Exam 2 Flashcards

Question

ADHD

Answer 1

- inattention, hyperactivity, impulsivity Treatments: amphets: Ridalin increases catecholamine activity in response to deficit Adderal: keep awake - due to catecholamine deficits

Answer 2

- decreased CNS activity - induce sleep - relaxation, exhilaration, inebriation, drowsiness, stuporous/uncoordinated - entered market to keep people calm and relaxed

Answer 3

Sedatives (anxiety reduction, low-dose prescription) | Hypnotics (sleeping pills)

Answer 4

Low doses of prescription depressants used to reduce anxiety - Xanax, Ativan (both benzodiazapenes)

Answer 5

Depressants used as sleeping pills

Answer 6

Ex: glue, paint, solvents Effects can also be similar to depressant drugs

Answer 7

1. Chloral Hydrate - Early 1900s bartender Mickey Finn would slip chloral hydrate into drinks and rob; slipping someone a "mickey" - Richardson introduced into GB in 1869 //rapidly metabolized by hypnotic agent=rapid onset

unintentional and intentional CODs (respiratory depression) 5. Meprobamate - patented in 1952, thought to be new CNS depressant - FDA approved in 1955 --> wide use - also produced same dependence 6. Methaqualone - wide search of better hypnotic (sleeping pill) - synthesized in India for sedative properties - Germany introduced it in 1962, changed status when 10-20% of people misusing and ODing - marketed in US in 1965, "ludes" "supors" qualades, by 1985 no longer available for prescription, now sched 1 7. Benzodiazepine - Librium marketed in 1960s as a more selective "antianxiety" that produced less drowsiness and OD - no dependency/OD, much safer than barbiturates - Replaced with Valium in 1970s - important difference in DOSE AND TIME COURSE OF DRUG TAKING (not chem class)

Answer 8

Duration of action - Reinforcement --> Psych Dependence - Short-acting drugs more likely to - Withdrawal --> Physical Dependence - drugs leaving body quickly more likely to Short acting = more dependency!

Answer 9

Rohypnol (GHP) - a benzodiazepine "date rape" drug - other drugs include!!!!!!!!!!!!!!!!!!!! - 1990s, illegal in US, put in drinks, Rohypnol+alc = profound intoxication (suggestibility and can't remember what happened); now changes color of drink - similar to benzo + alc effects in general - 1995 Drug-Induced Rape Prevention and Punishment Act (20 yrs in prison and give drug without person's knowledge, with intent of violent crime)

Answer 10

- Benzodiazepines have high affinity for receptors near GABA | - enhance inhibitory effects of GABA on its receptors

Answer 11

- Barbiturates act at a separate binding site nearby | - Creates a GABA-receptor COMPLEX, which includes barbiturate binding site + benzo receptor

Answer 12

- gaseous anesthetics (nitrous oxide "laughing gas") - nitrites (amyl nitrite "increase sexual pleasure) - volatile substances ("glue sniffing," paint, white-out)

Answer 13

- similar structure to GABA - CNS depressant - similar behavioral effects as alcohol - increasing use made FDA ban it as supplement - date rape --> Schedule 1 - exception: Xyrem, narcolepsy drug = schedule 3

Answer 14

- don't combine depressants with alc or opioids

Answer 15

- such strong /blind faith in drugs - drugs reduce, at best, not eliminate, symptoms - long-term effects may be more detrimental - not a panacea or "cure"

Answer 16

New drugs developed and tested by companies that profit from their approval A new drug may be approved and widely prescribed even when it produces only small effects, is less helpful than other drugs on the market, and produces more unwanted side effects than is implied in the published research

Answer 17

- most work by increasing NE or SO in synapse | - symptoms

Answer 18

- Antidepressant treat moderate to severe depression on hamilton scale

Answer 19

Model: patient appears to have set of symptoms, disease diagnosis is made, cause and cure determined once disease is known Is a mental disorder really a disease with a biological cause and cure? Or does a mental disorder merely describe a set of behaviors?

