Drugs

Question 1

How does dopamine activity look in patients recovering from cocaine addiction?

Answer 1

• drop in neuronal activity and decreased dopamine activity which can persist for up to a year and half after stopping the drug

Question 2

What pathway of dopaminergic neurons is thought be be highly involved in the sense of reward one gets from cocaine use ?

Answer 2

the mesolimbic pathway of dopaminergic neurons starting at the ventral tegmental area and projecting to the nucleus accumbens

Question 3

What part of the brainstem contains high number of adrenergic neurons and mediates the effects of opiates?

Answer 3

Locus ceruleus

Question 4

How long does PCP, cannabis, cocaine, and heroin stay in urine?

Answer 4

PCP-8 days
Cannabis-4 weeks
Cocaine-8 hours
Heroin-72 hours

Question 5

Are depressed reflexes seen in inhalant intoxication

Answer 5

yes

Question 6

signs of inhalant intoxication

Answer 6

assaultiveness, impaired judgement, dizziness, slurred speech, ataxia, tremor, blurred vision, stupor , coma
can cause persistent irreversible dementia

Question 7

How does LSD affect serotonin receptors?

Answer 7

Partial agonist at post synaptic serotonin receptors
- alters postsynaptic serotonin binding

Question 8

Physical effects MDMA (methylenedioxyamphetamine)

Answer 8

-fever, headache, cyanosis, vomiting (leading to dehydration), SOB, ataxia, tremor
MI, severe hypertension, ischemic colitis

Question 9

Physical signs of ketamine

Answer 9

nystagmus, hypertension, ataxia, dysarthria, muscle rigidity

Question 10

What is diacetylmorphine

Answer 10

heroin

Question 11

What do pupils look like on heroin?

Answer 11

Pinpoint

Question 12

What is the most common neurologic manifestation of chronic alcoholism?

Answer 12

alcoholic neuropathy

Question 13

How does alcoholic dementia differ from Alzheimers?

Answer 13

Predominance of fine motor control and verbal deficits

Question 14

Marchiafava-bignami

Answer 14

rare demyelinating disease affecting corpus callosum in chronic alcoholics

Question 15

alcoholic nutritional cerebellar degeneration

Answer 15

more in men than women, unsteadiness in walking evolving over weeks to months
- trucal ataxia, with wide based gait and difficulty with tandem walking

Question 16

PCP

Answer 16

NMDA receptor antagonist (subtype of the glutamate receptor)
- has calcium channel binding properties and prevents influx of calcium into neurons

Question 17

Pinpoint pupils are a feature of what?

Answer 17

opioid intoxication

Question 18

What is the most widely abused recreational drug among US high school students?

Answer 18

marijuana
- demonstarted to lead to future cocaine abuse in adolescents

Question 19

cocaine causes what effect on dopamine

Answer 19

cocaine causes dop and norepinephrine reuptake inhibition
- increases dopamine in the mesolimbic and mesocortical pathways as well as the corpus striatum

Question 20

what are sequelae of cocaine use?

Answer 20

hallucinations, paranoia, euphoria, increased energy, hypersexuality, and irritability
- with heavy use pts can experience a shower of lights in their central vision, as well as vivual hallucinations of black dots on their skin and in the environment

Question 21

cocaine overdose treatment

Answer 21

• cold blankets and ice for hyeprtermia
• IV diazepam for seizures
• IV phentolamine for malignant hypertension
• haldol and lorazepam for agitation

Question 22

sniffling glue, benzene, gasoline, paint thinner, lighter fluid, and aerosols

Answer 22

slurred speech, ataxia, hallucinations, tachy, ventricular fibrillation, liver damage, permanent brain damage, kidney damage, myocardial damage

Question 23

inhalants

Answer 23

neuropathy
- distal motor weakness

Question 24

cocaine

Answer 24

lowers seizure threshold
strokes

Question 25

opioid intoxication does what to the pupils

Answer 25

pupillary constriction

Question 26

have some studies shown that the efficacy of using carbamazepine in the treatment of alcohol withdrawal to be equal to benzos?

