16 - Drug Dependence

Question 1

Addiction

Answer 1

Chronic disease characterized by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences

Question 2

Drug Abuse

Answer 2

users consume the substance in amounts or using methods which are directly or indirectly harmful to themselves or others

Question 3

Drug Dependence

Answer 3

an adaptive state that develops after repeated drug use and which results in withdrawal symptoms upon cessation of drug use

Question 4

Drug Tolerance

Answer 4

the diminishing effect of a drug which results after repeated administration at a set dose

Question 5

Psychological dependence

Answer 5

dependence that involves emotional–motivational withdrawal symptoms (e.g. dysphoria, depression, anhedonia, restlessness)

Question 6

Physical dependence

Answer 6

dependence that involves significant physical–somatic withdrawal symptoms (e.g. fatigue, nausea, seizures, pain, delirium tremens)

Question 7

What is the molecular target for Cocaine

Answer 7

DA
NAd
5HT uptake systems

Question 8

What is the molecular target for amphetamine

Answer 8

Monoaminergic transmission

uptake systems

Question 9

What is the molecular target for Ethanol

Answer 9

GABAa and NMDA receptors

Question 10

What is the molecular target for Ket and phencyclidine

Answer 10

NMDA glutamate receptors

Question 11

Reward circuits in the brain in drug dependence

Answer 11

Dopaminergic projection from the ventral tegmental area  nucleus accumbens (Ventral Striatum) is essential in drug-dependence

Question 12

Stages of addiction

Answer 12

Intoxication
Binging
Withdrawal
Craving

Question 13

What is the opioid peptide that is upregulated in drug withdrawal

Answer 13

Dynorphin

Question 14

Effect of dynorphin

Answer 14

Activates kappa opiod receptors

Triggers dysphoria by reducing dopamine release

Question 15

What processes are associated with the PFC (these are impaired in addicts)

Answer 15

o Self control, motivation, working memory, awareness and insight, learning and memory, emotional regulation

Question 16

Which gene isoforms are more expressed in chronic drug use

Answer 16

FosB

Question 17

What is hazardous drinking

Answer 17

> 5 units a day for male

>3 units a day female

Question 18

Acute alcohol intoxication

Answer 18

Euphoria followed by depressive mood
slurring of speech
ataxia
pupil dilation

Question 19

What neuronal effects does alcohol have

Answer 19

Depressed excitatory transmission and potentiated inhibitory transmission

Question 20

Long term effects of alcohol

Answer 20

Shrinkage of grey matter
acute GI haemorrhage
pancreatitis
Hepatitis

Question 21

Methylene Dioxymethamphetamine

Answer 21

MDMA

Ecstasy

Question 22

MDMA cellular targets

Answer 22

5HT uptake system
Dopamine uptake system
5HT2 receptors
H2 receptors
a2 adrenergic receptors

Question 23

What does 5HT release do to MDMA

Answer 23

Mediates the behavioural actions

Question 24

What are temperature effects of MDMA dependent on

Answer 24

5HT

Question 25

Acute MDMA toxicity

Answer 25

Body temperature elevation Rhabdomyolysis Hyponatraemia

Question 26

What can block rhabdomyolysis

Answer 26

Dantrolene

Question 27

THC

Answer 27

T9 tetrahydrocannabinol

Question 28

CB1 receptors

Answer 28

CNS | Mainly presynaptic - modulate glutamate and GABA

Question 29

CB2 receptors

Answer 29

Peripheral organs | associated with the immune system

Question 30

Modes of action of cannabinoids

Answer 30

neuromodulators | mainly inhibitory

Question 31

Risks of cannabinoids

Answer 31

Schizophrenia depression gateway drug memory problems

Question 32

Cannabidiol

Answer 32

major non-psychotropic cannabinoid compound present in the plant

Question 33

Nabilone

Answer 33

synthetic analogue of THC

Question 34

Sativex

Answer 34

product which combines THC and CBD 1:1)  Has medical properties

Question 35

Cannador

Answer 35

product which combines THC and CBD 2:1)

Question 36

Long term effects of a cocaine/crack addiction

Answer 36

CVS issues - MI and stroke Cognitive decline Psychotic symptoms Major depression and anxiety

Question 37

Steps in management of addiction

Answer 37

``` Detoxification Psychological support Medication Evaluation and treatment of mental health problems Long-term follow up ```

Question 38

Nalmefene

Answer 38

Opioid antagonist used for reduction of alcohol consumption

Question 39

What drugs can be given to alcoholics

Answer 39

Thiamine SSRIs Dusulfram Benzodiazepines

Question 40

Varenicline

Answer 40

α4β2 selective partial agonist at nicotinic receptors Can be used for nicotine addiction but SE

Question 41

Methadone

Answer 41

can be given to opioid addicts (heroin)