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Pharm > Drugs of abuse 12/19 > Flashcards

Drugs of abuse 12/19 Flashcards

1
Q

drug abuse

A

non-medical or non-accepted recreational use of a drug

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2
Q

drug misuse

A

improper use of prescribed compounds

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3
Q

drug dependence/addiction

A

compulsive drug use,

substance dependence despite negative consequences (craving)

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4
Q

withdrawal syndrome

A

pattern of behaviors that follow discontinuation of a drug

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5
Q

physical dependence charecterized by

A

abstinence syndrome

type and intensity differ depending on drug

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6
Q

DSM IV substance dependent criteria:

maladaptive pattern of substance abuse leading to clinically significant impairment or distress as manifested by 3 or more of the following, occuring any time in same 12-month period

A

1) tolerance:
a) need for markedly increased amounts of substance to achieve intoxication OR
b) markedly diminished effect with continued use of same amount of substance
2) withdrawal:
a) characteristic withdrawal syndrome for substance OR
b) same substance (or related) is taken to relieve or avoid withdrawal symptoms

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7
Q

other substance dependent criteria

A

3) substance is taken in larger amounts or over longer period of time
4) there is significant desire or unsuccessful efforts to cut down substance
5) great deal of time is spent in activities to obtain substance
6) important social or occupational activities are given up to obtain substance
7) substance use is continued despite knowledge of harmful effects

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8
Q

pharmacokinetic tolerance

A

ability to metabolize drug increases over time

produce limited amount of tolerance

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9
Q

pharmacodynamic tolerance

A

produces large amounts of tolerance

cellular changes,changes in binding affinity, up or down regulation of receptors

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10
Q

behavioral tolerance

A

learned or conditioned

association between environmental cues with drug

can lead to overdose outside of conditioned environment

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11
Q

inverse tolerance (sensitization)

A

mechanism not understood

can persist for years

increase in effect of drug that occur with repeated use.lower doses elicit same effects

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12
Q

pathways of activation in cocaine and amphetamines

A

1) neostriatal to caudate putamen=motor stimulation and at higher doses stereotyped behaviors and convulsion
2) mesolimbic to nucleus accumbens=elevation of mood,euphoria and reward
3) mesocortical to limbic cortex=enhanced attention,alertness.At higher doses,see psychosis

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13
Q

amphetamines

A

methamphetamine,methylenedioxymethamphetamine (MDMA),fenfluramine,methylphenidate

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14
Q

fenfluramine

A

no apparent abuse liability

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15
Q

prolonged use of MDMA

A

neurotoxicity

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16
Q

amphetamine psychosis

A

panic,paranoia and repetitive behaviors

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17
Q

clinical uses of amphetamines

A

methylphenidate=ADHD

atomoxetine=ADHD,NE-reuptake inhibitor

rarely for narcolepsy and appetite suppression–> phentolamine

18
Q

tolerance and dependance of methamphetamines

A

tolerance=euphoria+anorexia rapidly, Slowly to locomotor and stereotyped behaviors

dependence=related to unpleasant after effects and euphoria

Withdrawal=no clear syndrome

19
Q

cocaine

A

less likely to produce psychosis

no clear-cut withdrawal,but see depression and fatigue

psychological dependence=craving

effect on CNS after chronic use can last for a long time–> CNS plasticity

20
Q

half-life of cocaine

A

very short–> binge use

21
Q

prenatal exposure to cocaine

A

functional deficit at birth

lower IQ,poor language

impaired cognitive functioning

impulsivity (self-regulation) and impaired attention

impaired auditory information processing and habituation

22
Q

Nicotine

A

on nAChR in VTA,cortex and hippocampus

chronic use–> desensitization and increase in number of receptors

causes muscle relaxation and increases learning

Antagonist=mecamylamine

23
Q

Tx of nicotine dependence

A

bupropion (wellbutrin)= NE-DA reuptake inhibitor,lowers seizure threshold,contraindicated with bipolar

varenicline (chantix)=nAChR partial agonist, prevents relapse,concerns over production of suicidal thoughts

24
Q

hallucinogens

A

affect thought, perception and mood without causing psychomotor stimulation or depression

no tolerance or dependence

target cortical and thalamic circuits

25
Q

LSD

A

lysergic acid diethylamide

very potent

agonist at 5-HT2A receptors

flashbacks and bad trips

26
Q

mescaline

A

from mexican cactus

27
Q

psilocybin

A

from fungi=magic mushroom

28
Q

effects of LSD,mescaline and psilocybin

A

visual,auditory,olfactory and tactile hallucinations

confusion of sensory modalities

thought process also affected

29
Q

MDMA (ecstasy)

A

amphetamine but inhibits 5HT transporter and also releases it–> large increase in 5HT followed by depletion

acute hyperthermia,damage to skeletal muscles and renal failure

increased ADH–> excess water intake and retention–> hyponatremia

prolonged after affects:depression,irritability and aggression

30
Q

hallucinogenic,psychomimetic,psychedelic

A

hallucinogenic=perceptual distortions

psychomimetic=thought disturbances

psychedelic=feelings of enhanced insight and self-knowledge often of a spiritual nature

31
Q

dissociative anesthetic

A

PCP,ketamine,dizocilpine (MK801)

noncompetitive blockers of NMDA-associated Ca channel

withdrawal symptoms=agitated psychotic state.tx with diazepam and haldol

32
Q

ketamine

A

special K

blocks sensory and perception signals to conscious mind from other parts of brain

euphoria

higher doses=hallucinations,confusion,numbness

frozen time,dream-like states

psychotic episodes

Currently used in tx of complex regional pain syndrome and being evaluated for resistent depression

33
Q

action of ketamine

A

blocks inhibitory GABA interneurons in cortical and subcortical brain areas–> increased glutamate in prefrontal cortex

also blocks NMDAR on cortical pyramids and increased glutamate release stimulates AMPA

34
Q

marijuana

A

psychoactive ingredient is THC(non-selective)

CB1 receptors in brain, CB2 receptors in periphery

CB1=analgesia,euphoria,hypothermia,decreased locomotor

withdrawal=restlessness,irritability,insomnia

35
Q

therapeutic cannabinoids

A

dronabinol=antinausea and antiemetic,appetite stimulant

sativex=MS and neuropathic pain

rimonabant=antagonist rejected by FDA for besity,smoking cessation

36
Q

EtOH

A

inhibits NMDAR,enhances GABA.Also inhibits Ca opening and active K channels

tolerance involves up-regulation of NMDAR and down regulation of GABAR–> withdrawal can lead to seizures

37
Q

benzo withdrawal

A

seizures and delirium

38
Q

withdrawal from opiates

A

yawning,agitation,goose bumps(cold turkey),twitching arms and legs (kicking the habit),sweating,v/d

39
Q

PCP (phencyclidine)

A

noncompetitive NMDA Ca channel blocker

40
Q

GHB

A

gamma hydroxybutyric acid

metabolism of GABA

can be prescribed to tx narcolepsy

before sedation,see euphoria,enhanced sensory perception and amnesia,social closeness

club drug,liquid ecstasy,date-rape drug

Pharm (10 decks)

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