Answer 20

1. Monoamine Oxidase Inhibitors - originated with TB drugs - MAO = enzyme that breaks down DA, SO, and NE - inhibition of MAO increases NT at synapse - LIMITATIONS: toxicity and side effects have limited their use; alter normal metabolism of dietary AA, tyramine, high blood pressure will result, death/stroke can arise; also should avoid sympathomimetic drugs 2. Tricyclic Antidepressants - originated with anti-psychotic drugs - interfere with reuptake of DA, SO, and NE 3. Selective Serotonin Reuptake Inhibitors - Prozac (SSRI) - less likely to OD compared to tricyclic - more selective (less action) compared to tricyclics - now developed for SO and NE 4. Selective SO-NE Reuptake Inhibitors - more selective (less action) compared to tricyclics

Answer 21

- phobia (unreasonable fear), social anxiety, panic disorder (recurrent panic attacks), agoraphobia (public transport, open spaces, shops/theatres, lines, outside, home alone), generalized anxiety disorder (excessive worry)

Answer 22

``` - bipolar: irritable mood, inflated self-esteem, decreased sleep, more talkative, flight of ideas, distractibility, increased activity, excessive pleasurable activity //> marked impairment in functioning ``` - major depressive: for 2 weeks, 5+ - depressed mood nearly every day, diminished interest/pleasure, changes in body weight, insomnia, psychomotor agitation or retardation (incr/decr activity), fatigue, worthlessness/guilt, can't concentrate, thoughts of suicide //> significant impairment, not due to medical condition or loss of loved one

Answer 23

- delusions (irrational belief), hallucinations (voices), disorganized speech or behavior, negative symptoms (no emotion) - interferences in function, duration 6+ months

Answer 24

Electroconvulsive shock therapy - single most effective treatment for depression - 7/8 studies more effective than placebos - more rapid effect (sometimes immediate)

Answer 25

- used to treat psychosis | - French surgeon with anesthesia, made them not worried about operation --> reduces emotionality

Answer 26

- introduction of antipsychotics in 1950s started mental health revolution and increased interest in pharmacology - reduce symptoms of schizophrenia, but often produce movement disorders - less people in mental hospitals now

Answer 27

- most increase SO or NE in synapse - MAO inhibitors, tricyclics, and SSRIs have a "lag period" - 2 week wait even though drugs act in minutes - other drugs like Wellbutrin are effective through different mechanisms - the fact that drugs with a wide variety of biochemical effects have a relatively equal effect means it is possible that there does not exist a single biochemical mechanism to explain the effects of these drugs

Answer 28

In Effect: - 1851 Maine - 1851-1855: 13 states - by 1868, 9 had repealed - Nat'l Prohibition Party and Women's Christian Temperance Union (1874) started second wave in 1880s - 1880-1889: 7 states - by 1896, 4 repealed - 1907-1919: 34 states, only 2 repealed - Jan 1918: Mississippi first state to ratify 18th amendment. in 1919 Nebraska became 36th state - Jan 1920: yr after 36th state ratified it, making it official Repealed: - Association Against Prohibition (small # of America's wealthiest men) - concern: income taxes (prior gov relied on alcohol sales) - irreverence to law created sense of "lawlessness" revolt - repealed by 21st amendment in 1933 Effects: - alcohol demonized, blamed for human problems - organized crime became more organized and profitable - it did reduce overall alcohol intake, but the rates of dependence and alcohol-related deaths rose during the period, but still remained lower than before - did not reduce availability, use, or related problems - increased organized crime and expensive law enforcement

Answer 29

- some absorbed in stomach, most through small intestine - rate depends on concentration of alcohol - alc taken with/after a meal is absorbed more slowly bc protein in food retains the alc in stomach - water slows absorption and carbonated drinks speed up

Answer 30

- facial and developmental abnormalities due to alc use during pregnancy 1. growth retardation 2. abnormal features 3. CNS abnormality (neural retardation) 0.2-1.5 per 1000 births of drinking mothers 23-29 per births of problematic drinkers Consequence of overstating % - guilt, stress on baby - abortion

Answer 31

- chronic mental impairments produced by heavy alcohol use over long period of time - loss of brain tissue, global decline in intellect,

Answer 32

- Hangovers compare to symptoms of withdrawal from a short- or long-term dependence on alcohol. --> Only known cure is analgesic for headache, and rest/time. Cellular dehydration, alcohol causes fluid inside cells to move outside. Basis of an increased thirst during hangover. Alcohol is a gas irritant, irritates local mucosa lining the stomach. This is the cause of nausea and upset stomach, as well as the accumulation of acetaldehyde (toxic). drink in moderation

Answer 33

- Blackout- when person becomes intoxicated and doesn't remember certain parts of the night, or party etc - Unconsciousness- the brain shuts itself down making the person not aware of their surroundings or activity going on around them. Inability to function normally.

Answer 34

