endogenous opioid peptide systems?

A

Proopiomelanocortin-derived Proenkephalin -derived Prodynorphin derived

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25
What are the Opioid receptors?
Mu (m1,m2,3) Delta Kappa Nociceptin/ orphanin receptors
26
What are factors determining the development of addiction?
Environment Drug-induced effects Genes
27
What is essential in reward and the development of drug-dependence?
Dopaminergic projection from ventral tegmental area to the nucleus accumbens
28
What are the stages of addiction cycle?
Binge/ intoxication Withdrawal/negative effect Preoccupation/Anticipation
29
What are the brain areas involved in the development of drug dependence?
Ventral tegmental area Nucleus accumbens Amygdala Insula Prefrontal cortex Hippocampus
30
Which compound is used to treat ADHD?
Metyhlphethamine
31
What is dopamine Involved in?
Important for first sensation involved in pleasure and reward
32
What are many withdrawal symptoms categorised by?
High levels of anxiety
33
What is a common feature of anxiety disorder?
Hyperactivity of the limbic structures
34
What are the fear/panic symptoms?
Heart rate/blood pressure Bradycardia, ulcers Panting/ respiratory distress Arousal/vigilance/ attention Increased startled response Freezing/ social interaction Corticosteroid release
35
When an individual takes crack cocaine, what happens in the prefrontal cortex?
The metabolism in prefrontal cortex is changed
36
What are altered in addicts?
Prefrontal circuits
37
What are the processes associated with prefrontal cortex and which are impaired in addicts ?
Self control Emotional regulation Motivation Attention and flexibility Working memory Decision making Awareness and insight Learning and memory Salience attribution
38
What are the core components of addiction?
Intoxication Bingeing Withdrawal Craving
39
What is intoxication?
Impaired self-awareness
40
What is Bingeing?
Loss of control
41
What is Withdrawal?
Amotivation and anhedonia
42
What is craving?
Drug expectation and attention bias
43
What are the characteristics of physical dependence?
Physical symptoms of illness Only seen with some abused drug Relatively shorted lived approx 2 weeks Associated with clear cut abstinence syndrome - symptoms of illness occurring on Withdrawal
44
What are the characteristics of psychological dependence ?
Compulsion, need or craving to take the drug Produced by all drugs of dependence Long lasting Produced by some drugs (cocaine, amphetamine, nicotine, caffeine)
45
What are examples of withdrawal symptoms of opiates?
Diarrhoea Nausea/ vomiting Abdominal cramps Sweating/ shivering Hypertension Seizures Anxiety/ agitation
46
What are some withdrawal symptoms of Alcohol?
Seizures Sweating Tremors Delirium tremens (delirium/ vivid hallucination) Anxiety/agitation
47
What are examples of treatment of withdrawal symptoms?
Clonidine Buprenorphine Carbamazepine
48
What is clonidine?
Alpha 2 receptor adrenoceptor agonist Management of Withdrawal symptoms in opiate addiction
49
What is Buprenorphine?
Partial opiate mu receptor agonist Kappa opiated receptor antagonist Management of withdrawal symptoms in opiate addiction
50
What is carbamazepine ?
Anticonvulsant Drug Sodium channel blocker Reduces seizures associated with alcohol withdrawal
51
What are sensitive genes ?
Go up and down Indication of stimulation
52
What is spines?
Where information arrived on dendritic spine important for information processing
53
What does exposure to drug change?
Architecture of Cell
54
How are abnormalities in brain caused?
Long term exposure to cocaine/morphine
55
What does drug dependence induce
Long lasting changes in gene expression Metabolic changes Changes in neurotransmission Global change in brain activity Structural changes
56
What can Alcohol modulate in the brain?
Both excitatory and inhibitory transmission
57
What happens when you apply ethanol and NMDA?
Decrease excitatory of glutamate receptors
58
Apply ethanol and GABA
Enhance function of chloride channel
59
How can transmission in brain be altered by both excitatory and inhibitory neutrotransmission?
Dose dependent manner and pattern manner
60
Why is the first phase of alcohol an CNS depressant,?
Enhances gabaminertic transmission
61
What happens to an Individual that keeps using alcohol?
Adaptation in synapse both glutaminergic and gabaminergic
62
What is alcohol abuse?
Social drug
63
What is acute alcohol intoxication?
Euphoria developed followed by depressed mood, slurring of speech, ataxia, general incoordination , pupillary dilation
64
What does acute alcohol ingestion lead to?
Depressed excitatory transmission Potentiated inhibitory transmission.
65
What happens to brain of chronic alcoholics?
Brain shrinks - loss of grey matter 12%
66
What are the treatment for alcohol addiction?
Naltrexone Acamprosate Disulfiram
67
Naltrexone
Antagonist at mu opioid receptors Rewarding effects of alcohol Reduce relapse
68
Acamprosate
Modulator of glutamtergic transmission Partial co-agonist at NMDA glutamate receptors Reduces insomnia, anxiety, restlessness and dysphoria
69
Disulfiram
Interferes with alcohol metabolism Acetylaldehyde cannot be transformed into Acetate - build up in body Flushing, nausea, confusion and irregular heartbeat
70
What is ecstasy?
Amphetamine
71
What are the multiple targets for MDMA?
5-HT uptake system Dopamine uptake system 5-HT2 receptors H2 histamine receptors Alpha 2 adrenergic receptors
72
What does long term recreational use of ecstasy affect?
Cognitive processes - metabolic changes in the brain
73
What are the acute MDMA toxicity?
Body temperature elevation Disseminated inteavascular coagulation Rhabdomolysis (blocked by danteolene) Increased renal reabsorption of water Hypontraemia and cerebral oedema I
74
What does prolonged exposure to MDMA lead to?
Loss of serotonin fibres
75
What receptors does Cannabis have?
CD1 and CD2 —> G protein coupled receptors
76
What does THC cannabinoids bind to?
CB1 and CB2 receptors
77
Where is CB1 receptor concentrated in?
Central nervous system
78
Where are CB2 receptors located?
Peripheral organs and are associated with immune system
79
Where are CB1 distributed?
Neocortex, hippocampus, basal ganglia, brainstem
80
What is cannabinoids intoxication symptoms?
Hypothermia, rigid immobility, decreased motor activity
81
What is the brain rich in?
Cannabinoids
82
If cannabinoids knocked out?
Lose all affects of cannabis
83
What does long term use of cannabis increase the risk of?
Schizophrenia and major depression
84
What is inhaled cannabis?
Marijuana
85
Why do people use cocaine?
Euphoria Inflated sense of self and increased self-importance Sense of escaping reality Intense burst of energy
86
What are the effects of cocaine?
Vasoconstriction, pupillary dilatation, hyperthermia, Increased heart rate, increased blood pressure, tremors, restlessness, anxiety, paranoia, vertigo
87
What are the modes of use of cocaine?
Inhalation, orally, intranasally, intravenously
88
What are the long term effects of cocaine/ crack addiction?
Cardiovascular issues: heart attack and stroke Marked cognitive decline Persistent psychotic symptoms Major depression and anxiety
89
What are general principles of treatment of drug addiction?
Detoxification, counselling, medication, treatment for co-occurring mental health issue, long term follow up to prevent relapse
90
What are treatment of nicotine addiction?
Nicotine replacement therapy: patches, spray, gum and lozenges
91
What are medication of treatment of nicotine addiction
Bupropion: antidepressant drug; inhibitor of dopamine reuptake) Varenicline
92
What are the components of comprehensive drug addiction treatment?
Vocational services, mental health services, medical services, educational services, HIV/AIDS services/ legal services, family services

System Neuroscience (17 decks)

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