Drugs of Abuse

Question 1

reinforcing properties (euphoria and CNS stimulation) is associated w. what NT

Answer 1

dopamine

Question 2

acute intoxication is associated w. what NT

Answer 2

opi

GABA

NMDA

5HT

Ach

CB

Question 3

opioids are agonists at __

CNS depressants enhance __

CNS stimulants block __

Answer 3

opioids: mu receptors

CNS depressants enhance: GABA

DA reuptake

Question 4

2 most addictive drugs

Answer 4

cocaine

methamphetamine

Question 5

nicotine and etoh work on

Answer 5

opioid peptides

Question 6

opiates work on

Answer 6

GABA

Question 7

etoh and benzos work on

Answer 7

GABA

Question 8

nicotine works on

Answer 8

DA

Question 9

etoh works on (3)

Answer 9

glutamate from cortex

opioid peptides

GABA

Question 10

all drugs w. abuse potential enhance __ activity

Answer 10

dopamine

Question 11

what 5 drugs produce euphoria

Answer 11

opioids

CNS depressants

CNS stimulants

dissociative anesthetics

cannabinoids

Question 12

nicotine increases

Answer 12

alertness

Question 13

t/f: the more intense and more direct a drug’s effect on DA release, the greater the addiction potential

Answer 13

T!

Question 14

acute liability is increased w.

Answer 14

faster onset of action

Question 15

__ is correlated w. onset of drug effect

Answer 15

route of administration

Question 16

2 routes of administration w. fastest onset

Answer 16

inhalation

IV

Question 17

what route of admin produces most intense rush-like feeling

Answer 17

IV

Question 18

__ is more effective than oral dt first pass bypass

Answer 18

mucous membrane

Question 19

route of admin useful in tx programs dt least reinforcing route

Answer 19

oral

Question 20

2 routes of admin for nicotine that reduce withdrawal

Answer 20

gum

patch

Question 21

drugs w. __ t½ have higher abuse potential

Answer 21

shorter

Question 22

2 factors related to increased likelihood for loss of control

Answer 22

quick offset

frequent admin

Question 22

2 factors related to increased likelihood for loss of control

Answer 22

quick offset

frequent admin

Question 23

which has a longer half life, heroin or methadone

Answer 23

methadone

Question 24

withdrawal effects are more severe for drugs w. \_\_ bc they must be administered continuously to \_\_

Answer 24

shorter t ½ prevent withdrawal

Question 25

type of drug used for tx strategy

Answer 25

**long acting w. no antagonist** *the more rapidly the target-receptor becomes unoccupied → more severe the withdrawal effects*

Question 26

tx for opioid toxicity

Answer 26

naloxone

Question 27

CNS depressants of abuse

Answer 27

ethanol benzos barbs

Question 28

tx for: ethanol toxicity: benzos: barbs:

Answer 28

etoh: thaiamine benzos: flumazenil barbs: supportive

Question 29

tx for CNS stimulants (2)

Answer 29

vasodilators benzos

Question 30

who is at risk for nicotine toxicity

Answer 30

insecticide cigarette ingestion by kids

Question 31

tx for nicotine toxicity

Answer 31

CVS support emetics gastric lavage activated charcoal

Question 32

hallucinogens produce effects via __ receptor

Answer 32

5HT

Question 33

2 hallucinogens of abuse

Answer 33

LSD-psilocybin MDMA

Question 34

tx for hallucinogen toxicity

Answer 34

talk down bdz

Question 35

risk of MDMA toxicity

Answer 35

hyponatremia

Question 36

dissociative anesthetics of abuse

Answer 36

phencyclidine (PCP) ketamine

Question 37

tx for dissociative anesthetic abuse

Answer 37

CVS support → avoid hyperthermia benzos

Question 38

cannabinoids act on __ receptor

Answer 38

CB1

Question 39

lessened response at active target site to the same drug concentration

Answer 39

pharmacodynamic tolerance

Question 40

tolerance is due to

Answer 40

changes in receptor sensitivity

Question 41

change in pharmacokinetics that results in lowered drug Cp at active site

Answer 41

metabolic (dispositional) tolerance *increase in metabolism is primary mechanism*

Question 42

tolerance develops to one drug → tolerance will be seen w. other drugs of same class

Answer 42

cross tolerance *resistance to same target*

Question 43

heroin has cross tolerance w.

Answer 43

hydrocodone *both mu*

Question 44

etoh has cross tolerance w.

Answer 44

benzos *both GABA*

Question 45

tolerance to opioids develops \_\_ except with what effect

Answer 45

rapidly constipation

Question 46

tolerance to CNS depressants low to high (3)

Answer 46

barbs -\> develops rapidly etoh benzos

Question 47

tolerance to CNS stimulants develop rapidly to __ (3) but supersensitivity can be seen to \_\_

Answer 47

euphoria, anorexia, hyperthermia paranoia

Question 48

withdrawal sx are seen when

Answer 48

drugs stopped abruptly

Question 49

perceived need for a drug (craving) in absence of any physiological dependence or withdrawal phenomena

Answer 49

psychological dependence

Question 50

psychological dependence is related to what pathway

Answer 50

pathologic learning in reward pathway

Question 51

ability of one drug to suppress withdrawal associated w. physical dependence on another drug

Answer 51

cross dependence

Question 52

cross dependence is related to \_\_ rather than \_\_

Answer 52

pharm effects at targets chemical effects

Question 53

overwhelming concern w. use of drug and securing supply

Answer 53

extreme compulsive drug use

Question 54

t/f: tolerance and dependence do not necessarily coexist

Answer 54

T!

Question 55

t/f: addiction and physical dependence do not necessarily coexist

Answer 55

T!

Question 56

development of dependence: opioids: CNS depressants: CNS stimulants:

Answer 56

opioids: rapidly CNS depressants: w.in weeks CNS stimulants: arguable → no physiologic effects w. withdrawal

Question 57

withdrawal effects are generally __ of the acute effects

Answer 57

opposite

Question 58

if a drug causes elevated sz threshold, __ can be seen during withdrawal

Answer 58

spontaneous sz

Question 59

if a drug relieves fatigue and elevates mood, withdrawal is characterized by

Answer 59

lethargy dpn

Question 60

risk of mortality w. withdrawal: opioids: CNS depressants:

Answer 60

opioids: rarely life threatening CNS depressants: significant risk dt sz

Question 61

tx for opioid withdrawal

Answer 61

clonidine methadone

Question 62

tx for CNS depressant withdrawal

Answer 62

benzo loading dose → taper

Question 63

tx for CNS stimulants

Answer 63

behavioral