- Children of alcoholics are more likely to have alcohol problems Not entirely determined by family history Most children of alcoholics do not develop alcohol problems Twin studies Monozygotic (identical) Dizygotic ( fraternal) Almost all studies higher concordant rates for monozygotic twins range 20-50% Adoption studies Adopted son of alcoholics have a greater chance of being diagnosed with alcoholism evidence- 18% vs 5% Biological markers Males of alcoholic parents have a reduced response to alcohol Concerns with this data 90% was white males Small effects only Female data differ

Answer 35

- mostly metabolized in liver (small amount <2% excreted in breath, sweat, urine) - MAIN FACTOR: alc dehydrogenase - Alcohol dehydrogenase converts alcohol to acetaldehyde - Aldehyde dehydrogenase converts it to citric acid - metabolic rate is constant (.25-.3) regardless of BAC

Answer 36

1. Metabolizes slowly (long duration of action that cannot be controlled) 2. Dose effective of surgical anesthesia not much lower than OD levels

Answer 37

Similarities: Differences: - acetaminophine safer than aspirin (analgesic, antiparetic) Aspirin (Acetylsalicylic acid): Used in place of/More potent than Salicylic acid because Aspirin irritates the stomach lining less, thus is absorbed more rapidly. Serves as an analgesic that effectively blocks mild-moderate somatic pain, antipyretic meaning it reduces fever, and an anti-inflammatory to reduce swelling in an injured area (arthritis). However, it does increase bleeding time by inhibiting blood platelet aggregation, induced gastrointestinal bleeding in ~70% of normal subjects, Reye’s syndrome if used to treat à common cold. Acetaminophen (Tylenol and Datril): Advertised as having the most of the good points of “other pain relievers” and many fewer disadvantages. If ONLY fever reduction and analgesia are desired, acetaminophen might be safer than aspirin if dosage is carefully observed. Overuse can cause serious liver disorders, surpassed aspirin for drug-related ER visits and deaths. Ibuprofen: works similar to aspirin by inhibiting the two COX enzymes, more potent analgesic and anti-inflammatory (arthritis). Gastrointestinal side effects like nausea, cramping, and stomach pain. Fatal liver damage reported with overdose. Nonsteroidal anti-inflammatory drugs (NSAIDs).

Answer 38

- OTC analgesics: Aspirin, Acetaminophen, Ibuprofen, Naproxen, Caffeine OTC cold/flu meds: Chlorpheniramine maleate, Phenylephrine, Acetaminophen OTC sleep aids: Diphenhydramine OTC stimulants: Caffeine

Answer 39

Three elements: 1. Respect for persons Allowing for informed consent and treating people with courtesy and respect 2. Beneficence Maximize benefits of research and minimize risk to subjects “do no harm” motto 3. Justice Reasonable and non-exploitative procedures administered to subjects, cost and benefits distributed fairly

Answer 40

- needs to be pure and safe, but doesn't need to prove effective beneficial - % active ingredient doesn't need to be listed - if they can demonstrate significant/damaging risk, then can remove ex: St. John's wort, seen as natural remedy for depression

Answer 41

- The difference between Negative reinforcement and punishment is that in negative reinforcement you are increasing a behavior while a punishment you are decreasing a behavior. Ex neg reinforcement : Bob does the dishes (behavior) to avoid his mothers nagging(aversive stimulus) Ex: punishment: Bobs mom takes away video games because he is being a brat.

Answer 42

Fixed v. variable Ratio (#) v. interval (time) - variable ratio more likely to produce a lot of behavior (operant conditioning) - Antecedents (events that set occasion) Behavior Consequence Ex. rat sees a light (antecedent), so it pulls a lever (behavior), and it is administered cocaine (consequence)

Answer 43

- Ex. Alcohol Studies (peers + environment + expectations of effects) Antidepressants (Placebo effect)

Answer 44

- Crack was steeped in a narrative of race and pathology. Problems related to crack were described as being prevalent in “poor”, “urban”, or “troubled neighborhoods”, “inner cities” and “ghettos” were codes for Blacks and other undesired people. In 1986, Congress passed the infamous Anti-Drug Abuse Act, setting penalties that were 100 times harsher for crack than for powder cocaine convictions. 85% of those sentenced for crack cocaine offenses were Black, even though the majority of users of the drug were, and are, White.

Answer 45

- Amphetamines increase the activity of monoamine neurotransmitters (dopamine, norepinephrine, and serotonin) by augmenting the activity of these neurotransmitters by stimulating release rather than by inhibiting reuptake like cocaine.

Answer 46

- It has been reported that one effect of methamphetamine is the restriction of salivary flow, which could lead to dryness of the mouth. Dryness of the mouth can increase tooth decay and plaque formation. However, dryness of the mouth is a common side effect of many medications and no dental study has been performed directly linking methamphetamine use to dental problems. Thus the myth of “meth mouth” has less to do with the direct pharmacological effects of methamphetamine and more to do with the non pharmacological factors, ranging from poor dental hygiene to media sensationalism.

Answer 47

