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neuro unit IV > drugs of abuse > Flashcards

drugs of abuse Flashcards

(57 cards)

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1
Q

Opioids examples

A

heroin, oxycodone and hydrocodone

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2
Q

CNS depressants examples

A

barbiturates, benzodiazepines, alcohol

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3
Q

CNS stimulants examples

A

methamphetamines, cocaine,

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4
Q

hallucinogens examples

A

Indoleamines (LSD, DMT, mushrooms), Phenylethylamines (MDMA, mescaline)

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5
Q

dissociative anesthetics examples

A

Phencyclidine (PCP), ketamine, dextromethorphan

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6
Q

Pharmacologic property of drugs of abuse

A

enhance dopamine activity in the nucleus accumbens

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7
Q

levels of drug abuse

A

experimental (one-few trials), circumstantial-recreational (occasional use under certain circumstances), and compulsive (reliance)

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8
Q

pathway of addiction

A

Amygdala learns drug and cues cause pleasure–may signal relief from craving > Drug cues lead to DA release in Nucleus accumbens > triggers output to thalamus and cortex > In absence of activity from reflective reward system (prefrontal cortex) drug-seeking initiated

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9
Q

Opioids MOA

A

Agonists at μ-opioid receptors [Gi]

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10
Q

CNS depressants MOA

A

Enhance GABA - inhibit glutamate

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11
Q

CNS stimulants MOA

A

Block DA reuptake or enhance DA release

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12
Q

nicotine MOA

A

Agonist at nicotinic neuronal receptors

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13
Q

hallucinogens MOA

A

Partial agonist at 5HT2 receptors

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14
Q

dissociative anesthetics MOA

A

Antagonist at NMDA-Glu receptors

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15
Q

cannabinoids MOA

A

Agonist at cannabinoid (CB1-CB2) receptors

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16
Q

Opioids reinforcing effects

A

Opioids: Euphoria, sedation, anxiolytic

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17
Q

CNS depressants reinforcing effects

A

CNS Depressants: Euphoria, sedation, loss of inhibition

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18
Q

CNS stimulants reinforcing effects

A

CNS Stimulants: Euphoria, decreased fatigue, increased arousal

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19
Q

nicotine reinforcing effects

A

Nicotine: Increased alertness

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20
Q

hallucinogens reinforcing effects

A

Hallucinogens: Altered sensory perception, enhanced insight

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21
Q

dissociative anesthetics reinforcing effects

A

Dissociative Anesthetics: Euphoria, heightened emotionality

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22
Q

cannabinoids reinforcing effects

A

Cannabinoids: Euphoria, “mellowness”, changes in perception

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23
Q

Opioids acute toxicity and treatment

Study These Flashcards
A

Respiratory depression-pinpoint pupils-coma. Treatment: naloxone

24
Q

CNS depressants acute toxicity and treatment

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A

Respiratory depression, coma (extremely rare with BDZs). Treatment- Ethanol: supportive plus fluids-electrolytes-thiamine. Benzodiazepines: flumazenil. Barbiturates: supportive

