Flashcards in Substance Abuse Deck (73)
withdrawal signs occur upon discontinuation; can be physically dependent but not addicted
Addiction; compulsive drug use; drug seeking, craving, despite negative consequences
higher doses are required to elicit the same effect, functional changes in receptors or drug metabolism; reflects adaptive changes the body has made to compensate for the drug's presence
signs of symptoms occurring as a result of drug discontinuation
All abused drugs active which dopamine pathway?
all abused drugs activate the mesolimbic DA pathway, causing release of DA in forebrain structures such as the NAc and PFC
How is dopamine usually used in the brain?
dopamine is normally used as a learning signal in the brain (signaling the difference between expected and actual reward)
Addiction to drugs is what type of learning?
maladaptive learning, often stronger than "natural rewards"
pharmacologically-induced onset of withdrawal; often worse than normal withdrawal because some or all the receptors are blocked at once
Example of precipitated withdrawal
buprenorphine can induced precipitated withdrawal to opioids such as heroin
withdrawal (and possible drug seeking) brought on or exacerbated by environmental cues
What did the controlled substance ace of 1970 establish?
established schedules for controlled substances
Alcohol used recreationally for
anxiolytic and euphoria
Other uses of alcohol besides recreationally
disinfectant, analgesic, organic solvents
How do you define alcoholism?
If it interferes with daily life, if you continue to do it even though it negatively impacts your life
Differences in distribution of alcohol between men and women
Men have 58% body water whereas women have 48% , so men can dilute it more and therefore drink more
What type of kinetics is alcohol eliminated by?
eliminated with zero order kinetics (constant rate)
Acute tolerance of alcohol
intoxication greater when BAC is ascending versus descending
Chronic tolerance of alcohol
greater concentrations needed to achieve desired effect
Alcohol dehydrogenase (ADH)
Aldehyde dehydrogenase (ALDH)
Fomepizol is used to treat
methanol, ethylene glycol poisoning
Disulfiram is used for
used for motivated drinkers; sensitizes a person to ethanol; disuades ethanol use during abstinence
Describe alcohol metabolism
1. Ethanol is metabolized to acetaldehyde by alcohol dehydrogenase
2. Acetaldehyde is metabolized to acetate by aldehyde dehydrogenase
CNS targets of alcohol
1. GABA(A) receptor potentiator (hyperpolarizes neuronal membrane, inhibits firing)
2. NMDA receptor antagonist (inhibits excitatory aa receptor)
What contributes to the CNS depression, cognitive deficits and memory impairment seen with alcohol?
NMDA receptor antagonism
Effects of the CNS targets of alcohol
1. Mild CNS stimulation (disinhibition)
2. CNS depression
3. Cognitive impairment
4. Motor impairment
5. Coma, death
Acute organ toxicity from alcohol
1. CNS: sedation, ataxia, intoxication
2. Cardiovascular: vasodilation, CV depression
Chronic organ toxicity from alcohol
1. CNS: tolerance, physical dependence, nerve injury
2. CV: prevent coronary disease, cardiomyopathy, arrhythmias, hypertension
3. Liver/GI: liver disease (cirrhosis)
4. Cancer: mouth, pharynx, larynx, esophagus, liver
Drug interactions with alcohol
1. Synergy with CNS depressants
2. Inhibits metabolism of phenothiazines, TCAs, sedative-hypnotics
4. Acetaminophen (promotes liver damage by NAPQI)