Drugs Of Abuse

Question 1

How can you tell if someone is physically dependent on a drug? how does this differ from tolerance?

Answer 1

If sudden cessation of the drug leads to withdrawal syndrome

Tolerance is just a diminution in effect of a drug over time

Question 2

which pathway in the brain is the prime target of addictive drugs?

Answer 2

mesolimbic dopamine pathway

Question 3

What term was used in DSM IV to describe what we know as addiction?

Answer 3

dependence

Question 4

What addictive drug has a withdrawal associated with tremor, nausea, sweating, anxiety and sometimes hallucinations

Answer 4

ethanol

Question 5

which addictive drug is associated with generalized seizures and delirium tremens? is this withdrawal fatal?

Answer 5

ethanol

fatal in 5-15% in pts with delirium tremens

Question 6

What 2 drugs can be used to treat alcohol withdrawal?

Answer 6

long half-life benzos: diazepam and chlordiazepoxide

Question 7

What 2 drugs are preferred in treatment of alcohol withdrawl in the elderly or those with liver failure?

Answer 7

intermediate-acting benzos: Lorazepam and oxazepam

Question 8

Name the 3 FDA approved drugs for the treatment of alcoholism and how each works

Answer 8

Disulfram: aldehyde dehydrogenase inhibitor - creates aversion (instant hangover)
Naltrexone: opioid antagnoist - reduces cravings
Acamprosate: NMDA receptor antagonist - prevents relapse

Question 9

Withdrawal from this addictive drug includes tremors, perceptual disturbances, dyspohoria, psychosis and seizures? what is the drug? is it life threatening?

Answer 9

Benzodiazepines or barbituates

yes

Question 10

What drug is used to treat benzo withdrawal? How?

Answer 10

Diazepam - switched to this (long-acting) then the dose is gradually reduced

Question 11

what is the mechanism of action for the addictive drugs methlxanthines? name them

Answer 11

block presynaptic adenosine receptors (activation of adenosine receptors inhibits NE release, so blocking adenosine increases NE release)

caffeine (also theophylline and theobromine)

Question 12

What schedule is cocaine?

Answer 12

schedule II

Question 13

How does cocaine cause euphoria?

Answer 13

blocks reuptake of dopamine, NE and serotonin

Question 14

what addictive drug has a mild withdrawal that includes dysphoria, sleepiness, and bradycardia? how do you treat?

Answer 14

cocaine - dont need to treat

Question 15

What schedule are amphetamines? how do they work?

Answer 15

Schedule II - inc release of catecholamines

Question 16

What class of drug can be used to treat ADD?

Answer 16

amphetamines

Question 17

Withdrawal from what drug includes increased appetite, sleepiness, exhaustion, and mental depression? What drugs can be given to help?

Answer 17

Amphetamine withdrawal - can give antidepressants

Question 18

what is the most widely used CNS stimulant? the second?

Answer 18

caffeine

2nd: nicotine

Question 19

What is the most abused drug? the second?

Answer 19

Alcohol

2nd: nicotine

Question 20

Nicotine causes its reward effects by causing the release of what where?

Answer 20

dopamine in the ventral tegmental area

Question 21

Name two drugs used for treatment of nicotine addiction

Answer 21

Bupropion

Varenicline

Question 22

which two opioids are most abused among health professionals?

Answer 22

meperidine and fentanyl

Question 23

withdrawal from what addictive drug includes: dysphoria, lacrimation, rhinorrhea, and yawning? is it life-threatening?

Answer 23

opiods - no

Question 24

how do you treat opioid addiction?

Answer 24

illicit agent replaced by long-acting opiod and dose is slowly reduced - use methadone or buprenorphine

Question 25

withdrawal from what type of drugs is caused by a noradrenergic storm? name two drugs used to treat and their MOA

Answer 25

Opioids - heroin Clonidine and lofexidine - alpha2 agonists

Question 26

What drug can be used in opioid detox in patients highly motivated to remain opioid free? why only in motivated patients?

Answer 26

Naltrexone - wont satisfy cravings or relieve withdrawal

Question 27

What drug binds to receptors CB1 and CB2? what type of receptors are these? where is each located?

Answer 27

cannabinoid receptors G protein linked coupled to Gi CB1: brain - major one for psych effects CB2: immune cells

Question 28

what is dronabinol? name 2 conditions it helps treat

Answer 28

``` therapeutic THC (cannabinoid) anorexia in AIDS pts and nausea/vomiting in chemo patients (2nd line) ```

Question 29

what three drugs are in the LSD-like group?

Answer 29

LSD Mescaline Psilocybin

Question 30

describe the symptoms of LSD addiction and withdrawal

Answer 30

trick! no addiction or withdrawal!

Question 31

what drug can be given for a "bad trip" on LSD?

Answer 31

diazepam - helps agitation

Question 32

ketamine is an analog of what street drug?

Answer 32

phencyclidine aka PCP aka angel dust

Question 33

what addictive drug causes feelings of empathy and intimacy? how does it work?

Answer 33

MDMA - ecstasy causes release of biogenic amines - mostly serotonin

Question 34

withdrawal of what drug is characterized by depression lasting several weeks?

Answer 34

MDMA - ecstasy

Question 35

which addictive drug produces euphoria, analgesia, then loss of consciousness?

Answer 35

nitrous oxide

Question 36

what two inhalants an be used to enhance erection and are NOT addictive?

Answer 36

amyl nitrite and butyl nitrite