Drugs of Abuse, Tolerance and Dependence Flashcards
(52 cards)
Differentiate mild from severe substance abuse
Mild: 2-3 symptoms
Severe: 5+ symptoms
Which pathway is activated by all drugs of dependence? What is the end results of activation?
VTA-nucleus accumbens pathway —> dopamine release
VTA= ventral tegmental area
What is responsible for the inhibition of dopamine release from the ventral tegmental area?
GABA-ergic inhibitory interneurons.
Drugs that affect these interneurons can cause dependence
What is cocaine’s MOA?
Cocaine inhibits the dopamine reuptake transporter –> increased dopamine in synaptic cleft
What is the MOA of amphetamines?
Amphetamines inhibits the vesicular monoamine transporter responsible for packing dopamine into the secretory vesicles –> increased dopamine in pre-synaptic clefts –> leakage of dopamine into presynaptic cleft
What aspects of cocaine are altered by route of administration?
Onset, magnitude and duration depend on the route of administration
Users prefer IV administration –> surge
Where is cocaine metabolized?
Liver- by cholinesterases.
Inactive metabolite is detectable in urine for up to 8 days
What is the problem of mixing cocaine and ethanol?
Cocaine in the presence of ethanol is transesterified resulting in cocaethylene, which produces more euphoria and has a longer duration of action.
It is more cardiotoxic than cocaine alone
People who take cocaine are at a higher risk for developing what type diseases?
Autoimmune diseases or connective tissue diseases such as lupus, Goodpasture’s syndrome, SJS
What is the deadly symptom of cocaine?
Cardiac arrhythmias
Name two drugs that may be used for the treatment of acute withdrawal from cocaine
Bromocriptine
Benzodiazepines (mostly lorazepam because it’s less toxic to the liver)
What are the treatment strategies for long term addiction?
No FDA approved pharmacological therapies
Cognitive-Behavioral Therapies- functional analysis and coping skills
Name the 4 most common opiods
Heroin
Morphine
Codeine
Oxycodone
What is the general MOA of opioids?
They cause inhibition of mesolimbic dopamine by acting on mu receptors located on GABAergic interneurons
Do tolerance and dependence occur with heroin use?
Yes, both –> increased in quantities taking
What are the dangerous symptoms associated with heroin overdose?
Respiratory depression and pulmonary edema
Describe the “cross-tolerance” phenomenon of opioids
Development of tolerance to one opioid leads to tolerance of other opioids
Why does heroin last longer than morphine?
Heroin is metabolized to 6-monoacetylmorphine, which is then metabolized further to morphine.
Double the trouble, double the fun.
Is heroin withdrawal life-threatening?
No, although it is profoundly painful
How soon will heroin withdrawal symptoms set in?
12 hours after last dose.
Last between 5-7 days, although some effects can linger
Name 5 withdrawal symptoms specific to opioids
Lacrimation Rhinorrhea Yawning Piloerection/gooseflesh Involuntary movement (kicking the habit!)
What is the treatment for opioid overdose?
Naloxone- mu receptor antagonist
What drug is used for the treatment of opioid addiction/dependence?
Naltrexone- mu opioid receptor antagonist
Name two drugs used for the treatment of opioid withdrawal symptoms/maintenance
Methadone- mu receptor opioid agonist
Buprenorphine- partial mu receptor opioid agonist
