Drugs of Abuse

Question 1

What are the three types of tolerance?

Answer 1

metabolic, functional, behavioral

Question 2

what does functional tolerance lead to?

Answer 2

physical dependence

Question 3

what are the two types of dependence?

Answer 3

psychological, physical

Question 4

What is the mechanism of drugs of abuse?

Answer 4

no one mech. many increase effects of dopamine in a “reward circuit”

Question 5

What are the opioids (4)?

Answer 5

heroin, morphine, methadone, codeine

Question 6

How do the opioids work?

Answer 6

increase mu receptor (endorphin)

Question 7

What are the sympathomimetics (4)?

Answer 7

amphetamine, methamphetamine, cocaine, caffeine (espresso)

Question 8

what do amphetamine, methamphetamine, and cocaine do?

Answer 8

increase catecholamine transmission

Question 9

what about caffeine?

Answer 9

decrease adenosine (increase cAMP, increase calcium)

Question 10

What are the depressants (3)?

Answer 10

ethanol, pentobarbital, diazepam

Question 11

What about the depressants?

Answer 11

increase GABA

Question 12

What are the nicotine drugs? what about them?

Answer 12

tobacco products. acetylcholine (CNS pre-synaptic?)

Question 13

What are the psychedelics (4)?

Answer 13

LSD, mescaline, PCP (phencyclidine), ketamine

Question 14

What do LSD and mescaline do?

Answer 14

decrease serotonin transmission

Question 15

What do PCP and ketamine do?

Answer 15

sigma receptors? decrease NMDA

Question 16

What are the inhalants (3)?

Answer 16

nitrous oxide, amyl nitrite, butyl nitrite

Question 17

how do the inhalants work?

Answer 17

GABA??

Question 18

What is the designer drug? how does it work?

Answer 18

MDMA = ecstasy. alters serotonin, catecholamines

Question 19

Cannabinoids?

Answer 19

THC = marijuana, cannabinoid ligands

Question 20

What are the effects of amphetamine and cocaine (5)?

Answer 20

euphoria, anorexia, insomnia, increased motor activity, reduced feeling of fatique

Question 21

How do amphetamine and cocaine work?

Answer 21

interact with reuptake systems for DA, NE, and 5-HT

Question 22

Which reuptake system is responsible for the reinforcing qualities of amphetamine and cocaine?

Answer 22

the DA system

Question 23

Which reuptake system is responsible for the euphoric effects of amphetamine and cocaine?

Answer 23

the NE system

Question 24

Why does amphetamine have additional effects? what are they?

Answer 24

causes release of DA from cytoplasm into the synapse. larger increase in extracellular DA and increased motor and psychotic effects. also more sustained duration of effect

Question 25

abuse potential for amphetamine and cocaine?

Answer 25

very great

Question 26

toxicity of amphetamine and cocaine?

Answer 26

arhrythmias and convulsions

Question 27

what's the toxicity of opioids? treat with __?

Answer 27

coma: Naloxone

Question 28

toxicity of sympathomimetics (amphetamine and cocaine)? treat with___?

Answer 28

sympathetic storm, seizures and stroke (cocaine). amphetamine: sedate with Haloperidol, cocaine: propranolol, diazepam, or Ca channel blockers

Question 29

toxicity of general depressants? how to tx?

Answer 29

coma, respiratory failure. tx with mechanical ventiliation, positive inotropic drug:dopamine, hemodialysis or hemoperfusion

Question 30

nicotine toxicity?

Answer 30

none

Question 31

cannabinoids toxicity?

Answer 31

none

Question 32

psychedelics and diliriant hallucinogens toxicity? tx?

Answer 32

anxiety, psychosis. tx with support, Physostigmine may be used after Scopolamine

Question 33

phencyclidine toxicity? tx? what's contraindicated in acute toxicity?

Answer 33

seizures. suction if secreted into stomach, acidify urine, Diazepam for seizures. ANTIPSYCHOTICS are CONTRAINDICATED in acute toxicity (possible synergy of serious side effects).

Question 34

inhalants toxicity? tx?

Answer 34

asphyxiation arrhythmias. mechanical ventilation and antiarrhythmics

Question 35

opioid withdrawal? tx?

Answer 35

withdrawal syndrome: runny nose, tearing, gooseflesh, spasms, muscle aches, hyperventilation, hyperthermia, vomiting, diarrhea, hostility, anxiety. tx with low levels of long acting drug (Methadone)

Question 36

sympathomimetics withdrawal? tx?

Answer 36

nothing has proven value

Question 37

general depressants withdrawal? tx?

Answer 37

convulsion, D.T. tx with low levels of a long acting drugs (Phenobarbital or Diazepam). also propranolol or Clonidine (may reduce sympathetic storm)

Question 38

nicotine withdrawal? tx?

Answer 38

anxiety, craving. tx: replacement therapy (nicotine), substitution therapy (Verenicline), Bupropion

Question 39

Cannabinoids and psychedelics withdrawal?

Answer 39

none aside from social readjustment

Question 40

alcohol withdrawal?

Answer 40

antiabuse, Naltrexone