2 - routes of administration

Question 1

how much do genetic factors account for in the risk for addiction

Answer 1

50%

Question 2

do monozygotic or dizygotic twins have a more similar rate of addiction

Answer 2

monozygotic

Question 3

do kids have addiction habits more like birth family or adopted family

Answer 3

birth family

Question 4

what is epigenetics

Answer 4

change in expression or regulation in genes

Question 5

how do epigenetics play a role in addiction

Answer 5

long term neuroplasticity, they can be passed on

Question 6

what did they find with the “candidate” genes (DAT, DRD2, OPRM1)

Answer 6

contradicting results, not just 1 gene has a role in addiction

Question 7

what do genome wide associates studied (GWAS) do

Answer 7

compare as many genes as possible between dependent and non dependent subjects

Question 8

do you need to know about certain candidate genes before doing a GWAS

Answer 8

no, because results of GWAS will show differences at any genetic location present

Question 9

what do GWAS tell us about addiction (3)

Answer 9

• many different genes are involved (polygenic)
• unexpected genes emerged
• genes overlap with different drugs

Question 10

what are some of the unexpected types of genes found in GWAS

Answer 10

genes that are involved in neuronal adhesion

Question 11

what do neuronal adhesion genes do

Answer 11

help with learning and plasticity

Question 12

what does the link between the drug-GWAS and the neuronal adhesion genes mean

Answer 12

that drug dependence may be a learning problem

Question 13

do certain genes only cause addiction susceptibility to only 1 drug

Answer 13

no, gene changes make you susceptible to many different addictions in general, not just 1 drug

Question 14

why is it hard to reproduce studies that link addiction to genetics

Answer 14

it is hard to define if someone is truly dependent and there is a large spectrum of dependence (people need different amounts of drug to getting to the point they want to achieve)

Question 15

why are GWAS for drugs critizied

Answer 15

lots of stats involved, easy to make a mistake there

also people argue whether there are any truly significant variations in genes that lead to abuse/dependence

Question 16

what are the 4 major routes of administration

Answer 16

mouth
injection
inhalation
insufflation(snorting)

Question 17

what route of administration has the fastest route to brain

Answer 17

inhalation

Question 18

what route of administration has the second fastest route to brain

Answer 18

injection

Question 19

what route of administration has the third fastest route to brain

Answer 19

snorting

Question 20

what route of administration has the slowest route to brain

Answer 20

ingestion

Question 21

what route of administration has the highest peak of concentration in the brain

Answer 21

inhalation slightly higher than IV

Question 22

do slower administration methods have a high concentration peak

Answer 22

no

Question 23

do faster administration methods have a high concentration peak

Answer 23

yes

Question 24

do slower administration methods have an intense high

Answer 24

no

Question 25

do faster administration methods have an intense high

Answer 25

yes

Question 26

do slower administration methods last a long time in brain

Answer 26

yes

Question 27

do faster administration methods last a long time in brain

Answer 27

no

Question 28

what is bioavailability

Answer 28

the fraction of drug that ends up in circulation

Question 29

what is the bioavailability for IV drug intake

Answer 29

100%

Question 30

what are the 2 main properties of drugs that make them easily absorbed in the gut

Answer 30

lipid soluble | uncharged

Question 31

what is first pass metabolism

Answer 31

when drugs are metabolized by enzymes in the liver or gut before entering general circulation

Question 32

why do we eventually sober up from drugs but why isnt it immediate

Answer 32

many drugs arent 100% metabolized by the liver the first time through, so thats why it takes time

Question 33

what are the main enzymes in the liver that provide the majority of metabolism

Answer 33

cytochrome P450 enzymes | -CYP

Question 34

does intravenous, intramuscular or subcutaneous injections have 100% bioavailability

Answer 34

only IV

Question 35

why does injection have high bioavailability

Answer 35

avoids first pass metabolism

Question 36

how does rate of injection affect peak height

Answer 36

pushing the drug faster makes the peak higher

Question 37

where is a good place to inject if there are drugs with contaminants and why

Answer 37

blood vessels because they are insensitive in irritants

Question 38

what are the downsides to injecting into veins (2)

Answer 38

veins collapse due to inflammation and risk of disease/infection

Question 39

is intramuscular or subcutaneous quicker at absorbing

Answer 39

intramuscular because of better blood supply to the muscle

Question 40

rate thigh, glutes and deltoid in terms of fastest absorption rate

Answer 40

fastest is deltoid, then thigh, then glutes

Question 41

can IM or subQ inject more volume

Answer 41

IM

Question 42

does IM or subQ have a higher chance of irritation

Answer 42

subQ

Question 43

why does inhalation occur faster than IV (for drugs to get in brain)

Answer 43

inhale - lungs to brain | IV - vein to heart to lung to brain

Question 44

what is a difficulty in inhalation

Answer 44

hard to control doses

Question 45

how can snorting and chewing avoid first pass metabolism

Answer 45

if you use the mucous membranes in the mouth or nose (cocaine or chewing tobacco)

Question 46

what kind of drugs have the lowest abuse potential

Answer 46

hallucinogens

Question 47

what kind of drugs have the highest abuse potential

Answer 47

IV or smoked things

Question 48

what are the 4 main things in pharmacokinetics

Answer 48

ADME | absorption, distribution, metabolism and excretion

Question 49

are drugs free or bound to plasma protein

Answer 49

both

Question 50

what 3 factors determines how much drug is in the plasma

Answer 50

rate of absorption, excretion and metabolism

Question 51

how are drug removed from the body

Answer 51

excretion and/or metabolism (some drugs are excreted unchanged/unmetabolized)

Question 52

what is a drug half-life?

Answer 52

the time it takes for the concentration of drug in plasma to fall 50%

Question 53

what does the dose response curve describe

Answer 53

amount of drug in system and the response it produces /or %of a population in affects

Question 54

why is there overlap in the curves in the dose response curve

Answer 54

because some people are affected quicker than others

Question 55

what is TD50

Answer 55

the concentration of drug that is toxic in 50% of subjects

Question 56

what is ED50

Answer 56

the concentration that produces the desired effect in 50% of users

Question 57

what is theraputic index formula

Answer 57

LD50/ED50 | the ratio

Question 58

what does theraputic index measure

Answer 58

how different a dose must be for the effective dose and the lethal/toxic dose measures safety of a drug

Question 59

what does a low therapeutic index mean

Answer 59

not a big different in dosage from ED to TD (easier to overdose)

Question 60

what does a high therapeutic index mean

Answer 60

big different in dosage from ED to TD (harder to overdose)

Question 61

how can TI change when other drugs are present

Answer 61

they can drop dramatically