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Pharmacology I > 4 - Substance Use Disorders > Flashcards

4 - Substance Use Disorders Flashcards

1
Q

Substance Use Disorder is defined as:

A

Continued use of a substance despite significant substance-related problems

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2
Q

How is SUD related to tolerance and withdrawal?

A

Tolerance and withdrawal are among the criteria for diagnosing/identifying SUD

BUT THEY ARE NOT necessary or sufficient by themselves for an SUD to exist

The pattern of drug use can exist in people who are not physically dependent on drugs and have not developed tolerance

BEING PHYSICALLY DEPENDENT ON A DRUG IS NOT THE SAME THING AS HAVING SUD

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3
Q

The major neurotransmitter in the reward circuit is ______

A

dopamine

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4
Q

Alcohol exerts its effects by interacting with three proteins on membrane phospholipids:

A
  1. GABA receptors
  2. Glutamate receptors
  3. 5-HT3 receptors
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5
Q

Why does alcohol depress the CNS?

A

When it binds with GABA receptors, it ENHANCES GABA mediated inhibition

When alcohol binds with glutamate receptors it BLOCKS glutamate-mediated excitation

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6
Q

How does alcohol activate the reward circuit?

A

Alcohol activates 5-HT3 receptors, which activates the reward circuit and triggers release of dopamine

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7
Q

Two neuropsychiatric syndromes are common in alcoholics:

A

Wernicke Encephalopathy

Korsakoff Psychosis

BOTH ARE CAUSED BY THIAMIN DEFICIENCY

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8
Q

Wernicke Encephalopathy is characterized by:

A

Reversible

Confusion, nystagmus, abnormal ocular movements

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9
Q

Korsakoff Psychosis is characterized by:

A

IRREVERSIBLE

polyneuropathy, inability to form long term memories, confabulation (unconsciously fill gaps in memory with fabricated facts and experiences)

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10
Q

How does alcohol abuse effect neuroanatomy?

A

Enlarged ventricles d/t cerebral atrophy

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11
Q

Why does alcohol feel like it has a warming effect?

A

It promotes vasodilation in the skin which feels warm, but actually promotes heat loss

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12
Q

Why does moderate drinking protect against heart disease?

A

It raises HDL levels

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13
Q

Which kind of alcohol prevents dementia?

Which kind is cardioprotective

A

Only red wine protects against dementia

But the cardiovascular effects are dose dependent, not isolated to a certain alcohol

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14
Q

Who benefits most from the cardioprotective effects of alcohol?

A

People who are NOT leading a healthy lifestyle

There’s no protective effect for people who are already leading a healthy lifestyle

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15
Q

Why does alcohol cause gastric ulcers?

A

Increases acid secretion AND attacks the mucus barrier directl

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16
Q

What is unique about alcohol metabolism?

A

It is metabolized at a constant rate, whether or not the serum concentration increases or decreases

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17
Q

Alcohol-induced hypotension results from:

A

Direct effect on peripheral blood vessels that CANNOT BE CONRRECTED WITH VASOCONSTRICTORS

18
Q

What is usually the cause of death with alcohol overdoses?

A

Usually cardiovascular shock from profound hypotension. Usually not due to respiratory depression.

19
Q

Why is naltrexone used in AUD?

A

blocks the reward circuit activation of alcohol by blocking dopamine release

IF THIS PATIENT IS TAKING OPIOIDS IT WILL CAUSE WITHDRAWAL

20
Q

Why is antabuse given to treat AUD?

A

Causes Acetaldehyde Syndrome with mixed with alcohol

21
Q

What are the symptoms of acetaldehyde syndrome?

A

N/V, blurred vision, hypotension

Can be life threatening!

22
Q

What is the single greatest cause of preventable death in the US?

A

Cigarette smoking

23
Q

How does nicotine impact nicotinic receptors?

A

Low doses activate nicotinic receptors

High doses block them

Cigarettes have relatively low doses, and therefor cause activation

24
Q

The CV effects of smoking results from activating NN Receptors in the ______ and ______

A

Sympathetic ganglia

adrenal medulla

Stimulation leads to release of epinephrine and NE, causing CV s/s

25
Q

Where are NN Receptors found?

A

At the ganglion, between the pre-ganglionic and postganglionic neurons

in BOTH THE SNS and ParaSNS

26
Q

Nicotine influences GI function by:

A

activating parasympathetic ganglia in the gut, increasing tone, motility, and acid production

27
Q

How does Acute Nicotine Poisoning manifest?

A

GI: N/V/D, salivation

CNS: cold sweats, confusion, altered sight/hearing

CV: rapid pulses that are weak and irregular

MOST OF THE TIME DEATH RESULTS FROM EFFECT OF NICOTINE ON REPIRATORY MM

28
Q

How is nicotine poisoning treated?

A

Supportive measures until it’s all been metabolized, which only takes a few hours

29
Q

Which antidepressant is used for smoking cessation?

A

Wellbutrin

Structurally similar to amphetamine, and reduces some of the CNS irritability associated with withdrawal

30
Q

Which medication is the most effective aid in stopping smoking?

A

Chantix

31
Q

What is the MOA of Chantix?

A

Partial agonist at nicotinic receptors, promoting the release of dopamine

32
Q

Do most people begin Opioid addiction through recreational or medical access?

A

the overwhelming majority are recreational/illicit

33
Q

Heroin can be consumed three ways:

A

IV

Smoking

Sniffing/Snorting

34
Q

Once in the brain, heroin is rapidly converted to:

A

morphine

35
Q

How dangerous is opioid withdrawal?

A

Not very. It’s very uncomfortable, but not that dangerous

36
Q

The classic triad of symptoms in opioid overdose is:

A

respiratory depression

coma

pinpoint pupils

37
Q

METHADONE

CLASSIFICATION & MOA

A

Mu Receptor Opioid Agonist

No subjective effects are felt from methadone, and because cross-tolerance exists among all opioids, taking heroin will not cause a euphoric high

38
Q

BUPRENORPHINE

CLASSIFICATION & MOA

A

Suboxone. Agonist-Antagonist.

Mu agonist, kappa antagonist

Alleviates cravings, reduces use, and increases therapeutic program retention

39
Q

Where can methadone be prescribed?

Suboxone?

A

Methadone has to be prescribed in a certified opioid treatment program

Suboxone can be prescribed by a PCP

40
Q

What medication in cough syrup is abused?

A

Dextromethorphan

Very large doses can cause euporia

Pharmacology I (29 decks)

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