Drugs of Abuse Flashcards by Janelle Lussier

What is recreational drug use?

use of a pharmacologically active agent for purposes other than its intended medicinal or other purpose

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what is tolerance?

a state at which there is no longer the desired response to the drug; to achieve the desired response, more drug is required

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how long does it take before tolerance is typically lost?

10-14 days

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what is reverse tolerance?

sensitization; requires less drug to achieve the desired response

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what is functional tolerance?

aka pharmacodynamic tolerance
change in the post synapses of the CNS
desensitization of receptors is short; down regulation of receptors/signalling pathways is long

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what is metabolic tolerance?

aka pharmacokinetic tolerance

adaptation of the metabolic machinery to repeated exposure to a drug (similar to drug resistance mechs)

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what is withdrawal?

a maladaptive behavioural change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance

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what are some drug classes that are known to cause withdrawal?

alcohol
opioids
hypnotics
anxiolytics
sedatives
amphetamines
nicotine
cocaine
cannabis

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what is dependence?

the state at which the user functions normally only when taking the medication
reinforced by withdrawal symptoms

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what is an example of physiological dependence?

withdrawal of alcohol from an alcoholic can be life threatening

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what is an example of psychological dependence?

repeated crack cocaine use; drug seeking habits in spite of risks; repeated dosing related need to keep the high
implies addiction

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what are 5 characteristics of addiction?

1) Inability to consistently abstain
2) Impaired in behavioural control
3) craving: or increased “hunger” for drugs or rewarding experiences
4) diminished recognition of significant problems with one’s behaviours and interpersonal relationships
5) a dysfunctional emotional response

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what is the difference between opioids and opiates?

opioids - fully synthetic; umbrella term

opiates - synthetic derivatives from opium poppy

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what are some other effects opioids have on the body besides euphoria?

respiratory depression
dependence
prominent effect on GI tract
miosis (excessive constriction of eye pupil)

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which receptor are opioids selective for? what is the one exception?

mu receptor

pentaocine (kappa receptor)

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what are some desirable effects of opioid use?

analgesia
euphoria
sedation
relief of anxiety
depress cough reflex

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what are some undesirable effects of opioid use?

dysphoria (dizziness, nausea)
vomiting
constipation
biliary tract spasm
urinary retention
withdrawal
respiratory depression

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what are the available routes of administration for opioids

oral
IV
IM
smoked
intranasal
transdermal

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briefly describe the PK of opioids

readily absorbed orally
lipid solubility affects distribution and CNS levels
First pass metabolism: glucoronidation
renal elimination
enterohepatic recycling

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what are some effects of opioid toxicity?

CNS: convulsions
Resp: rate/volume/exchange depression, decreased resp responsiveness
CV: orthostatic hypotension, stroke, ECG abnormalities
GI: decreased motility, intestinal obstruction, increased biliary tract pressure

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what symptoms will be experienced in the first 8-12h of opioid abstinence syndrome? (4pts)

lacrimation
perspiration
yawning
rhinorrhea

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what symptoms will be experienced in the first 12-14h of opioid abstinence syndrome? (7pts)

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irritability
piloerection
restlessness
weaknesses
mydriasis
tremor
anorexia

what symptoms will be experienced in the first 48-72h of opioid abstinence syndrome? (13 pts)

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increased irritability
increased HR
insomnia
marked anorexia
hypertension
sneezing
hyperthermia
hyperpnea 
aching muscles
hot and cold flashes
nausea/vomiting
piloerection
abdominal cramps

how long does opioid abstinence syndrome typically last?

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7-10 days

what is acetyl fentanyl?

designer drug that is 5-15x more potent than heroin

what is some effects of acetyl fentanyl?

euphoria altered mood drowsiness resp depression

what is the problem with acetyl fentanyl?

responsible for multiple deaths

what are some effects of cannabis that cause it to be used recreationally

dysphoria and hallucinations

what is the major psychoactive constituent in cannabis?

