[PHARM] Alcohol, Caffeine, Drugs of Abuse [Iszard]

Question 1

What is abstinence syndrome?

Answer 1

The signs and symptoms that occur on withdrawal of a drug in a dependent person

Question 2

What is a controlled substance?

Answer 2

A drug deemed to have abuse liability that is listed on governmental schedules of controlled substances

Question 3

What is a designer drug?

Answer 3

A synthetic derivative of a drug, with slightly modified structure

Question 4

What is tolerance?

Answer 4

A decreased response to a drug, necessitating larger doses to acheive the same effect

Question 5

What is sensitization?

Answer 5

An increase in response with repetition of the same dose of the drug

Question 6

What is withdrawal?

Answer 6

Adaptive changes that become fully apparent once drug exposure is terminated

Withdrawal is the evidence of physical dependence

Question 7

What is the criteria for a schedule I drug?

Some examples?

Answer 7

No medical use; high addition potential

Heroin, LSD, PCP, MDA, MDMA

Question 8

What is the criteria for a schedule II drug?

Some examples?

Answer 8

Medical use; high addition potential

Amphetamines, cocaine, methylphenidate, short acting barbiturates, strong opiods

Question 9

What is the criteria for a schedule III drug?

Some examples?

Answer 9

Medical use; moderate abuse potential

Anabolic steroids, barbiturates, dronabinol, ketamine

Question 10

What is the criteria for a schedule IV drug?

Some examples?

Answer 10

Medical use; low abuse potential

Benzodiazepines, chloral hydrate, mild stimulants, most hypnotics, weak opioids

Question 11

What are commonly abused prescription painkillers? (3)

Answer 11

Fentanyl

Hydrocodone

Oxycodone

Question 12

What are commonly abused prescription depressants? (3)

Answer 12

Alprazolam

Zolpidem

Zaleplon

Question 13

What are commonly abused prescription stimulants? (2)

Answer 13

Adderal

Methylphenidate

Question 14

What are the overdose effects of [Amphetamines, methylphenidate & cocaine]?

Answer 14

Agitation

HTN

Tachycardia

Delusions

Hallucinations

Hyperthermia

Seizures

Death

Question 15

What are the overdose effects of [Barbiturates, Benzodiazepines, Ethanol]?

Answer 15

Slurred speech

Drunken behavior

Dilated pupils

Weak and rapid pulse

Clammy skin

Shallow respiration

Coma

Death

Question 16

What are the withdrawal symptoms of [Barbiturates, benzodiazepines, ethanol]?

Answer 16

Anxiety

Insomnia

Delirium

Tremors

Seizures

Death

Question 17

What are the overdose effects from [Heroin and other strong opioids]?

Answer 17

Constricted pupils

Clammy skin

Nausea

Drowsiness

Respiratory depression

Coma

Death

Question 18

What drugs do you use to treat opioid dependence/addiction? (4)

Answer 18

Opioid receptor Antagonists: Naloxone (Narcan) & Naltrexone

Synthetic opioid: Methadone

Partial mu-opioid receptor agonist: Buprenophrine

Question 19

What drugs do you use to treat smoking dependence/addiction? (1)

Answer 19

Nicotinic receptor partial agonist”: Varenicline (Chantix)

Question 20

What are two drugs you can give to alleviate benzodiazepine dependence/addiction?

Answer 20

Oxazepam

Lorazepam

Question 21

What is the one NMDA receptor antagonist used to reduce desire to drink alcohol?

Answer 21

Acamprosate

Question 22

What are examples of drugs that are abused but aren’t necessarily addictive?

Answer 22

LSD

Mescaline

Psiolcybin

Phencyclidine

Ketamine

Question 23

What are the potential long term effects of abusing drugs like (LSD, ketamine, PCP)?

Answer 23

Irreversible schizophrenia-like psychosis

Flashbacks of altered perception years after consumption

Question 24

What is caffeine most commonly used for?

Answer 24

Improve mental alertness

Question 25

What can **caffeine** be used to treat?

Answer 25

Migraine headaches Asthma ADHD Memory

Question 26

What is a "drink"?

Answer 26

0.6 ounces

Question 27

What is a "drink" for the following? Beer Liquor Wine

Answer 27

Beer = 12 oz Liquor = 8 oz Wine = 5 oz

Question 28

How long does 1 oz of alcohol take to metabolize?

Answer 28

1 ounce takes 1 hour to metabolize

Question 29

Describe the metabolism of alcohol

Answer 29

Alcohol --(alcohol dehydrogenase)--\> Acetaldehyde --(acetaldehyde dehydrogenase)--\> Acetic acid --\> Oxygen --\> CO2

Question 30

Ethanol undergoes ____________ metabolism

Answer 30

Ethanol undergoes **_1st pass_** metabolism

Question 31

What are the major considerations a physician should make for **acute alcohol intoxication?**

Answer 31

Monitor **respiratory depression** Monitor **aspiration of vomitus** **Glucose** can treat metabolic alterations (hypoglycemia/ketosis) **Thiamine** to protect against Wernicke-Korsakoff syndrome

Question 32

What is the presentation of **wernicke-korsakoff syndrome?**

Answer 32

Double vision Drooping upper eyelid Loss of muscle coordination

Question 33

What are the (4) drugs used for the treatment of **acute alcohol withdrawal syndrome?**

Answer 33

Diazpam (Valium) Lorazepam (Ativan) Oxazepam Thiamine (vitamin B1)

Question 34

What are (3) drugs used for the **prevention of alcohol abuse?**

Answer 34

Acamprosate Disulfiram Naltrexone

Question 35

What are (2) drugs used for the treatment of **acute methanol** or **ethylene glycol poisoning?**

Answer 35

Ethanol Fomepizole

Question 36

**_Naltrexone_** Indication? MOA?

Answer 36

Treatment of alcohol and opiate dependence Mu opioid receptor antagonist (long acting)

Question 37

**_Acamprosate_** Indication? MOA?

Answer 37

Reduces **relapse rates** during alcohol/opioid rehabilitation Weak NMDA receptor antagonist and GABA(A) receptor agonist

Question 38

**_Disulfiram_** Indication? MOA?

Answer 38

Treatment of alcohol dependence Irreversibly inhibits **aldehyde dehydrogenase** and causes extreme discomfort in patients who drink alcoholic beverages (flushing, throbbing headache, N/V, sweating, hypotension)