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Neuro Pt 4 > Drug of Abuse > Flashcards

Drug of Abuse Flashcards

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1
Q

Opioids (name some)

A 
Heroin
Morphine
Fentanyl
Oxycodone
Hydrocodone
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2
Q

Opioids (mechanism)

A

u-opioid agonists

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3
Q

Opioids (reinforcing effects)

A

euphoria

sedation

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4
Q

Opioids (acute toxicity symptoms and treatment)

A

RESPIRATORY DEPRESSION
Miosis
COMA
Death, arrhythmias, convulsions are possible

Treatment: Naloxone (IV/SC)

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5
Q

Opioids (tolerance)

A

Develops rapidly

Does NOT develop to constipation or miosis

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6
Q

Opioids (Dependence)

A

Develops rapidly (3-4 doses/day x 1-2 weeks)

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7
Q

Opioids (Withdrawl)

A

Rarely life-threatening
Irritability, insomnia, increased BP, increased HR, cramps, diarrhea,

Treatment: clonidine (decrease SNS signs), methadone

Relapse: buprenorphine +/- naloxone, naltrexone

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8
Q

Ethanol (Mechanism)

A

CNS depressant

Facilitate GABA function
Inhibit GLU-NMDA fxn

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9
Q

Ethanol (reinforcing effects)

A

Anxiolysis, sedation, loss of inhibition

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10
Q

Ethanol (acute toxicity symptoms and treatment)

A

RESPIRATORY depression
COMA
Death

Treatment: Supportive plus fluids, thiamine, electrolytes

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11
Q

Ethanol (tolerance)

A

Moderately rapid

Tolerance to sedation-intoxication, less to lethal dose

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12
Q

Ethanol (Dependence)

A

YES

Within weeks

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13
Q

Ethanol (Withdrawl- treatment and relapse treatment)

A

Significant risk of mortality due to seizures
Visual hallucination
Delirium tremens

Treatment: BDZ (flumazenil)
Relapse: acamprosate, naltrexone, disulfiram

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14
Q

Benzodiazepines (mechanism)

A

CNS depressant

Facilitate GABA fxn

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15
Q

Benzodiazepines (reinforcing effects)

A

anxiolysis
sedation
loss of inhibition

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16
Q

Benzodiazepines (acute toxicity symptoms and treatment)

A

Lethality rare, unless combined with other CNS depressants

Treatment: Flumazenil

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17
Q

Benzodiazepines (tolerance)

A

Less than with ethanol

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18
Q

Benzodiazepines (dependence)

A

Harder to become dependent than with ethanol but still possible

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19
Q

Benzodiazepines (Withdrawl- treatment and relapse treatment)

A

Yes, can have seizures

Dose taper may require months

Treatment:
Busiprone is used for anxiety
Carbamazepine, phenobarbital are used as anticonvulsants

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20
Q

Barbiturates (mechanism of action)

A

CNS Depressant
Facilitate GABA fxn
Inhibit GLU-AMPA fxn

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21
Q

Barbiturates (Reinforcing effects)

A

anxiolysis
Sedation
Loss of inhibition

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22
Q

Barbiturates (acute toxicity signs and treatment)

A

Respiratory depression
Coma
Death

Treatment: supportive

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23
Q

Barbiturates (tolerance)

A

Very rapid

Significant tolerance to sedation-intoxication but less to lethal dose

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24
Q

Barbiturates (dependence)

