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PHAR 100 > Module 2 - PHAR 100 > Flashcards

Module 2 - PHAR 100 Flashcards

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1
Q

How many criteria must a person meet to be defined as having a mild SUD?

A

2

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2
Q

What are the different criteria for SUD? WRIST

A

Withdrawal - experience withdrawal syndrome after stopping

Risky Use - may use substance in physically hazardous situations or despite physiological problems caused by use

Impaired Control - persistent craving for it

Social Impairments - fail to fulfill major roles (ex. work, school, home) and/or has persistent social/interpersonal problems. In addition, social, occupational, or recreational activities may be given up/reduced.

Tolerance - may develop tolerance to the substance

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3
Q

What is addiction? What can it occur to?

A
  • Emotional and mental preoccupation with drug’s effects
  • Persistent craving regardless of consequences
  • Stopping or abrupt reduction of dose produces non-physical symptoms
  • Addiction can occur to other stimuli (ex. gambling)
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4
Q

What’s the dopamine hypothesis?

A

Explains addiction.

Suggests commonly misused drugs increase dopamine in reward systems of brain. Drugs cause exaggerated increase in dopamine, altering communication in brain.

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5
Q

What are dopaminergic systems also responsible for?

A

Natural rewards (ex. food and sex) and stimulus-related rewards (ex. video games and gambling)

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6
Q

What are three categories of addictive drugs?

A

Increase Dopamine (CNS stimulants, opioids, alcohol, cannabis)
Produce Novelty (LSD, ecstasy)
Reduce Anxiety (CNS depressants like barbiturates and benzodiazepines)

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7
Q

What is drug withdrawal?

A

Abnormal physiological state produced by repeated administration of a drug that leads to the appearance of a withdrawal syndrome when drug administration is discontinued or dose is decreased. Severity of withdrawal syndrome increases with speed of drug withdrawal, as biological processes that have accommodated to presence of drug do not have time to reverse themselves.

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8
Q

What is one factor that contributes to the continuing of the drug-taking behaviour?

A

Fear of withdrawal

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9
Q

What are common withdrawal syndrome of stimulants (cocaine and amphetamines)?

A

Sleepiness
Muscle pain
Anxiety
Tremors
Low mood
Suicidal ideations
CV problems

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10
Q

What are withdrawal symptoms of opioids?

A

Sweating
Muscle Aches
Agitation
Diarrhea
Abdominal Cramping
Vomiting

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11
Q

Withdrawal symptoms of drugs are usually… to the effects of the drug

A

opposite

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12
Q

Drug tolerance is usually expressed as a (2)

A

Shortened duration of action
Decreased magnitude of effect

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13
Q

True or false: Tolerance develops to all drugs and all aspects of drug action.

A

False

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14
Q

What is cross tolerance? What can it occur between?

A

Defined as resistance or tolerance to one drug because of resistance or tolerance to another pharmacologically similar one.

Can occur between pharmacologically similar drugs.

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15
Q

What are factors that influence SUD?

Get pretty every…

A

Genetic Factors
Pre-Existing Disorders
Environmental Factors (ex. family dynamics)
Developmental factors (adolescence are age groups primarily associated with initiation of SUD, smoking usually begins before age 18, 80% of those with alcohol use disorder begin problematic use before age 30, illicit drug use begins between 15 and 18 years old)

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16
Q

People with SUD have been… not only by society in general but also by medical professionals. Can lead to isolation and low self esteem.

A

Stigmatized

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17
Q

What is harm reduction?

A

Approach that seeks to reduce/prevent negative consequences of substance use and improve health without judgement, coersion, or discrimination, and without requiring person to stop using substance.

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18
Q

What are the two types of goals for harm reduction?

A

Health Harms –> decrease morbidity (transmission of blood borne diseases like HIV/AIDS, hepatitis infections such as skin and heart infections and mortality from overdoses and secondary to associated morbidity)
Societal Harms –> decrease lost productivity, apprehension of children, criminal activity

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19
Q

Can SUD occur with prescription meds?

A

Yes

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20
Q

What is misuse?

A

Using drugs in ways or amounts other than what is prescribed or against social norms.

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21
Q

Is withdrawal and tolerance enough for someone with prescription to have SUD?

A

No

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22
Q

What are the five factors that contribute to misuse potential?

