Drugs of abuse [3] Flashcards Preview

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Flashcards in Drugs of abuse [3] Deck (18):
1

Drugs of abuse share which final common pathway?

VTA activation releases DA onto NA neurons
- pleasure is received

2

MOA of
CNS stimulants
Dissociative anesthetics
Hallucinogens

CNS stim: block DA reuptake or enhance DA release

Dissociative anesthetics: antagonist at NMDA-Glu

Halluc: partial agonist at 5HT2 receptor (DA releaser)

3

Drug that blocks reuptake of DA and NE into presynatptic catecholamine (DA, NE, E) neurons and also block Na channels in neuronal membrane:

Cocaine

- caines: block Na channels in neuronal membrane
ie: lidocaine - amide - longer duration of action

4

opioid (mu opioid rcptr activ)
acute toxicity and tx

respiratory depression
pinpoint pupils
coma

tx: naloxone

5

CNS depression (GABA activ, GLU inhib)
acute toxicity and tx for:
ethanol
BDZ
barbs

resp depression
coma (with BDZs)

Tx:
Ethanol: thiamine
BDZ: Flumazenil
Barbs: supportive

6

CNS stimulants (activ of NE and DA receptors)
acute toxicity and tx

SNS overactivity
Increase HR-BP=Temp
Chest pain-MI, payxhoaia

Tx: vasodilators, BDZs

7

Nicotine acute toxicity (insecticides) and tx for:
Nicotine

nausea-vomit
diarrhea
convulsions

tx: emetics-gastric lavage charcoal
(nicotine replacement
bupropion
verenicline)

8

Tx for Hallucinogens and dissociative anesthetics

BDZs for agitation

Dissociative anesthetics: antagonist at NMDA-Glu

Halluc: partial agonist at 5HT2 receptor (DA releaser)

9

very little chance of resulting in fatality if ingested orally in excessive amts as single agents

Diazepam (BDZ)

10

Cross tolerance
- what is it
- give 2 ex

tolerance develops to one drug
- then will be seen to other drugs of the same class-same target

ie:
heroin→cross tolerance to hydrocodone
- both act at u-opioid receptors)

alcoholic patient tolerant to ethanol → cross tolerance to BDZ
- both act at GABA receptors

11

Pt who is alcoholic, would display cross tolerance to which of the followig drugs

OH: enhance GABA + decrease Glu

BDZ: ie diazepam (Valium)

12

CNS depressants:
which one is more rapid
ethanol, barbs, BDZ

Barbs > ethanol, BDZ

13

Cross dependence

ability of one drug to suppress the w/drawal associated with physical dependence on another drug

ie: suppressing w/drawal symp of ethanol with BDZ

- w/drawal symp can be fata and may require emergent intervention for drugs of abuse

14

Withdrawal effects from drug of abuse

characterized by rebound effects

effects generally opposite of the acute effects of the drug

Can be fatal and may require emergent intvn

15

Opioids w/drawal
- tx

you feel miserable - rarely life threatening

Tx: clonidine, methadone

clonidine: short term
- shut down SNS, muscarinic saliva formation - dry mouth side effect

methadone: long term sub

16

CNS depressant w/drawal
- tx

Significant risk of mortality due to seizures

Tx: sub w/ BDZ

17

Nicotine tx:

irritability, hostility, anxiety, increase appetite

nicotine replacement
bupropion
verenicline

18

Which drug of abuse is least likely to be associated with seizures?

Opioid analgesics

(typically CNS depressant w/drawal will have risk of mortality due to seizures)