THC

what is the MoA of cannabis?

bind to cannabinoid receptors CB1 and CB2 | CB1 associated with MAP kinase/adenylyl cyclase/K-channel

what is the approx % of THC in leaves, hashish, and oil extract?

leaves: 2-5% hashish: 5-25% oil extract: >20%

what are some CNS effects of cannabis?

euphoria lack of concentration motor function impairment (reaction time) impaired attention, memory, learning users at heightened anxious state (CB1 in amygdala) paranoia

what are some CV effects of cannabis?

``` increased HR decreased BP (vasodilation) ```

what are some resp effects of cannabis?

deceased resp rate bronchodilation lung damage (smoking)

What are two drug interactions that can occur with cannabis?

cocaine/amphetamines - increased hypertension, tachycardia, possible cardiotoxicity CNS depressants - additive effect

briefly describe the PK of cannabis

smoking: rapid onset and 18-50% bioavailability oral: slower onset, 6-18% bioavailability, first pass effect THC is lipophilic; enterohepatic circulation; t1/2 = 3 days in chronic users

what are the desirable effects of cocaine?

``` locomotor stimulation euphoria elevation of mood increased energy alertness, sociability confidence sexual arousal decreased need for food ```

what are some undesirable effects of cocaine?

``` dysphoria (state of unease/dissatisfaction) irritability drug craving paranoia assaultive behaviour hallucinations hyperthermia psychosis death ```

what is cocaine?

a stimulant that inhibits the reuptake of NE, DA, and 5-HT

how do DA, NE, and 5-HT contribute to the side effects of cocaine?

DA - localized in the striatum; reward and control of motivation; hyperthermia NE - adrenergic (tachycardia) 5-HT - dysphoria, depression and craving

what is the difference between crack cocaine and cocaine?

cocaine - hydrochloride salt | crack cocaine - free base

when is the peak effect of cocaine seen in the following forms: IV, smoking, intranasal

``` IV = 5min smoking = 7min intranasal = 20min ```

what is the time to decrease effect to 1/2 max of cocaine in the following forms: IV, smoking, intranasal

``` IV = 15min Smoking = 17min Intranasal = 27min ```

what is the duration of action for cocaine?

10-30min

what are some of the withdrawal symptoms for cocaine?

fatigue irritability loss of sexual desire muscle pain

what are some symptoms of cocaine toxicity? (9pts)

1) increased muscular activity and vasoconstriction (hyperthermia) 2) psychosis 3) grand-mal convulsions 4) coma 5) vasoconstriction 6) ventricular arrhythmia 7) MI 8) chenyn-stoke breathing 9) respiratory paralysis

what are some of the combination drugs that include cocaine?

speedball: cocaine and heroin and alcohol tick: cocaine and phencyclidine turbo: cocaine and marijuana

what are some of the symptoms that can occur with chronic cocaine use? (9pts)

1) malnutrition 2) violent protective behaviour 3) hyperkinetic behaviour 4) distorted perception 5) rhinitis (nasal septum performation) 6) SoB 7) cold sweats 8) tachycardia 9) MI; stroke (vessel rupture)

how does ecstasy cause its effects on the body?

increases 5-HT, DA, and NE release and inhibits serotonin receptors

what are the positive effects of ecstasy?

empathy well-being reduced anxiety

what are the adverse effects of ecstasy?

``` hyperthermia dehydration increased BP depression risk of serotonin syndrome ```

what is the difference between the S and R enantiomers of ecstasy in regards to effects on the body?

S is far more neurotoxic than R

what are the effects of bath salts on the body? (15pts)

1) paranoia, violent behaviour 2) hallucinations 3) delusions 4) suicidal thoughts 5) seizures 6) panic attacks 7) chest pain 8) N/V 9) Increased HR 10) increased BP 11) increased body temp 12) rhabdomyolysis 13) multiple organ failure 14) coma 15) death

give an example of a bath salt

mephedrone

Drugs of Abuse Flashcards

(54 cards)