1- Drugs of Abuse Flashcards
With drug tolerance is the dose/response curve shifted to the left or right?
RIGHT (more drug is required to produce effect)
With sensitization is the dose/response curve shifted to the left or right?
LEFT (increased responsiveness after repeated use, need less drug to produce effect)
If a drug is taken to alleviate a craving/dysphoria this is considered what?
Addiction
Addiction is typically psychological in nature. If a physiological dependence is present does this mean it is addiction?
No
Addiction typically develops to drug w/ short or long duration of action?
Short/rapid onset. The shorter the duration, the more often you need to reinforce the effect
Drugs that stimulate what pathway have an increased potential for addiction?
Mesolimbic DA pathway
What is the MOA of CNS stimulants?
Reverse DA transport through the DAT → increased release of DA
What drug class is adderall, ritalin, and methamphetamine?
CNS stimulants (amphetamines)
What is the use of CNS stimulants?
Narcolepsy, ADHD
What CNS effects do CNS stimulants have?
Alertness, euphoria, excitement, appetite suppression, aggression, paranoia, delusions
What peripheral effects do CNS stimulants have?
Increased BP, cardio toxic → pulmonary edema & HF
What are the SEs of meth?
weight loss, dental problems, formication, stroke, MI, organ damage, +/- amphetamine psychosis
PTs that use meth will have rapid physical and psychological dependence. Why are withdrawal sx so severe and long lasting?
Significant loss of DA transporters
What is the MOA of cocaine?
Inhibits DA reuptake
Does cocaine results in a physical and psychological dependence?
Yes (dysphoria and craving when drug levels drop, withdrawal can be severe)
What CNS effects does cocaine have?
Alertness, euphoria, anxiety, hyperactivity
What peripheral effects does cocaine have?
tachycardia, vasoconstriction, HTN, bronchodilation, hyperpyrexia
What is the medical use for cocaine?
Local anesthetic
Vasoconstrictor
Will intranasal or inhaled cocaine have a more rapid onset?
Inhaled (very fast onset)
What results from chronic cocaine use?
Reduction in overall brain activity
Cocaine OD will result in what sx?
V. tachycardia/fibrillation, stroke, seizures
What is the pharmacological tx used to help stop cocaine use?
Bromocriptine - decreases craving for cocaine
What is the MOA of nicotine?
Activates nicotinic receptors in the CNS and periphery, increased 5-HT and DA release
Does nicotine cause psychological and physical dependence?
Yes (very intense)
What is the half life for nicotine?
30 minutes (promotes reinforcement → addiction)
Nicotine is metabolized by CYP450s and induces what?
CYP450s
What is used to help pt stop using nicotine?
Nicotine replacement therapy
Bupropion
Chantix
CBT
What is the MOA for MDMD/Ecstasy?
Increased 5-HT activity by blocking reuptake and stimulating 5-HT receptors
What are the CNS effects of nicotine?
mild euphoria, increased arousal, appetite suppression
What are the psychological effects of MDMA?
Produces feelings of peacefulness, empathy, trust
What are the physiological effects of MDMA?
Increased BP and HR
Hyperthermia, dehydration, kidney failure
What does pts feel depressed, paranoid, anxious, or confusion after a weekend of taking MDMA?
Body has down regulated production of 5-HT
What is the MOA for marijuana?
Stimulates presynaptic CB1 receptors to inhibit transmitter (ACh) release
Why is the half life of marijuana so long?
Very lipophilic
What are the effects of marijuana?
Mild euphoria, altered sense of time, difficulty concentrating, tranquility
Do pts that use marijuana have a physical and psychological dependance?
No physical dependence. Psychological dependence possible
What are the SEs of marijuana use?
Amotivational syndrome, cannabinoid hyperemesis, decreased ovulation/T/sperm production, decreased memory, impaired cognitive function
What are the effects synthetic cannabinoid agents?
Psychoactive effects - paranoia, hallucinations, mood swings, increased HR and BP
LSD, mescaline, & psilocybin act on what receptors?
Acts on 5-HT receptors in the brain
Synesthesis (colors can be heard, sounds may be seen) is associated w/ use of what drug?
LSD
Does LSD cause dependence? Why or why not?
No. Does not stimulate DA pathway
What are the effects of LSD?
Euphoria, visual hallucinations, DILATED pupils, increased BP, HR, flushing
What is the MOA for PCP and Ketamine?
NMDA receptor antagonist
What is the MOA for GHB?
GABA receptor weak agonist
What is the use of PCP, Ketamine, GHB?
General dissociative anesthetic
PCP can cause what SE. How is it treated?
Produces psychosis. TX w/ Haloperidol in ER
Ketamine and GHB are aka what?
Date rape drugs
What are the SE of PCP, Ketamine, GHB?
Increased BP, amnesia, personality changes, NON-REACTIVE pupils
What is the MOA for inhalants?
Unknown
What is the effect of huffing inhalants?
Euphoria
What are the SEs of inhalants?
Toxicity to many organs, lesions in brain’s white matter
