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Flashcards in Drugs of Abuse Deck (55):
1

Family of Drugs that do not cause addition

hallucinogens

2

concept: Whats going on in the brain to make a substance addictive

general rule: all addictive drugs activate the mesolimbic dopamine system (alters behavoiur...something to the cortex that i cant remember **FILL IN WED AM)

3

Name that substance.
intial presentaiton: tremor, n/v, sweating, agitation, anxiety --> hallucinations --> 24-48 hours later generalizes seizures ---> 48-72 hours delirum tremens :)

alcholo withdrawal

4

~*~Treat your OH addicted patient.

SHARK - flashback

Disulfiram - aldehyde dehydrogenase inhibitor - creates AVERSION

Natrexone - opioid antagonist - decreases CRAVING

Acamprosate - NMDA receptor antagonist - prevents relapse

Topiramide - Glutamate receptor facilitation - may reduced craivns **NOT FDA APPROVED

5

~*~Treat your Oh withdrawal patient

long acting benzos: diazepam and chlordiazepoxide *new, not in benzo lecture)

6

~*~ Treat your elderly or liver failure OH patient

lorazepam and oxazepam (error here or in other lecture; this lecture says intermediate acting; benzo lecture says oxazepam is short acting, be careful :) )

bc less dependent on hepatic metabolism

7

Just a refreshed, which benzodiazepines don't need to be P450'd at the liver?..... whats the relevance to OH withdrawal treatment?

oxazepam
lorazepam
temazepam

since dont get metab by P450 are more gentle on elderly and liver failure :)

8

~*~*Name that drug ER doctor. tremors + anxiety + perceptual disturbances + dysphoria + psychosis + seizures

benzodiazepine withdrawal

9

~*~Which drug(s) produce a withdrawal symptom that can be life threatening?!

benzodiazepines

10

How do you treat benzodiazepine withdrawal

if on short acting drug --> switched to a long acting drug

usually use DIAZEPAM and gradually taper the dose

11

SHARK: addiction is rare with what drugs

benzodiazepines
caffeine

12

what schedule number of drug is cocaine classified as?

schedule II

13

Name that drug
wellbeing and euphoria
tachycardia, hyperT, mydriasis ***, diaphoresis

cocaine intoxication

14

Name that drug: dysphoria, depression, sleepiness, fatigue, craving, bradycardia = generally mild and tx not generally required

cocaine withdrawal

15

How to treat cocaine addition?

we cant help yet.

16

Schedule DEA ranking of amphetamies

schedule II

17

MOA amphetamines

1) increase release of catecholamines
2) weak inhibitors of MAO
3) possibly act as direct catecholaminergic agonists @ brain

18

Name that drug: increased alertness, decreased fatigue *depressed appetite* and insomnia + @ high doses - psychosis and convulsions + peripheral adrenergic symptoms

amphetamines

19

Treatment for narcolepsy

amphetamine and methylphenidate

20

SHARK: flashback. What parkinson drug is metabolized to amphetamines and shouldn't be taken later in the day

MAOb inhibitor

* seleGILINE

:)

21

Name that drug: *increasd appetite*, sleepiness, exhaustion, mental depression

amphetamine withdrawal

22

Describe how the rewarding effect of Nicotine comes about

full agonist at the nicotine receptor found @ ventral tegmental area on dopamine neurons

23

MOA of nicotine please

low dose - ganglionic stimulation

high dose - ganglionc blockade

**midterm I pharm

24

Effects of nicotine @ low dose

euphoria and relaxation
improves attention, learning, problem solving, reaction time

25

Effects of nicotine @ high dose

central respiratory paralysis, severe hypotension due to medullary paralysis

26

Name that drug: mild withdrawal, irritability and sleeplessness, relapse common, very addictive

nicotine withdrawal

27

Treat the nicotine addiction! drug style

SHARK: flashback to antidepressant lecture

a) Nicotine replacement thearpy
b) Sustained release Buproprion (from antidepressnat lecture -- NDRI; no sexual dysfunction, also second line for anxiety disorders, overdose can cause seizures)
c) varenicline - partial agonist at nicotine receptors in the CNS

28

Varenicline. MOA. Uses.

