10-29 L1 Neurobio of addictions Flashcards
What is pseudo-addiction?
problem: substance seeking and use behavior
- inadequate treatment of condition
solution: Dose or med adjustment eliminates this
What is pseudo-dependence?
Increase dosage req’d for same therapy
- Disease progression
- New disease
- Changes in physical activity or diet
- Adding or discontinuing other meds
- Lack of compliance.
Substance seeking behavior is mediated by what?
Mediated by DA release in reward system (attenuated by antagonist)
What is the difference b/t neurotransmitters in type 1 ‘drug craving’ and type 2 substance craving behavior?
- Type 1: neurotransmitter: glutamate
- Type 2: CRF in amygdala, NE from brainstem
What’s the difference between substance seeking (have) and substance craving (don’t have)?
Substance seeking: in anticipation of further DA release
Substance craving: anticipation of remembered conditioned reward
(Alcohol) What are the 4 important aspects of homeostatic inhibitory mechanism of DA release pathways in the reward center?
- Stimulates GABAa receptor
- Blocks NMDA receptor
- Releases endorphins stimu mu opitae receptor
- Releases endo-cannabinoids
Name the 8 addictive substances that cause a release of DA in the reward center (CABE-CON)
- Cocaine & Amphetamines
- Alcohol
- Benzodiazepines/Phenobarbital
- Endocannabinoids
- Cannabis
- Opiates
- Nicotine
What receptors do Endocannabinoids target? (CNS & Immune system)
- CNS: CB-1 receptors
- Immune system: CB-2 receptors
What do Endocannabinoids do?
Counteract activation of glu/NMDA receptor ‘neuroprotective’
Play a role in feeding and appetite behaviors
What do benzodiazepines/Phenobarbital do?
stimulate GABAa receptor
- effect similar to EtOH (inhibits the inhibitor)
- sedative hypnotic effect
What drugs stimulate CB-1? (COE)
- Cannabis
- Opiates
- Endocannabinoids
Which of the addictive substances have no withdrawal symptoms
cocaine and amphetamines (deplete DA from reward center)
Satiety of a substance depends on what?
depends on the elimination rate
What drugs are used as alcohol pharmacotherapy?
Di-NaCT
- Disulfiram (blocks aldehyde dehydrogenase)
- Naltrexone (mu receptor antagonist)
- Campral/acamprosate (indirectly blocks glu effect on NMDA receptor, offsets GABA/glu imbalance)
- Topamax/topiramate (anticonvulsant)
What drugs are used as opiates pharmacotherapy?
- Naltrexone (mu receptor antagonist)
- Methadone (mu receptor full agonist)
- Buprenorphine (mu receptor partial agonist)
Buprenorphine
what is it?
what do you combined it with?
mu receptor partial agonist
high affinity
combined with naloxane (blocks action when used IV, bitter taste deters multiple doses).
What drugs are used as nicotine pharmacotherapy?
- Gum
- Patch
- Buproprion
- Varenicline/Chantix
- Cocaine/amphetamines
What drug can be used in alcohol and opiate pharmacotherapy?
Naltrexone
