Lecture 35 - Emerging treatments for drug dependence: preclinical evaluation Flashcards Preview

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Flashcards in Lecture 35 - Emerging treatments for drug dependence: preclinical evaluation Deck (24):
1

What was the 2010 cost of drug and alcohol abuse to austrlia?

$56 billion

2

What is a good working definition of addiction?

a chronic relapsing disorder which consists of a compulsive pattern of drug seeking and drug taking behaviour

takes lace at the expense of other activities

persists despite adverse consequence

3

What parts of the brain are important in stress induced relapse?

Extended amygdala - central amygdala nucleus

4

What parts of the brain are important in Que (seeing a picture of beer) induced relapse?

basolateral amygdala

5

What is the common pathway for que and stress induced relapse?

pre-frontal cortex -> nucleus accumbens core -> ventral pallidum

6

What kind of disorder is alcoholism and what are the factors ?

polymodal disorder - multiple causes

Gnenetic factors - still awaiting definitive marker gene

Environmental factors - peer pressure to self-medication of underlying psychological disturbance

Diagnosis is critical for selection of appropriate therapy

7

What are most alcoholism patientsbeing presscribed?

antidepressants - not to alleviate depression, but an attempt to reduce the abberant alcohol use

8

What are the problems with Disulfiram

ALDH inhibitor - needs high motivation and compliance - significant adverse side effects

9

what is Baclofen?

GABAb agonist - used in initial withdrawal period

ongoing trials

10

Are antidepressants, Benzodiazepines useful clinically?

no

11

what is the problem with Naltrexone?

non-selective opioid receptor antagonist - tolerance an issue

12

CRF1 receptor antagonists are...

under development

13

Explain naltrexone

may have a clinically meaningful effect for alcohol - dependent patients with a high chance of consistent drinking

trials have had abstinence as end points - not realistic

14

How can you model drug seeking behavior?

Self-administration
- continual access
-restricted access
operant responding
(does the drug stop people taking the drug when its available)


conditioned place preference

extinction (suddenly doesn't get the drug) / reinstatement (make the drug available) - "relapse"

sensitisation

withdrawal syndrome

15

What does naltrexone do clinically?

reduces responding for ethanol in primates and rodents

16

The Orexin-containing neurons are activated during...

cue-induced reinstatement to alcohol-seeking

17

What does CRF receptor antagonism stop?

the enhanced responding for alcohol observed in withdrawing dependent rats - ineffective in non-dependent rats3

18

What are the emerging treatments for smoking addiction?

Nicotine replacement

Bupropion - amine uptake inhibitor

modafinil - amine uptake inhibitor

Mementine - partial NMDA R antagonist

Varenicline - partial agonist at nicotinic Rs

Vaccine

19

What are the emerging treatments for smoking addiction and have any been approved?

none have been approved

selegeline - MAO inhibitor

Venlafaxine - SNRI

20

What are the emerging treatments for cocaine addiction and have any been approved?

none have been approved

Modafinil

Topiramate

antidepressants are often used

21

What are the emerging treatments for opiates addiction and have any been approved?

yes

methadone

heroin prescription

Buprenorphine

22

What 3 things should effective therapeutic be?

safe, well-tolerated and efficacious

combination with Cognitive behavioral therapy and other behavioural strategies

23

What are the major issues with addiction-medication?

non-compliance

co-morbidity

24

Episodic Rx for ____ ______ may possibly provide wider windows of opportunity for Rx

.relapse prevention