25
CNS stimulants acute toxicity and treatment
SNS overactivity, increased HR-BP-temp, chest pain-MI, psychosis. Treatment: CVS support, vasodilators for BP (phentolamine), BDZs (diazepam) for agitation-seizures, haloperidol for psychotic symptoms
26
nicotine acute toxicity and treatment
rare – ingestion of insecticide or cigarettes by children. Nausea-vomiting, diarrhea, CVP collapse, convulsions. Treatment: CVS support, emetics-gastric lavage-charcoal
27
hallucinogens acute toxicity and treatment
LSD-Psilocybin: “Bad trip”, severe anxiety. Treatment: “talking down”, BDZs for agitation. MDMA: Agitation, hyperthermia, ADH release causing hyponatremia
28
dissociative anesthetics acute toxicity and treatment
PCP and ketamine. Delirium,  RR-HR-BP-temp, agitation, violent behavior. Treatment: supportive for BP-hyperthermia, agitation (BDZs)
29
cannabinoids acute toxicity and treatment
Minimal - possible anxiety, impaired coordination-tracking, acute psychosis
30
What is pharmacodynamic tolerance
Lessened response at active target site to the same drug concentration. Due to changes in receptor sensitivity or other adaptive changes
31
What is metabolic (dispositional) tolerance
Change in pharmacokinetics results in lowered drug Cp at active site, due to increased metabolism
32
What is cross tolerance and give examples
•Tolerance develops to one drug – then will be seen to other drugs of the same class - same target. Ie. Heroin and hydrocodone both work at mu opioid receptors, and can develop cross tolerance. Ethanol and benzos work at GABA receptors and can develop cross tolerance
33
What is learned tolerance
Reduction in effects of a drug due to learned compensatory mechanisms. Behavioral tolerance and conditioned tolerance
34
What is reverse tolerance
Sensitization (increased response) to drug following repeated doses. Sensitization in nucleus accumbens may play a role in drug craving properties
35
Opioids tolerance
Develops rapidly (up to 100-fold); not to constipation
36
CNS depressants tolerance
Rapid to barbiturates > ethanol, benzodiazepines. Significant to sedation-intoxication, less to lethal dose
37
CNS stimulants tolerance
: develops to euphoria-anorexia-hyperthermia, but can see supersensitivity to paranoia
38
nicotine tolerance
Develops to subjective effects and nausea
39
hallucinogens tolerance
Not common, since repeated use minimal
40
cannabinoids tolerance
Rapid to most effects, also disappears rapidly
41
Compare physical and psychological dependence
physical: stop use abruptly leads to withdrawal symptoms due to resetting of homeostatic mechanisms. Psychological: perceived need (craving), related to pathologic learning in reward pathway
42
What is cross dependence and give examples
* Ability of one drug to suppress the withdrawal associated with physical dependence on another drug. Related to pharmacological effects at target – not chemical similarities. Ie. Morphine and other opioids. Alcohol, barbiturates and other sedative hypnotics * Ability of one drug to suppress the withdrawal associated with physical dependence on another drug. Related to pharmacological effects at target – not chemical similarities. Ie. Morphine and other opioids. Alcohol, barbiturates and other sedative hypnotics
43
opioids dependence
develops rapidly (within 1-2 weeks)
44
CNS Depressants dependence
Appears within weeks
45
CNS stimulants dependence
arguable- strong psychologic dependence
46
nicotine dependence
moderate development
47
hallucinogens dependence
does not develop
48
dissociative anesthetics dependence
probably none
49
cannabinoids dependence
accumulating evidence
50
What are the characteristics of withdrawal symptoms
•Effects generally opposite of the acute effects of the drug. Ie If a drug relieves fatigue and causes mood elevation, withdrawal is characterized by lethargy and depression
51
Opioids withdrawal symptoms and treatment
Rarely life-threatening - insomnia, diarrhea, irritability, cramps, muscle aches, increased BP. Treatment: clonidine (for SNS overactivity), methadone (works via cross tolerance), buprenorphine (partial mu agonist), or naltrexone (blocks reinforcing actions of heroin)
52
CNS depressants withdrawal symptoms and treatment
Significant risk of mortality due to seizures (monitor). Treatment: substitution with BDZs - loading dose - then taper to prevent seizures
53
CNS stimulants withdrawal symptoms and treatment
sleepiness, fatigue, depression, hyperphagie, craving.. Treatment: behavioral
54
nicotine withdrawal symptoms and treatment
Irritability, hostility, anxiety, increased appetite, weight gain. Treatment of relapse: nicotine replacement, bupropion, varenicline (partial nicotine receptor agonist)
55
hallucinogens withdrawal symptoms and treatment
Not known, “flashbacks” in some former users [HPPD - hallucinogen persisting perception disorder]
56
dissociative anesthetics withdrawal symptoms and treatment
None observed
57
cannabinoids withdrawal symptoms and treatment
not clinically significant, no treatment needed

neuro unit IV (25 decks)

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