Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

PHRM 845 Module #1 > Lecture 74 - Pathophysiology of Substance Use Disorder > Flashcards

Lecture 74 - Pathophysiology of Substance Use Disorder Flashcards

1
Q

Stimulants

A

Cocaine
Amphetamine
Meth
Bath salts
Ecstasy
Nicotine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Depressants

A

Opioids
Alcohol
Cannabis
GHB
Inhalants

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Psychedelics

A

LSD
Psilocybin
PCP
Mescaline
Ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

CONTROLLED SUBSTANCE ACT - DRUG CLASSIFICATION

A

Schedule I-V

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Schedule I

A

No medical use, high abuse potential. Safety not guaranteed
Heroin, Marijuana, THC, LSD, GHB, psilocybin, MDMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Schedule II

A

Medical use, high abuse potential, large risk of dependence
Morphine, fentanyl, cocaine, ritalin, PCP, barbiturates, oxycodone, hydropmorphone, Vicodin (hydrocodone+tylenol) , Percocet (oxycodone +tylenol), nabilone (synthetic cannabinoid)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Schedule III

A

Medical use, moderate abuse and dependence Ketamine, buprenorphine, Marinol (THC in oil capsule)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Schedule IV

A

Medical use, low abuse and dependence Benzodiazepine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

Schedule V

A

lower risk relative to IV
Cough suppressants with small amount of codeine; Lomotil (antidiarrheal opioid with atropine)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

“SEMI LEGAL” HIGHS – ON THE BORDER OF LEGALITY

A

Some are legal: Fuel, glue
Some were legal: Spice, K2 (synthetic THC mimics), Bath salts, Banned, updated by DEA
- Case by case, Blanket ruling
Some are still legal: New designer drugs - “Not for consumption”, Until DEA catches up
Some are illegal: But hard to enforce - Mushrooms

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

SUBSTANCES OF ABUSE THAT ACT DIRECTLY ON G PROTEIN-COUPLED RECEPTORS

A

Opioids (heroin, prescription meds): Opioid receptors (mu)
LSD, Mushrooms (psilocybin, psilocin): Serotonin receptor (5-HT2A, 5-HT2C)
Marijuana, K2, spice: Cannabinoid receptors (CB1)
Gamma Hydroxy Butyric acid: GABAB
Caffeine: Adenosine receptors

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

SUBSTANCES OF ABUSE THAT ACT INDIRECTLY ON G PROTEIN-COUPLED RECEPTORS

A

Cocaine, amphetamine: Dopamine transporter (dopamine receptors); Noradrenaline, serotonin transporters; Release dopamine, noradrenaline, serotonin -> GPCRs
MDMA/Ecstasy: Monamine transporters
- dopamine, serotonin
Alcohol: GABA channels, 5HT3, NMDAR, nAchR, KiR3; Causes release of endogenous opioids -> GPCRs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

SUBSTANCES OF ABUSE THAT ACT ON ION CHANNELS

A

Nicotine: Ionotropic acetylcholine receptors (Na+), agonist
PCP, ketamine: Ionotropic NMDA receptor (Ca2+, Na+ - K+), Antagonist
Benzodiazepines, barbiturates: Ionotropic GABAA receptors (Cl-); positive allosteric modulators

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Frontal cortex

A

decision making, impulsivity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Striatum

A

reward/value

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Nucleus accumbens

A

pleasure, valuation

17
Q

VTA

A

source of dopamine

18
Q

Hippocampus

A

memory, learning

19
Q

STIMULANTS, DEPRESSANTS AND PSYCHEDELICS ALL ACT ON THE

A

mesolimbic system

20
Q

THE DOPAMINE HYPOTHESIS OF ADDICTION

A

“Pleasurable events” release dopamine
Parkinson patients only develop addiction during treatment
Dopamine important for assigning value to reward prediction error: Value provides the drug with an incentive salience; Salience = state or quality of an item that stands out relative to neighboring items

21
Q

LIMITS OF DOPAMINE HYPOTHESIS

A

Dopamine not required for reward learning: Dissociation between liking (direct effect)
and wanting (motivation) - “You don’t always like what you want”
Tolerance to pleasurable effect (↓ liking), enhanced craving
Dopamine does not encode liking, but involved in making reward predictions and learning from
the outcome/error

22
Q

THE GLUTAMATE HYPOTHESIS OF ADDICTION

A

Glutamate can increase dopamine activity in NAcc: Glutamate projection to VTA; Destruction of this pathway reduces cocaine/morphine reward; NMDA antagonist blocks acquisition of reinforcement learning; Intra NAcc AMPA injection causes relapse
Dopamine controls glutamate activity in amygdala

23
Q

DRUG USE INDUCES LONG TERM CHANGES IN NEURONAL PLASTICITY

A

Rewarding substances cause relative increase in glutamatergic AMPA receptors

24
Q

Drug abuse

A

The use of a drug for a nontherapeutic effect

25
Q

Drug misuse

A

Inappropriate, illegal, or excessive use of a prescription or nonprescription drug: Taking more/more frequent then prescribed; Taking it for different indication; Taking someone else’s medication

26
Q

SUBSTANCE USE DISORDER CRITERIA

A

Previously substance abuse and substance dependence
Mild (2-3), moderate (4-5) or severe (>6): taking substance in larger amounts for for longer; unable to stop; preoccupied; cravings; distracted; problems in relationships; giving up; put yourself in danger; against better judgement; tolerance; withdrawal

27
Q

PHYSICAL VERSUS PSYCHOLOGICAL DEPENDENCE

A

Physical dependence: Body needs more drug – tolerance - Cellular adaptations upon repeated activation of receptors; Body withdraws without the drug
Psychological dependence (≈addiction): Mental urge to take drug to function; Compulsive need/craving; Even in absence of withdrawal

28
Q

TYPES OF WITHDRAWAL SYMPTOMS

A

emotional
physical
dangerous

29
Q

Emotional Withdrawal Symptoms

A

Anxiety, depression
Restlessness, insomnia
Irritability
Headaches
Poor concentration

30
Q

Physical Withdrawal Symptoms

A

Sweating
Racing heart
Goose bumps = Cold turkey
Muscle spasms = kicking the habit
Tremors
Nausea, vomiting, diarrhea

31
Q

Dangerous Withdrawal Symptoms

A

Alcohol and tranquilizers
Grand mal seizures (also tramadol)
Heart attacks, Strokes
Hallucinations, Delirium tremens (DTs)

32
Q

DRUG REWARD AND ITS RELATION TO POSITIVE AND NEGATIVE REINFORCEMENT

A

Drug is “rewarding” or produces positive reinforcement when the user feels pleasure/satisfaction: Of value, strengthen behavior to repeat; Just liking isn’t enough
Negative reinforcement: reward by escaping negative/painful stimulus or event (NOT same as punishment)

33
Q

WHAT ARE RISKS OF DRUG BINGES AND MULTI DRUG USE

A

Use depressant together with stimulant to numb the crash of stimulant: Speedball (heroin + cocaine)
Risk of overdose (not aware of some signs): More difficult to treat overdose

34
Q

PHYSIOLOGICAL RESPONSES THAT MAY LEAD TO FATAL OVERDOSE

A

Respiratory depression: opioids, alcohol
Cardiac arrhythmias, Brain hemorrhage, stroke: Stimulants
Fatal seizures: Choke on own vomit, Also risk during withdrawal

PHRM 845 Module #1 (50 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions