Neurology class 3

Question 1

psychological dependence

Answer 1

caused by decreased activity in the ventromedial prefrontal cortex which leads to decreased impulse control

Question 2

opioids, ketamine, PCP, mushrooms, DMT, benzodiazepines

Answer 2

‘downers’

Question 3

cannabinoids, alcohol, nicotine

Answer 3

‘mixed’

Question 4

CNS stimulants, psychoactive stimulants

Answer 4

‘uppers’

Question 5

altered mood, relaxation (euphoria), uninhibited behaviour

Answer 5

desired effect of downers

Question 6

modulate serotonin, increase dopamine, inhibit substance P, decrease glutamate, inhibit ion channel transport

Answer 6

dynamics of downers

Question 7

opioid dynamics

Answer 7

inhibition of substance P produces analgesia and the more drug there is the more dopamine (reward pathway) is released
- decreased neuronal excitation which causes CNS depression

Question 8

most potent opioid

Answer 8

fentanyl

Question 9

least potent opioid

Answer 9

codeine

Question 10

what to monitor for patients on opioids

Answer 10

• orthostatic hypotension due to peripheral vasodilation
• itching due to mast cell stimulation and histamine release
• nausea due to substance P binding

Question 11

fentanyl

Answer 11

‘downer’
extremely potent and commonly laced into other drugs

Question 12

Heroin

Answer 12

‘downer’
highly lipophilic and crosses the BBB quickly
- commonly combined with fentanyl and if so then it is poison

Question 13

ketamine

Answer 13

dissociative anesthetic; ‘downer’
- potent, high sedation, causes amnesia, and respiratory depression
- known as date rape drug

Question 14

PCP

Answer 14

derivative of ketamine; ‘downer’
- originally developed for anesthesia
- goes from excitation to sedation but depends on dosage

Question 15

mushrooms

Answer 15

hallucinogenic; ‘downer’; increases GABA and decreases glutamate
- low potency and low addiction

Question 16

DMT (dimenthyltryptamine)

Answer 16

‘downer’

Question 17

altered mood, relaxation, un-inhibition of behaviour

Answer 17

desired effects of mixed drugs

Question 18

addiction

Answer 18

negative neuroplasticity in the brain

Question 19

vape

Answer 19

• safety testing based on ingestion not inhalation
• aerosols more toxic when heated
• formaldehyde, glycidol, acetol

Question 20

nabilone, dronabinol

Answer 20

cannabinoids

Question 21

CB1

Answer 21

target CNS

Question 22

CB2

Answer 22

target PNS

Question 23

• modulate serotonin which deals with mood alterations
• increased anandamide which results in memory loss
• stimulate dopamine release

Answer 23

CB1 and CB2 receptors

Question 24

competition of these cannabinoids at receptors to create a balance

Answer 24

CBD and THC

Question 25

antagonizes adrenergic NS producing a “calming” effect

Answer 25

high CBD

Question 26

modulates adrenergic NS producing alertness, focus, and agitation along with VS changes and hallucinations

Answer 26

high THC

Question 27

binds nicotinic receptors (cholinomimetic and adrenergic)
- vasoconstriction, decreased GI motility
- stimulates dopamine release
- lipophilic
- oxidizes lipoproteins causing plaque formation in atherosclerosis

Answer 27

nicotine

Question 28

increase in Ach and serotonin –> stimulation of dopamine –> increase in GABA –> decrease in glutamate

Answer 28

effects of alcohol (in order)

Question 29

• absorbed via gastric mucosa
• crosses BBB
• hepatic metabolism (uses vitamin B)
• zero order kinetics
• withdrawal syndrome ‘delirium Tremens’

Answer 29

alcohol

Question 30

metadoxine

Answer 30

accelerates the removal or clearance of alcohol by enhancing metabolism to inactive metabolites

Question 31

altered mood, excitation (euphoria), uninhibited behaviour
- increases norepi, serotonin, dopamine

Answer 31

‘uppers’ abuse desired effect

Question 32

hallucinogenic, psychedelic, altered reality, visual alterations

Answer 32

stimulant abuse desired effect

Question 33

sympathomimetics, amphetamines

Answer 33

stimulants

Question 34

cocaine, crystal meth

Answer 34

stimulants

Question 35

cocaethylene

Answer 35

cocaine and alcohol

Question 36

amphetamine-type, hallucinogenics

Answer 36

psychoactive stimulants

Question 37

LSD (acid), ecstasy (MDMA)

Answer 37

psychoactive stimulants