Varenicline - used for nicotine treatment addiction; partial agonist at nicotinic receptors in the CNS

29

I say mydriasis, you think?

cocaine intoxication -- increaesed NE at the eyeball

30

Name the most commonly abused opioids please.

heroin
morphine
codeine
oxycodone

31

Name the most commonly abused opioids in health professionals

m-eperidine
f-entanyl

M-edical professional
F-ail

32

Name the drug: strong tolerance and dependence, behavioural disruptions and incompatibility with a productive life

opioid addiction

33

Name the drug: not life threatening; dysphoria, **lacrimation** **rhinorrhoea** and yawning **

opioid withdrawal

34

~*~Describe how you could help a patient in opioid withdrawal

replace (usually short acting) abused opiod with a long acting opioid and slowly reduced the dose

METHADONE or BUPRENORPHINE

M-edical professionals
B-etter

35

Clonidine and lofexidine - used for what detoxification and why?

opioid withdrawal - chronic opioid - intolerance on teh ANS - rebound firing of neuroms; noradrenergic storm results......

36

Naltrexone effect on detox from opioids

only used when paitents have high moticiation bc will not satisfy craving or relieve withdrawal symptoms (naltrexone also used for OH addiction)

37

MOA of Mary-do-you-wanna

delta9-tetrahydrocannabinol --> Gi @ CB1 (brain = effects) and CB2 (immune cells)

38

Effects of THC

euphoria --> drowsiness and relazation
affects short term memory and mental activity

others: appetite stimulation (amphetamine withdrawal too), xerostomia, visual hallucinations, delusions, enhancement of sensory activty

@ high doses - toxic psychosis (also see this at high doses of amphetamine)

39

Dronabinol = ?

therapeutic THC
used @ anorexia with weight loss in AIDs patients AND @ nasuea and vomiting with cancer chemo (second line)

40

To be continued

when i get hoem

41

Name the psychedelic agents

LSD
mescaline (LSD like)
psilocybin (LSD like)
phenciclidine
MDMA (ectasy)

42

Affects of psychedelic agents

affect thought, perception and mood
DO NOT cause psychomotor stim/depression

43

MOA LSD

agonist effects at 5 HT2 receptors in CNS

44

Cxl presentation of LSD

combo of somatic and psychomimetic symptosm - usually due to SYMPATHOMIMETIC

* mydriasis (cocain also)
* hypertension
* tacychardia
* increased body temperature
* flushing
* sweating
* tremors
*piloerection

45

LSD addiction or withdrawal symndrome

not cause addiction
no withdrawal

46

MOA Phencyclidine

a dissociative anesthetic AND blocks reuptake of NE and DA and also causes choli and anticholi effects AND action at nicotinic and opoid receptors

47

What causes dissociatve effects of PCP?

due to actions of PCp as a NON COMPETITIVE ANTAG at NMDA receptors

48

Name that drug: violent or bizarre behaviour, confusion, mystagmus, tachycardia, hypertension, diaphoresis, miosis, anesthesia, analgesia; appear to be having a psychotic episode, ~*~PINPOINT pupils in an AGITATED patient~*~

phencyclidine intoxication

49

Name that drug: empathpy and intimacy without impairment of intellectual capacities

MDMA/ectasy intoxication

50

MOA MDMA/ectasy

causes release of biogenic amines; increases concentration fo 5HT (the 'im in love' neurotransmitter) the most

51

Name that drug: depression lasting several weeks

MDMA/ectasy withdrawal

52

Name that drug: euphoria, analgesia then loss of consciousness

nitrous oxide intoxication

53

Name that drug: exhiliration and light headedness

volatile organic solvent intoxication - gas, paint thinner, lighter fluid, glue, degreaser

54

COmplications of volatile organic solvent use pelase

cancer
cardiotoxicity
neuropathies
hepatotoxicity

55

Are organic nitrites addictive?

no