A

Nature of Drug (ex. natural reinforcement)
Route of Administration
Amount/Frequency of Use
Availability
Inherent Harmfulness

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23
Q

What drug class has tolerance and addiction but no withdrawal?

A

Hallucinogens

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24
Q

Amphetamines are … substances in Canada

A

controlled

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25
What are three drugs in amphetamine drug class?
Amphetamine Dextroamphetamine Methamphetamine
26
What are two amphetamine related compounds? What are they used for? What is the second known for that is bad?
Methylphenidate (Ritalin) - treats ADHD MDMA (ecstasy) - derivative of methamphetamine - fosters feeling of intimacy and empathy, while improving intellectual capacities. Neurotoxic - causing neuronal damage or death (long lasting or permanent)
27
Amphetamines are ... organic compounds. Structurally similar to the endogenous NT, ... and ...
synthetic norepinephrine dopamine
28
True or False: Amphetamines can be synthesized readily.
True
29
Purity of amphetamines (illicit substances) is ... and may contain side products of the chemical reaction, unreacted chemicals, and "cutting" or filler agents (ex. starch, baking soda) which can be dangerous.
variable
30
What are the four main CNS effects of amphetamines?
Decreased threshold for transmitting sensory input to cerebral cortex leading to CNS excitation. Feeling of euphoria and reward Temperature regulation and feeding centre modifications leading to appetite suppression. Increase in aggressive behaviour and mood swings.
31
What are short term effects of amphetamine on non CNS tissues?
Chest pain or heart attack Cardiovascular collapse Increased respiratory rate Overdose: seizure, high fever, stroke
32
What are effects of long-term use of amphetamines?
Chronic sleeping problems Poor appetite Anxiety, repetitive behaviour, psychoses, aggressive behaviour Elevated blood pressure and abnormal cardiac rhythm
33
Other drugs may be sought concurrently with amphetamines in an attempt to ... various toxic effects of the amphetamines.
antagonize
34
What are two therapeutic uses for amphetamine like drugs?
Narcolepsy ADHD - calm hyperactivity and improve attention/control, enhancing task completion and scholastic performance
35
What is the misuse potential for amphetamines (3)?
- Extremely high as amphetamine and methamphetamine produce powerful euphoria - water soluble forms of drugs allow them to be readily injected - long term inherent harmfulness, but does not deter use
36
Does tolerance develop to mood elevating effects, euphoria, anorectic effects, cardiovascular and respiratory effects of amphetamines?
Yes
37
Does tolerance develop to the therapeutic effects or drug-induced psychosis of amphetamines?
No
38
What is the mechanism of action for amphetamines?
Increase dopamine or norepinephrine in synaptic cleft. Block reuptake of dopamine via dopamine transporter. Block VMAT, which packages dopamine - more free dopamine in neuron, forces it out, increases CNS excitation
39
What is used to treat Narcolepsy and ADHD? Why?
Ritalin - decreased incidence of CV and appetite suppressing effects.
40
Does tolerance develop to the therapeutic or drug-induced psychosis of amphetamines?
No
41
What are withdrawal symptoms amphetamines?
Prolonged sleep, huge appetite, lack of energy, fatigue
42
Describe addiction of amphetamines.
Amphetamines are usually self-administered to produce euphoria and an abrupt awakening sensation (“rush”). These effects act as rewards and those who take the drug will crave the drug’s effects so intensely that if it is not available they will experience panic.
43
What is cocaine classified as (2)? What about in terms of the law?
Local anesthetic and CNS stimulant Narcotic
44
What are the two main differences between cocaine and amphetamines?
Cocaine has a shorter duration of action (<1hr) compared to 12 hours with amphetamines Cocaine is commonly smoked or sniffed, amphetamines are commonly administered intravenously
45
Cocaine causes generalized CNS stimulation in a ... manner (more cocaine = more CNS stimulation)
dose dependent
46
What is the mechanism of action of cocaine?
Inhibits re-uptake of dopamine and serotonin into presynaptic neuron, increasing concentration of these NT in synaptic cleft, and increases activation of postsynaptic neuron's receptors.
47
What is a therapeutic use of cocaine?
Local anesthetic for mouth and throat. Rarely used since better local anesthetics have been developed with similar chemical structures, but do not have the associated potential for misuse and SUD.