A

YES

within weeks

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25
Barbiturates (withdrawl)
Risk of mortality due to seizures Treatment: Busiprone is used for anxiety Carbamazepine, phenobarbital are used as anticonvulsants
26
Cocaine (machanism)
CNS stimulant | Inhibits monoamine reuptake transporters
27
Cocaine (reinforcing effects)
euphoria Decreased fatigue increased arousal and confidence appetite suppression
28
Cocaine (acute toxicity- signs and treatment)
``` SNS overactivity Increased HR, BP, body temp Chest pain Arrhythmias MI Paranoid psychosis ``` Treatment: CV support Vaodilators for BP BDZs for agitation/seizures
29
Cocaine (tolerance)
Tolerance to euphoria, anorexia, hyperthermia | Supersensitivity to paranoia
30
Cocaine (dependence)
Arguable | Lack of physiological symptoms
31
Cocaine (withdrawl- symptoms and treatment)
Generally mild sleepiness, fatigue, depression, hyperphagia, craving Treatment: largely behavioral
32
Amphetamine, methylphenidate, methamphetamine (mechanism)
CNS stimulants | Stimulate monoamine release
33
Amphetamine, methylphenidate, methamphetamine (reinforcing effects)
euphoria Decreased fatigue increased arousal and confidence appetite suppression
34
Amphetamine, methylphenidate, methamphetamine (acute toxicity- signs and treatment)
``` SNS overactivity Increased HR, BP, body temp Chest pain Arrhythmias MI Paranoid psychosis ``` Treatment: CV support Vaodilators for BP BDZs for agitation/seizures
35
Amphetamine, methylphenidate, methamphetamine (Tolerance)
Tolerance to euphoria, anorexia, hyperthermia | Supersensitivity to paranoia
36
Amphetamine, methylphenidate, methamphetamine (Dependence)
Arguable | Lack of physiological symptoms
37
Amphetamine, methylphenidate, methamphetamine (Withdrawl- symptoms and treatment)
Generally mild sleepiness, fatigue, depression, hyperphagia, craving Treatment: largely behavioral
38
Nicotine (mechanism)
CNS stimulant | Nicotinic cholinergic receptor agonist
39
Nicotine (reinforcing effects)
Milder stimulant than amphetamines | increased alertness
40
Nicotine (acute toxicity- signs and treatment)
rare, unless ingestion of insecticide or tobacco products by children n/v, diarrhea, weakness, CVP collapse, convulsions Treatment: CVP support, emetics, gastric lavage, charcoal
41
Nicotine (tolerance)
Tolerance to subjective effects and nausea
42
Nicotine (dependence)
moderate development
43
Nicotine (withdrawl- symptoms and treatment)
irritability, hostility, anxiety, increased appetite, weight gain Relapse: nicotine replacement, bupropion, varenicline
44
Indoleamines (name some!)
LSD Psilocybin Bufotenine
45
Indoleamines (mechanism)
Hallucinogen | Partial agonist at 5HT-2 serotonin receptors
46
Indoleamines (reinforcing effects)
altered sensory perception, hallucinations, intense arousal, mood elevation
47
Indoleamines (acute toxicity- symptoms and treatment)
"bad trip" severe anxiety intense depression visual disturbances treatment: "talking down", BDZ for severe agitation
48
Indoleamines (tolerance)
not common since repeated use unusual
49
Indoleamines (dependence)
NO | no abstinence syndrome
50
Indoleamines (withdrawl)
not known but "flashbacks" seen in some former users (hallucinogenic persisting perception disorder)
51
Phenylethylamines (name some!)
MDMA | Mescaline
52
Phenylethylamines (mechanism)
Hallucinogen | Partial agonist at 5HT-2 plus DA releasing actions
53
Phenylethylamines (reinforcing effects)
pleasant sensory experience with enhanced perception, enhanced insight and self-knowledge
54
Phenylethylamines (acute toxicity)
visual hallucinations, agitation, hyperthermia, increased ADH can lead to hyponatremia
55
Phenylethylamines (tolerance)
not common since repeated use unusual
56
Phenylethylamines (dependence)
NO | no abstinence syndrome
57
Phenylethylamines (withdrawl)
not known but "flashbacks" seen in some former users (hallucinogenic persisting perception disorder)
58
Dissociative anesthetics (name some!)
Phencyclidine Ketamine Nitrous oxide Dextromethorphan
59
Dissociative anesthetics (mechanism)
antagonist at GLU-NMDA receptors
60
Dissociative anesthetics (reinforcing effects)
euphoria and heightened emotionality (low dose) misperceptions, unreality (intermediate dose)
61
Dissociative anesthetics (acute toxicity- signs and treatment)
delirium, increased RR, HR, BP, and body temp Muscle rigidity agitation violent behavior Treatment: supportive via control of BP, hyperthermia, agitation (with BDZ or antipsychotics)
62
Dissociative anesthetics (tolerance)
not well studied
63
Dissociative anesthetics (dependence)
probably not
64
Dissociative anesthetics (withdrawl)
not observed
65
Marijuana (mechanism)
Cannabinoid | agonist at cannabinoid receptors
66
Marijuana (reinforcing effects)
euphoria, "mellowness", changes in perception, mood, motivation
67
Marijuana (acute toxicity)
minimal, possible anxiety, impaired coordination and tracking behavior acute psychosis
68
Marijuana (tolerance)
Develops rapidly to most effects | Disappears rapidly too
69
Marijuana (dependence)
abuse potential is moderate | 10% of chronic users become addicted
70
Marijuana (withdrawl)
not clinically significant due to long t1/2 Mild symptoms following chronic high doses (malaise, headache, anxiety, nausea)

Neuro Pt 4 (25 decks)

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