2/23 Rx: Drug Abuse Noteset (Jeff)

Question 1

7 main criteria of addiction

Answer 1

1) tolerance
2) withdrawal
3) loss of control
4) preoccupation
5) continued use despite adverse consequences

Question 2

Tolerance

Answer 2

EITHER:

• markedly increased amounts of the substance to achieve intoxication or desired effect
• markedly diminished effect w/continued use of the same amount of the substance
• normal response that can occur w/chronic drug tx

Question 3

Withdrawal

Answer 3

EITHER:

• characteristic w/drawal syndrome for the substance
• same (or closely related) substance is taken to relieve or avoid w/drawal sx
• normal response that can occur w/chronic drug tx

Question 4

loss of control

Answer 4

• substance is often taken in large amounts over a longer period than was intended
• a persistent desire or unsuccessful effort to cut down or control substance use

Question 5

Preoccupation

Answer 5

great deal of time is spent in activities necessary to obtain the substance, use the substance, or recover from its effects

Question 6

continued use despite adverse consequences

Answer 6

-important social, occupational, or recreational activities are given up or reduced bc of substance abuse

Question 7

exhibiting __ of the criteria would imply abuse.

Answer 7

1-2 of the criteria

Question 8

exhibiting __ of the criteria would imply addiction.

Answer 8

3+ of the criteria

Question 9

what inc the likelihood of a drug being sampled repeatedly?

Answer 9

Agent: more readily available, low$, ease of admin, potency/purity
Host: tolerance, rapid metab, prior experiences/expectations
Environment: peer pressure, community attitudes, availability, employment, conditioned stimuli

Question 10

which pathways are activated in drug abuse?

Answer 10

dopamine pathways in the VTA projecting to the NA (usurp this pathways response to other natural rewards, like food, liquids, sex)

Question 11

which pathways are weakened by drug abuse?

Answer 11

frontal cortex (serves as a brake on the reward pathway) becomes weakened by repeated exposure

Question 12

is sensitization the same thing as tolerance?

Answer 12

NO

tolerance: dec effectiveness of a given drug with repeated administration (bc of resetting of homeostatic mech w/repeated drug use)
sensitization: increased effectiveness with repeated administration

Question 13

most abundant cannabinoids

Answer 13

Cannbinol, cannibidol, THC (MC-delta 9, then delta 8 isoform)

Question 14

medical marijuana

Answer 14

dronabinol, nabilone

*these are synthetic forms of THC that are missing other cannabinoid ingredients

Question 15

what is medical marijuana approved as?

Answer 15

anti-emetic (chemo) and appetite stimulant (in AIDS, for wasting syndrome)

Question 16

what are CB2-selective agonists potentially used for?

Answer 16

immune responses, neuroinflamm, chronic pain

Question 17

CB1-selective antagonist/inverse agonist or inhibitors of endocannabinoid synthesis?

Answer 17

Rimonabant: smoking (no longer approved for anti-obesity)