48
What are the effects of long-term cocaine use?
Toxic psychosis (including paranoia) Hallucinations or sensations of insects crawling under skin Impaired sexual function Permanent brain damage and impairment of neuronal function High blood pressure and irregular heart rhythm Changes to nasal mucosa
49
What is the misuse potential for cocaine?
Extremely high
50
Why does cocaine have a high misuse potential?
Powerful euphoria rapidly caused by injecting drug or smoking the freebase.
51
Does inherent harmfulness deter cocaine use?
No
52
Does tolerance develop toward mood-elevating effects of cocaine?
Yes
53
Does tolerance develop towards hallucinatory and behavioural effects of cocaine compared to amphetamines?
Not as readily
54
Does tolerance develop towards drug-induced psychotic effects of amphetamines?
No
55
What are short term effects of cocaine?
Same as amphetamines
56
What are two commonly used stimulant drugs?
Nicotine and caffeine
57
Nicotine is a naturally-occuring substance found in ...
tobacco
58
Describe absorption of nicotine. How big are particles? Are they rapidly absorbed? Where are they absorbed (apart from lungs) (3)?
- small particles, when inhaled rapidly absorbed - absorbed from GI tract, oral mucosa, across skin
59
How do smokers control dose of nicotine absorbed?
- Depth of inhalation - Frequency of smoking
60
Nicotine is distributed... the body and ... gains access to the ...
throughout, rapidly, brain
61
Nicotine is ... metabolized in the ...
rapidly, liver
62
Where are metabolites of nicotine excreted? What's the half life of nicotine?
Urine 2 Hours
63
What is the mechanism of action of nicotine? What receptors does it stimulate? What does activation of those receptors do? What does large doses do?
- stimulates nicotinic receptors at synapses like acetylcholine - increases psychomotor activity, cognitive function, attention, memory - large doses: cause agitation, tremors, seizures
64
The mechanism of action of ecstasy is similar to amphetamines, but has preferential effect on ... containing neurons.
serotonin
65
What neurotransmitters does nicotine release?
Dopamine and serotonin
66
What percent of males and females smoke in 2022?
12%
67
What is therapeutic use of nicotine?
Smoking cessation programs - administered in form of chewing gum, transdermal patches, or buccal spray - allows one to maintain blood nicotine levels and satisfy craving for a cigarette, allowing for tapering of the nicotine dose
68
What are short-term effects of nicotine?
Mild euphoria, enhanced arousal, increased ability to concentrate, sense of relaxation, small increase in heart rate and blood pressure, may suppress appetite
69
What are short-term effects of nicotine in non-smoker?
Dizziness, headache, nausea, vomiting, abdominal cramps, coughing, gagging
70
Long term effects of smoking (3) main? Are these caused by nicotine or combustion? What are types of the last one (4)?
- NICOTINE causes cardiovascular disease (atherosclerosis, thrombi). Carbon monoxide reduces the capacity of red blood cells to carry oxygen - COMBUSTION causes lung disease - smoker's syndrome (difficulty breathing, wheezing, chest pain), emphysema, chronic obstructive lung disease - COMBUSTION causes cancer: 30% of cancers - lung, oral cavity and throat, bladder, uterus
71
Is exposure to passive smoke harmful? What about in children?
Yes - increased risk of CV disease & cancer Passive smoke increases risk of bronchitis, pneumonia, asthma, SIDS
72
What are the effects of smoking on pregnancy?
2-3 times more likely to be small for gestational age, or preterm, low birth weight (decreased oxygen delivery). Effects reversed if person stops smoking early in pregnancy.
73
What is the nicotine misuse potential?
High
74
True or false: cessation of smoking often fails.
True. Craving of nicotine is so great. Requires counselling and pharmacological support.
75
Describe Tolerance, Withdrawal, Addiction of nicotine.
Tolerance - keep nicotine blood levels at certain range (30-40 ng/mL), number of cigarettes per day keeps at this level Withdrawal - irritability, restlessness, anxiety, insomnia, fatigue, inability to concentrate Addiction - does occur, extreme urge to smoke
76
Does tolerance develop nicotine?
No
77
What is caffeine found in?
Tea, coffee, chocolate, cola drinks, stimulants, analgesics, diuretics about 200mg in cup of coffee and 300mg in energy drink
78
What is lethal dose for caffiene?
10g
79
What is ADME of caffeine? Half life?