``` Aspirin Analgesic effects Antipyretic effects Anti-inflammatory effects Acetaminophen Analgesic effects Antipyretic effects Ibuprofen Analgesic effects Anti-inflammatory effects ```

Answer 48

``` - Benefits of alcohol consumption Moderate alcohol consumption associated with in Lowers risk of Coronary heart disease Hearts attacks Ischemic strokes Risk for depression Better cognition Better well being Fewer depressive symptoms ```

Answer 49

- (This from notes please add on to it) Alcohol outcome expectancies Double placebo studies (bold=what they were told, regular text= what they actually had) alcohol=alcohol, alcohol=no alcohol, no alcohol=alcohol, no alcohol= no alcohol If I drink, then I will Positive and negative expectancies Peer expectancies Different from peer pressure Expectation to act a certain way when drunk Drink to get drunk Overestimated the amount and frequency of peer drinking Peer permission Permission (lack of discouragement) for bad behavior when drunk Allow peers to act a certain way cause they are drinking (may not be socially acceptable)

Answer 50

The monoamine theory of depression is based off the idea of excess or depletion of monoamines in the brain. Antidepressants-increase activity of monoamines Serepines- depletes activity of monoamines Popularized Easy way to describe behavior that we dont understand Hope for future medical cures/ treatments Explains inability to correct behavior Concerns No direct evidences of monoamines (excess or depletion) in MDD Antidepressant treatment requires to weeks for benefits/clinical improvements of treatment to be seen small portion of people get better from treatment (20%) New theories like Glutemate neuroplasticity theory comes about due to uncertainty Stressed induced brain hyper-cortisolemia is the new monoamine deficency “Provides most promising framework”

Answer 51

6 people studied (previous history of cocaine smoking) Wanted to test whether or not different reinforcers modified self administration of cocaine Did this by have 8 sessions where cocaine was offered as well as an alternative which was a money voucher Results non significant But cocaine users did self administer more with higher dosage Huge drop in usage as well when money increased Money vouchers are more of an reinforcer than cocaine with cocaine abusers

Answer 52

- Similarities: same drug molecule in the body, same behavioral effects Differences: Crack: doesn’t have HCl group, 100x harsher penalties under Anti-Drug Abuse act of 1986, 18x harsher penalties under Fair Sentencing Act, associated with “despised groups” throughout American history Powder: has HCl group associated with it, less strict penalties for possession of much larger amounts than crack

Answer 53

Relationship between them | If and why the drugs are used medically and something about their chemical structures

Answer 54

- Methamphetamine & Amphetamines Sequestered dopamine in vesicles, amphetamines trick these vesicles into packaging them and disrupt these vesicles and then leaks out Causes release of neurotransmitters while (crack blocks reuptake) Dopamine and norepinephrine more active on receptors Causes reverse of transport Comparison to cocaine Amphetamines increases the amount of dopamine Reverse transport and trick vesicles of sequestering dopamine Crack blocks dopamine receptors (also increases dopamine but amphetamines does it to a larger extent) Similar Increase HR, BP Increase euphoria Increase alertness Different Amphetamines have longer duration’ Longer ½ life (12hrs) Effects last longer

Answer 55