Answer 26

yes

Question 27

PCP activates ventral tegmental dopamine what does this result in?

Answer 27

the reinforcing qualities of the drug

Question 28

wernicke's encephalopathy

Answer 28

acute neurological disorder characterized by ataxia, confusion, vestibular dysfunction and eye movement impairment - reversible w/ treatment but if progresses to Korsakoff's may be irreversible

Question 29

korsakoff's

Answer 29

impaired recent memory and anterograde amnesia

Question 30

ecstacy

Answer 30

designer amphetamine that acts through both the dopaminergic and serotonergic systems

Question 31

chronic alcoholism brain changes

Answer 31

cerebellar atrophy- truncal ataxia- preferential involvment in vermis

Question 32

Do women have less alcohol dehydrogenase in their gut?

Answer 32

yes

Question 33

how does MDMA work

Answer 33

blocking the repuptake of serotonin and inducing the massive release of serotonin contents of serotonergic neurons

Question 34

How long should IV thiamine and dextrose be given for alcohol withdrawal symptoms

Answer 34

3 days then switch to oral thiamine

Question 35

What drugs can cause nystagmus

Answer 35

pcp inhalants sedative hypnotics alcohol

Question 36

what should you avoid in cocaine induced hypertension

Answer 36

b- blockers (metroprolol)and combined alpha beta blocks (labetolol)

Question 37

matrix therapy

Answer 37

for substance abuse - relapse prevention groups, education groups, social support groups, indivisual counseling, and urine and breath testing delieverd in a structed mannor over 16 week period

Question 38

methylenedioxymethamphetamine (ecstacy)

Answer 38

hyperthermic syndrome that can progress to disseminated intravascular coagulation, rhabdomyolysis, liver and kidney failure and death -not dose related

Question 39

how long after narcotic and the first dose of naltrexone

Answer 39

5 days from short acting narcotic and 10 days if long acting narcotic

Question 40

how long after stopping alcohol can you take disulfiram

Answer 40

12 hours

Question 41

at what dose is methadone thought to be most effective for opioid relapse prevention

Answer 41

at or above 60mg

Question 42

how do you dose disulfiram

Answer 42

500mg daily for first 1-2 weeks then lowered to 250mg daily

Question 43

how does buprenorphine work at the mew opiate receptor

Answer 43

agonist and antagonist

Question 44

what can abrupt discontinuation of cannabis look like

Answer 44

insomnia, irritability, drug craving, restlessness, depressed mood, nervousness anxiety, nause, tremors, muscle twitches, sweating, myalgia, malaise begins 24 hours after last use peaks 2-4 days diminishes after about 2 weeks

Question 45

fetal alcohol syndrome

Answer 45

- perinatal growth deficiency - mental retardation - microcephaly - wide set eyes - flattened philtrum - thin upper lip - small palpebral fissures

Question 46

fetal alcohol syndrome

Answer 46

- perinatal growth deficiency - mental retardation - microcephaly - wide set eyes - flattened philtrum - thin upper lip - small palpebral fissures

Question 47

stimulant medical issues

Answer 47

cerbrovascular incidents, hemorrhagic stroke, cardiac dysrythmia, pneumonitis, pulmonary hemorrhage, pulmonary edema, right heart failure, pancreatic hemorrhage, mesenteric ischemia,a and acute renal failure and myoglobinuria

Question 48

skin picking and missing teeth

Answer 48

meth

Question 49

how does meth work?

Answer 49

cause monoamines to be released from storage vesicles into the cytoplasm disruption of glutamate and serotonin

Question 50

how does cocaine work

Answer 50

block re-uptake of monamine transporters and causes inverse agonism of the dopamine transporter which leads to an increase in dopamine activity -imbalance in glutamate system