Absorption - rapidly and completely absorbed. Significant after 30 min, peak after 2 hours of ingestion. Distribution - freely crosses placenta and brain Metabolism - genetics determine this. Elimination - half life between 2.5 - 10 hours
80
What is the mechanism of action for caffeine?
Without caffeine - adenosine receptors activated, stimulating GABAergic neurons that inhibit dopamine release With caffeine - competitively blocking adenosine receptors, neurons released from adenosine inhibition, decreasing GABA activation and increasing dopamine release --> stimulation
81
What are short term effects of caffeine? (3)
CNS - mild mood elevation and reduce fatigue. For people that don't take caffeine, can cause nervousness, irritability, rambling flow of thoughts CV - produces constriction of cerebral blood vessels (headache), increases peripheral blood flow, stimulates cardiac muscle -> irregular heart beat Respiration - relax bronchial smooth muscle - stimulate breathing in preterm newborns (remember how to breathe)
82
What are the long term effects of caffeine?
Nervousness, restlessness, insomnia, increased urinary output, gastric upset, rambling thought and speech
83
What happens with caffeine and smoking?
- cigarette smoke increases metabolism of caffeine - smokers - duration of action of caffeine shortened - when they quit, metabolism of caffeine returns to normal
84
Impact of caffeine on pregnancy? Moderate doses vs large?
Moderate (3 cups) - no impact Large doses (12 cups per day) increases risk of stillbirth, decreases fetal growth rate, increases chance of miscarriage.
85
Is metabolism of caffeine slower or faster in pregnant?
Slower, don't feel good (2x longer)
86
What is the misuse and SUD potential for caffeine?
Low - mild reinforcer, mild adverse effects
87
What is the potential for SUD for caffeine? Tolerance, withdrawal, addiction?
Tolerance - does develop Withdrawal - yes Addiction - mild can occur
88
What are amphetamines used for in sports?
Endurance & Speed - Feeling of power, reduced fatigue, increased aggression, increased responsiveness, increases heart rate and blood pressure. 40% extended duration for bikers 14/15 swimmers faster and 73% runners improve times Appetite suppression - helpful for weight loss Mask pain and fatigue
89
Large doses of amphetamines can lead to... increases in blood pressure, or a "crash"
Fatal
90
What are anabolic steroids used for?
Increase muscle mass
91
How are synthetic anabolic steroids different from natural (testosterone)?
Synthetic - reduced androgenic (body hair, deep voice) effects but maintain anabolic
92
What are the three mechanisms of action for anabolic steroids?
Anti-Catabolic - does not breakdown proteins to fuel training Anabolic - protein production (with protein supplementation) Motivation - roid rage
93
Anabolic steroids have greater effects in individuals with ... basal circulating levels.
Low
94
What do low doses of anabolic steroids do?
Have modest effects on average adult - effect in inexperienced weightlifters is less than a good exercise program
95
What do large doses of anabolic steroids do?
For athlete at peak training, causes significant increase in lean body mass, body weight, strength. Aggressive behaviour contributes to performance enhancing effects.
96
What are bad effects of anabolic steroids?
Mood swings, severe acne, CV disease (increase LDL, decrease HDL), altered liver function (hepatitis, liver failure, liver cancer), reduced testosterone - infertility, reduced libido, impotence. For females, produce androgenic effects (ex. facial hair), lowered voice, enlarged clitoris, increased libido - may not be reversible
97
What are benzodiazepines used for in sports? What are the types used?
Lorazepam diazepam, combat insomnia and anxiety. Allow them to recover faster. BUT can impair psychomotor coordination and focus at high doses and cause disorder.
98
What are blood doping and erythropoietin used for?
Blood doping - reinfusion of own red blood cells before performance, increases oxygen carrying capacity Erythropoietin - stimulates RBC production, increases oxygen carrying capacity, increases endurance
99
How are blood doping and erythropoietin detected?
Blood doping - measuring age of RBC Erythropoietin - testing urine for it
100
What are diuretics used for?
Increase excretion of salt and water through kidneys. Used just before competition to get to lower weight class, or to excrete drugs faster. - excess water and electrolyte depletion

PHAR 100 (5 decks)

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