``` - Please explain what is meant by the term “crack baby,” when the phenomenon first appeared, and the evidence supporting (or against) this notion ```

Answer 56

- Most effective at treating severe (>23 HAM-D) depression Moderate effects on moderate-severe depression Placebo effects - 40% effectiveness in placebo group - 50% effectiveness in antidepressant group - Only a 10% increase attributed to drug (moderate-severe only) - Mild-mod: no difference

Answer 57

Early 1990s: aggressive supplement marketing worried FDA, in 93 FDA approved 7 health claims for use, document of dietary supplement hazards - concerned that supplements would become prescriptioned, pressured Congress to limit FDA 1. Redefined dietary supplements to include a variety of substances such as herbs, amino acids, and extracts of herbs (before had only allowed items deemed "essential nutrients" -vitamins and minerals- to be sold) 2. The safety guidelines altered. FDA could declare product adulterated only if it presents significant or unreasonable risk of illness or injury - anything at time assumed to be fine, new must prove 3. Products cannot claim cure, but can claim they have beneficial effect - don't have to approve but do have to have supporting evidence that not misleading - has to be CLEARLY FALSE AND MISLEADING 4. Products must include disclaimer - "not approved by FDA" - not intended to treat/cure any disease RESULT: - manufacturers free to market wide variety of products with little regulation - industry boomed, expanding from $3.5B in 1992 to $24.7 billion in 2007 - ephedra (weight loss supplement), baseball player Steven Bechler died 10 yrs later, banned by FDA - burden of proof too strong on FDA **Change! 6. FDA now has right to establish "good manufacturing practices" that require makers to ensure products have correct ingredients and not adulterated; FDA then spot checks to make sure in place - harder for small companies 7. Adverse events reporting - for customers to call in manufacturer Mcain - ds safety act - report ingredients - withdrew after month

Answer 58

- MAOIs: Iproniazid; prevents breakdown of monoamine neurotransmitters Tricyclics: he didn’t give any examples; interferes with the reuptake of monoamine neurotransmitters (from google: an example is doxepin) Tofranil (Imipramine) SSRI: prozac; prevents reuptake of serotonin into the pre-synaptic neuron SNRI: cymbalta; prevents reuptake of norepinephrine and serotonin into the pre-synaptic neuron

Answer 59

- required that all OTC drugs be monitored for safety and efficacy

Answer 60

- anesthetics: reduces all sensation or blocks consciousness local anesthetics (dentist) general anesthetics (general) - analgesics: selectively reduce pain opioids OTCs (aspirin, acetaminophen, ibuprofen)

Answer 61

- Hoffman's father had RA, needed solution for gastric issues + nausea of other meds - aspirin is converted to salicylic acid in bloodstream in gastro track or bloodstream - more potent bc irritates stomach less so absorbed more quickly USES: 1. Algesic: mild-moderate pain blocker 2. Antipyretic: reduces fever 3. Anti-inflammatory: reduces swelling, inflam, soreness Algesic uses: does not affect pain anticipation, just ability to withstand continuing pain - especially effective against headache Antipyretic use: acts on temp area of hypothalamus to increase heat loss (vasodilation of periph blood vessels, + sweating) Main use: anti-inflammatory Adverse reactions ==> bleeding works by inhibiting COX enzymes

Answer 62

Analgesic and antipyretic - tylenol and datril popularized this in 70s - overuse: liver disorders

Answer 63

Analgesic and anti-inflammatory - developed as a more potent analgesic - used for arthritis too - side effect: nausea, gastric issues

Answer 64

- Hypnotics = stronger sedatives - Hypnotics tend to use larger dose (larger dose, comes on fast, wears of quickly ~~shorter half-life), sedatives smaller (lower dose, comes on slower, wears off longer ~~longer half-life)

Exam 2 Flashcards

(90 cards)