Drugs of Abuse

Question 1

Hallmark of drug addiction

Answer 1

COMPULSIVE DRUG USE - due to brain alterations associated with chronic exposure

Question 2

Two Types of Dependence

Answer 2

Physical

Psychological

Question 3

Physical dependence - DEPENDENCE

Answer 3

when drug is NECESSARY FOR NORMAL PHYSIOLOGICAL FUNCTION

Question 4

Two Tolerance types

Answer 4

pharmocokinetic - associated with METABOLISM

pharmacodynamic - DESENSITIZATION/down regulation/increased receptor internalization

Question 5

Psychological Dependence - ADDICTION

high risk of?

Answer 5

compulsive drug use to induce pleasure/escape from realitY DESPITE NEGATIVE CONSEQUENCES

relapse

Question 6

Relative Risk of Addiction

Answer 6

1 - non-addictive
2 - slightly
3 - moderate
4 - addictive
5 - highly

Question 7

Addictive nature of drugs comes from effects on what two areas?

Answer 7

ventral tegmentum
reward pathway

DOPAMINERGIC

Question 8

Ventral Tegmentum acts on what four main areas in the reward pathway?

Answer 8

amygdala
nucleus accumbens
pre-frontal cortex
hippocampus

Question 9

Three mechanisms of increasing DA release

Answer 9

activation of Gi protein-coupled receptors - blocks GABA-ergic

Activation of ionotropic receptors or ion channels

Targeting DOPAMINE TRANSPORTER

Question 10

CNS/Depressants

RR =

Answer 10

Alcohol
Benzo’s
Barbiturates
GHB

RR=3

Question 11

Ethanol effects?

Answer 11

sedation, sleep, suppression of inhibitory systems, mild euphoria

Question 12

Ethanol pharmacokinetics

Answer 12

rapidly and completel absorbed from GI tract

BLOOD BRAIN BARRIER AND PLACENTA ARE FREELY PERMEABLE

Question 13

Ethanol metabolism

Elimination kinetics?

Answer 13

90% LIVER
10% GI tract

Excreted through KIDNEY AND LUNGS

ZERO ORDER ELIMINATION

Question 14

Why do women have higher blood EtOH than men for same dose?

Answer 14

DECREASES first pass metabolism

LOWER total body water

Question 15

3 enzymes of alcohol metabolism

Answer 15

ALCOHOL DEHYDROGENASE

MICROSOMAL ETHANOL-OXIDIZING SYSTEM

ALDEHYDE DEHYDROGENASE

Question 16

Fomepizole

Answer 16

alcohol dehydrogenase inhibitor

treats methanol and ethylene glycol poisoning

Question 17

Disulfiram

Answer 17

aldehyde dehydrogenase inhibitor

ecnourages alcoholics to abstain of EtOH

Question 18

EtOH Mechanism of Action

Answer 18

POTENTIATES GABA AT GABA-A receptors

Also INHIBITS GLUTAMATE ACTIVATED NMDA RECEPTORS

Question 19

Wernicke-Korsakoff Syndrome

Answer 19

vitamin B1 deficiency associated with excessive alcohol intake

Question 20

Cocaine and Alcohol

Answer 20

liver combines them to make COCAETHYLENE

produces an intensification of cocaine’s euphoric effects

most common two drug combination that causes death

Question 21

Management of Chronic Alcoholism

Answer 21

Disulfiram

Naltrexone

Question 22

Sedative/Hypnotics RR=

Answer 22

RR = 3 moderately addictive

Question 23

Most commonly abused benzo’s (2)

Answer 23

Diazepam

Alprazolam

Question 24

Flunitrazepam

Answer 24

rohypnol

date rape drug

tasteless when dissolved in a beverage

60 Hour detection window

Question 25

Flumazenil

Answer 25

BENZO ANTAGONIST treatment of overdose and reversing effects of long acting benzo's

Question 26

Overall mechanism of benzo's and barbiturates as drugs of abuse

Answer 26

DISINHIBITION OF VTA DOPAMINE neurons ACTIVATION OF MESOLIMBIC REWARD PATHWAY

Question 27

GHB

Answer 27

activates reward pathway causes amnesia also used as date rape drug

Question 28

Psychostimulants RR = ?

Answer 28

``` cocaine amphetamine methamphetamine methylphenidate MDMA ``` RR = 5

Question 29

Cocaine associated with what positive effects? linked to what major negative effect?

Answer 29

intense euphoria increase energy increased libido/self confidence linked to CARDIOVASCULAR TOXICITY

Question 30

Cocaine has what characteristic?

Answer 30

STRONGEST PSYCHOLOGICAL DEPENDENCE

Question 31

Methamphetamine effects last? Also has what?

Answer 31

6 to 24 hours vs 30 to 60 mins of cocaine sympathomimetic activity

Question 32

Cocaine MOA

Answer 32

blocks DA RE-UPTAKE INCREASES SYNAPTIC RELEASE

Question 33

Amphetamines MOA

Answer 33

cause VESICLE RELEASE OF DA AND NE REVERSE DA transporter

Question 34

Methylphenidate used for? (2)

Answer 34

ADHD | Narcolepsy

Question 35

MDMA MOA Causes?

Answer 35

interferes with 5-HT TRANSPORTERS to release 5-HT significant depletion of 5-HT for 24 hrs

Question 36

Toxicity of MDMA

Answer 36

acute - HYPERTHERMIA AND DEHYDRATION chronic - neurotoxicity and irreversible brain damage

Question 37

Long term use of psychostimulants causes?

Answer 37

TOXIC PSYCHOSIS INDISTINGUISHABLE FROM PARANOID SCHIZOPHRENIA

Question 38

Psychedelics (4) RR =

Answer 38

Lysergic acid diethylamide Psiolcybin Ketamine Phencyclidine RR = 1

Question 39

LSD and Psylocibin effects MOA? key receptor?

Answer 39

hallucinations, illusions, paranoia, euphoria, or depression RELEASE GLUTAMATE in CORTEX via THALAMIC EXCITATION target 5-HT-2a receptors --> INCREASES CALCIUM

Question 40

Negative effects of LSD and Psylocibin

Answer 40

Flashbacks Bad trips Rapid tolerance No dependence or addiction

Question 41

Ketamine and PCP MOA

Answer 41

block NMDA-YPE GLUTAMATE RECEPTORS DECREASE ACTIVITY OF CORTEX AND LIMBIC SYSTEM

Question 42

Opioids RR

Answer 42

RR = 4

Question 43

Most commonly abused opioids (4)

Answer 43

codeine heroin morphine oxycodone

Question 44

Naloxone

Answer 44

emergency overdose treatment

Question 45

Naltrexone

Answer 45

primarily for MAINTENANCE THERAPY longer acting, slower onset

Question 46

Methadone

Answer 46

strong opioid agonist MILDER WITHDRAWAL SYMPTOMS

Question 47

Dronabinol

Answer 47

SYNTHETIC THC approved for chronic pain treatment

Question 48

Cannabinoids RR

Answer 48

RR = 2

Question 49

THC/Cannabinoids MOA

Answer 49

DISINHIBITS DA NEURONS in VTA via PRE-SYNAPTIC CANNABINOID RECEPTORS likely involves removing GABA-A inhibition

Question 50

Cannabinoids effects

Answer 50

euphoria relaxation sense of wellbeing

Question 51

Treatments for nicotine addiction (3)

Answer 51

transdermal patch bupropion varenicline