drugs of abuse

Question 1

cannabis use disorder

Answer 1

a problematic pattern of cannabis use leading to clinically significant impairment or distress, as manifested by at least 2 of the following, occuring within a 12 month period

Cannabis is often take in larger amounts or over a longer period than was intended, there is a persistent desire or unsuccessful efforts to cut down or control cannabis use, a great deal of time is spent in activites to necessary to obtain cannabis, use cannabis or recover from its effects, cravign or strong desire or urge to use cannabis

cant do work obligations

Question 2

marijuana

Answer 2

drug plant and hemp plant

THC- its gotten more potent,
CBD- precursor
CAnnabinol- low

Question 3

mj pharmacokinetic

Answer 3

Rapidly metabolized by liver to 11 oh THC which is highly active in man, then metabolized to 9 nor COOH THC which is inactive

Metabolites excreted in urine and feces, they are detectable in urine for many days

smoked it reaches brain in 15-30 seconds, 3-5 times more potent smoked than when ingested oral onset of action is about 30 mins

Metabolized and redistributed in fat, slowly leaves body

duration of action 1-6 hours, t.5 20-50 hrs, 20% remains in body 5 days and is not detectable at 30 days, saliva can detect recent use 2-4 hrs

Question 4

MOA of THC

Answer 4

CB1 receptor- unique distribution in brain, high densities in cerbellum hippocampus and basal ganglia, low in hypothalamus– CB2 in peripheral tissue

Negatively coupled to adenylyl cyclase via Gi, generally inhibits transmitter release

Affinity for receptor correlates with psychoactive potency of cannabinoid agonists, there are endogenous ligands for CB1 receptsor
endorphics

Question 5

Endocannabinoids

Answer 5

bind to CB1 receptor
CB1 antagonist - rimonabant

diet drugs - produced depression and suicide

Question 6

marijuana thc effects

Answer 6

euphoria, memory impairment, perceptual motor alterations, cardiovascular, pulmonary, reproductive, psychopathological

Drivign- legal blood levels are not there, and people will kill

Question 7

marijuana effects on memory

Answer 7

impairs- digit symbot substitution, choice reation time, digit span, repeated subtactions, recal of material learned while hgh

Question 8

marijuana cardiovascular and pulmonary effects

Answer 8

1. tachycardia
2. orthostatic hypotension
3. exacerbate angina
4. bronchodilation
5. lung irritant
6. decreases in alveolar macrophage activity and ciliary function, but no epidemiological evidence of increased infections

Question 9

reproductive effect sof marijuana

Answer 9

lowers T and sperm counts, in rodents, gonadal weights are decreased, LHRH release is decreased, which decreases levels of FSH and LH
Prolactin release is decreased in females, greater incidence of abnormal menstrual cycles
hazard to marginal fertile

Question 10

psychopathologically effects of marijuana

Answer 10

acute anxiety reaction, transient paranoid feelings, exacerbation of schizophrenia

Diffuse acute brain syndrome with high doses–clouding of consciousness and memory, perceptual and sleep disorders

Amotivational syndrome

Question 11

tolerance and dependence marijuana

Answer 11

YES!, in frequent heavy users commonly reported symptoms associated with cessation of marijuana use include: Restlessness, irritability and mild agitation, sleep difficulties, decreased appetit and nausea, craving

Question 12

Therapeutic use of THC

Answer 12

Control of nausea, AIDS wasting syndrom- Dronabinol- oral THC in sesame oil

Sativex THC cannabidiol miz MS pain treatment and cancer pain

Rimonabant CB1 antagonist- weight loss
MEdical marijuana

Treatment of seizures with Dravet and LEnnox Gastuat in 2 yrs old +

Question 13

synthetic marijuana

Answer 13

K2 ro spice

legal

THC like CB1

Question 14

ketamine and phencyclidine

Answer 14

anesthetics, psychological disturbance right after coming down

rapid and complete absorption, plasma t1/2 12-24 hours for phencyclidine, shorter for ketamine, longer in overdose

hydroxylation and conjugation in liver

excretion in urine primarily as metabolites

in an overdose drug excretion can be enhanced by acidifying the urine

Question 15

pharmacology of ketamine and phencylidine

Answer 15

Autonomic and cardiovascular systm sympathomimetic: Tachycardia, Hypertension, Potentiation of catecholamines

Tolerance develops

CNS effects are complex and dose related, ketamine is less potent and has a shorter duration of action than PCP
Small doses- drunken state with numbness of extremities, moderate doses- analgesia and anesthesia, psychic state crudely resembles sensory isolation except that sensory impulses reach neocortex, cataploid motor phenomenon are observed, large doses may produce convulsions

Question 16

Ketamine and phencyclidine MOA

Answer 16

non competetitve antagonist of NMDA receptor

Cation channel (when glutamate opens it–> neuron depolarization)

learning and memory

Esketamine for nasal antidepressant

Question 17

Indoleamine and phenethylamine Hallucinogens

Answer 17

Indolamines are 5HT, essentionally LSD, Psilocin, DMT

DMT is ioasca

Phenelthylamines (MDMA, MEth, mescaline, amphetamine)

Question 18

LSD

Answer 18

less than 1% crosses BBB, onset (15-20 minutes, duration 12 hours), Sympathomimetic - tachycardia, increased BP, psychomotor stimulation

Sensory and subjective effect- Altered perception (particularly visual), Lability of mood, impaired judgment

Sensory effects thought to be due to an action at 5HT2 receptors- agonist or partial agonis
Tolerance and cross tolerance

Question 19

toxiccity of LSD

Answer 19

Acute reactions- hallucinations, anxiety, panic and depersonalization, < 24 hours, quiet environment, BDZs for sedation

Flashbacks days to years later, can be associated with drug use

Neurotoxicity- 5HT damage may be associated with phenethylamine type drugs such as MDMA

Question 20

MDMA EX

Answer 20

induces feelings of well being and connection, altered time perception

Typical oral dose 100-150 mg

Onset of action 20-40 minutes, duration 3-4 hours

psychomotor stimulation, restlessness, bruxism, anorexia, sweating, tremor

Hangover- anhedonia, neurotoxicity- serotonin neurone

Question 21

other abused substances ghb

Answer 21

GHB- essentially a metabolite of GABA and precursor, (can be made in body from GBL),
GHB- a depressant- a date rape drug, characterized by drowsiness, loss of bladder control, temproray amnesia, clonus

Question 22

toluene ethyl acetate

Answer 22

huffing glue- bone marrow depression

Question 23

legal drugs

Answer 23

opioids, fentanyl, otc dextromethophan , bath salts