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Flashcards in Drugs of Abuse Deck (39):
1

Opioids

agonists at μ-opioid receptors [Gi]

2

CNS Depressants

enhance GABA and/or inhibit glutamate fxn

3

CNS Stimulants

block DA reuptake or enhance DA release

4

Nicotine:

agonist at nicotinic neuronal receptors

5

Hallucinogens

partial agonist at 5HT2 receptors (DA releaser)

6

Dissociative Anesthetics:

antagonist at NMDA-Glu receptors

7

Cannabinoids

agonist at cannabinoid (CB1-CB2) receptors

8

Reinforcing Effects of Drugs of Abuse
Opioids

Euphoria, sedation, anxiolytic

9

Reinforcing Effects of Drugs of Abuse
CNS Depressants

Euphoria, sedation, loss of inhibition

10

Reinforcing Effects of Drugs of Abuse
CNS Stimulants

Euphoria, decreased fatigue, increased arousal

11

Reinforcing Effects of Drugs of Abuse
Nicotine

Increased alertness

12

Reinforcing Effects of Drugs of Abuse
Hallucinogens

Altered sensory perception, enhanced insight

13

Reinforcing Effects of Drugs of Abuse
Dissociative Anesthetics

Euphoria, heightened emotionality

14

Reinforcing Effects of Drugs of Abuse
MJ

Euphoria, “mellowness”, changes in perception

15

Opioids - via mu-opioid receptor activation

Respiratory depression-pinpoint pupils-coma

Treatment: ________________

naloxone

16

CNS Depressants - via GABA activation +/- GLU inhibition

Respiratory depression, coma (extremely rare with BDZs)


Benzodiazepines Rx: ____________

flumazenil

17

CNS Depressants - via GABA activation +/- GLU inhibition

Respiratory depression, coma (extremely rare with BDZs)

ETOH

Treatment

Ethanol: supportive plus fluids-electrolytes-thiamine

18

CNS Stimulants - via activation of NE and DA receptors

SNS overactivity, increased HR-BP-temp, chest pain-MI, psychosis

Treatment: CVS support, ____________________

vasodilators for BP

BDZs for agitation-seizures
-reduce sym overactivity

19

Nicotine: rare (insecticide-cigarettes ingestion by children) - via activation of nicotinic-cholinergic receptors

Treatment: CVS support, _____________

emetics-gastric lavage-charcoal

20

Tox MDMA: Agitation, hyperthermia, _____________

ADH release--> hyponatremia

21

Tox Cannabinoids via activation of CB1 receptors


Minimal -->possible anxiety, impaired coordination-tracking, acute psychosis

22

Which of the following drugs of abuse is least likely to result in a fatality if orally ingested in excessive amounts as a single agent?
 
Ethanol
Heroin
Morphine
Oxycodone
Phenobarbital
Diazepam

Ethanol- rd
Heroin rd
Morphine rd
Oxycodone rd
Phenobarbital rd
Diazepam- generally safe w/o resp comorbid

23

Tolerance to Drugs of Abuse

Cross Tolerance means?




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



Examples

Drug of abuse (heroin)--> cross-tol to medically used drug (hydrocodone) -->both drugs act at u-opioid receptors

Alcoholic patient tolerant to ethanol--> cross-tolerance to benzodiazepines - both drugs act at GABA receptors

24

A patient who is an alcoholic would be most likely to display cross-tolerance to which of the following drugs?
 
Lidocaine (Xylocaine)
Hydrocodone (in Vicodin)
Ibuprofen (Motrin)
Diazepam (Valium )
Acetaminophen

Diazepam (Valium)

ETOH and Bdz--> Facilitates GABA fxn

25

Dependence on Drugs of Abuse
Opioids

Develops rapidly

26

Dependence on Drugs of Abuse
CNS Depressants

Appears within weeks

27

Dependence on Drugs of Abuse
Cannabinoids

Accumulating evidence for dependence syndrome

28

Tolerance to Drugs of Abuse
Rapid

Opioids: Develops rapidly

CNS Depressants--> Rapid to barbiturates

29

Cross Dependence
+ side

Ability of one drug to suppress the withdrawal associated with physical dependence on another drug

30

Tolerance and dependence do not necessarily coexist - nor do addiction and physical dependence

Tolerance and dependence do not necessarily coexist - nor do addiction and physical dependence

31

The exaggerated expression of drug effects experienced immediately after cessation of treatment

withdrawal

32

A state of neuroadaptation produced by repeated drug administration that necessitates continued drug administration to prevent the withdrawal syndrome from occurring.

drug dependence

33

A reduced effect of the drug generated by repeated administration of the drug in a particular environment.-

tolerance

34

The ability of one drug to suppress the manifestations of another drug’s actions

cross dependence

35

Withdrawal SZ

↑↑↑ Cl--> wd ↓ Gaba ETOH

↓ Glu--> wd ↑ Glu Benz

36

Opoid wd rx

clonide ↓ SNS
methadone cross tol


Rarely life-threatening  insomnia, diarrhea, irritability, cramps, muscle aches, increased BP

37

CNS ↓ wd

Significant risk of mortality due to seizures (monitor)

Treatment: substitution with BDZs --> loading dose - then taper to prevent seizures


use benzos for cross, most often wd is from etoh

38

Withdrawal from Drugs of Abuse
Nicotine

Treatment: relapse--> nicotine replacement, bupropion, varenicline

39

Untreated withdrawal from drugs of abuse can produce symptoms that include potentially life-threatening seizures. Seizures are LEAST likely to occur following withdrawal from which of the following classes of abused drugs?
 
Alcohol
Barbiturates
Benzodiazepines
Opioid analgesics

 
Alcohol- cns
Barbiturates- cns
Benzodiazepines- cns
Opioid analgesics- u- least likely