8.1: Drug of Abuse Flashcards
- No medical indication
- Abuse vs Misuse
- Euphoria
- Altered perception
- “Compulsive” 🡪 Addiction
Drug of Abuse
Identify if Dependence or Addiction:
- Physical
- Tolerance
- Withdrawal Syndrome
Dependence
Identify if Dependence or Addiction:
- Psychological
- Compulsion
- Relapsing
- Craving
Addiction
Identify what Regulation Schedule:
High potential for abuse, no known medical use and lacks accepted safety for use.
Schedule I
What are the examples of Schedule I?
- Heroin
- Lysergic acid diethylamide
Identify what Regulation Schedule:
Potential for abuse with proven and accepted medical use but WITH SEVERE RESTRICTIONS, because abuse may cause severe psycho/physio dependence.
Schedule II
What are the examples of Schedule II?
- Morphine
- Cocaine
- Methadone
- Methampetamine
- Phencyclidine
MoCoMeMeP
Identify what Regulation Schedule:
- Less potential for abuse than schedule I or II; with accepted medical use
- Abuse may cause moderate or low physical dependence or high psychological dependence
Schedule III
Regulation Schedule:
What are the examples of Schedule III?
- Anabolic steroids
- Codeine with hydrocodone
- Aspirin or Tylenol
Identify what Regulation Schedule:
- The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule III
- Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule III
Schedule IV
What are the examples of Schedule IV?
- Valium
- Xanax
Identify what Regulation Schedule:
- The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule IV
Schedule V
Regulation Schedule:
What are the examples of Schedule V?
- Cough syrups
- Codeine
What are the pharmacokinetic tolerance?
- Reduction of concentration
- Shorter duration of action
What are the pharmacodynamic tolerance?
- Recruitment of Adaptor protein (β-arrestin)
- Desensitization
- Receptor internalization
Enumerate the withdrawal symptoms:
- Restlessness
- Eating more than usual
- Excessive hunger
- Anxiety/tension
- Impatience
- Depression
- Disorientation
- Loss of energy/fatigue
- Tremors
- Craving for cigarettes
This is a high motivation to obtain and use and has a negative consequences.
Addiction
They revert back because of the environment and drug availability. It has re-exposure, stress, and context recall.
Relapse
This alter perception and has no reward/euphoria. It targets cortical and thalamic system.
Nonaddictive Drug of Abuse
Examples of nonaddictive drug of abuse:
- Hallucinogens
- Dissociative anesthetics
- LSD
- PCP/Ketamine
- Dextromethorphan
What are the Class I drugs that Activate G-protein coupled receptors?
- GHB
- LSD, Mescaline & Psilocybin
- Opioids
- Cannabinoids
GLOC :3
What are the Class II drugs that Bind to Ionotropic receptors?
- Nicotine
- Benzodiazepines
- Alcohol
- Ketamine & PCP
- Inhalants
NiBAKIn
What are the Class III Drugs that Bind to Transporters of Biogenic Amines?
- Cocaine
- Amphetamines
- Ecstasy (MDMA)
Identify this nonaddictive drug abuse:
- Strong analgesics
- Opiates – morphine, codeine, thebaine, papaverine
- Narcotic – “sleep inducing”
- Leads to respiratory arrest
Opioids
Identify the opioid receptor subtypes:
- Supraspinal and spinal analgesia
- Sedation
- Inhibition of respiration
- Slowed gastrointestinal transit
- Modulation of hormone and neurotransmitter release
µ (mu)
Identify the opioid receptor subtypes:
- Supraspinal and spinal analgesia
- Modulation of hormone and neurotransmitter release
δ (delta)
Identify the opioid receptor:
- Supraspinal and spinal analgesia
- Psychotomimetic effects
- Slowed gastrointestinal transit
κ (kappa)
What are the common opioid analgesics that are strong agonist (+++,++, ++)?
- Morphine
- Oxycodone
- Hydromorphone
- Oxymorphone
- Methadone
- Meperidine
- Fentanyl
- Sufentanil
- Alfentanil
- Remifentanil
- Levorphanol
MOHOMMFeSARL :D
What are the common opioid analgesics that are partial or weak agonist (±)?
- Buprenorphine
- Butorphanol
- Codeine
- Hydrocodone
- Pentazocine
BuBuCoHyP :P
What are the common opioid analgesics that are antagonist (-)?
Nalbuphine
Plant source of opioids:
Papaver somniferum
True or False:
Opioids is a powerful narcotic painkiller where the principal active ingredient is morphine.
True
Mode of administration of opioids:
Subcutaneous, Intravenous
Effects of opioids:
Insomnia, hallucination, nightmares
True or False:
Opioids is a histamine release and have more pronounced effects than heroin.
True
It is a diamorphine addictive drug as a white or brown powder that tends to be used with other drugs.
Heroin
Mode of administration of Heroin:
Fast-acting; Intravenous
What is the half-life of heroin?
3-5 hours, several doses per day
Hours of withdrawal of heroin:
5-10 hours after
It is derived from codeine and synthesized from thebaine. This type of drug is in tablet or oral form.
Oxycodone
This type of drug has a serious interaction with MAO’s, and has resulted in MPTP which can cause parkinsonism.
Meperidine (pethidine; Demerol)
Degrees of tolerance:
What are the effects of high degree of opioid efficacy?
- Analgesia
- Euphoria, dysphoria
- Mental clouding
- Sedation
- Respiratory depression
- Antidiuresis
- Nausea and vomiting
- Cough suppression
Degree of tolerance:
What are the effects of moderate degree of opioid efficacy?
Bradycardia
Degrees of tolerance:
What are the effects of minimal or none degree of opioid efficacy?
- Miosis
- Constipation
- Convulsions
What are the adverse effects of opioid analgesics in acute use?
- Respiratory depression
- Nausea/vomiting
- Pruritus
- Urticaria
- Constipation
- Urinary retention
- Delirium
- Sedation
- Myoclonus
- Seizures
What are the adverse effects of opioid analgesics in chronic use?
- Hypogonadism
- Immunosuppression
- Increased feeding
- Increased growth hormone secretion
- Withdrawal effects
- Tolerance, dependence
- Hyperalgesia
- Impairment while driving
Identify what drug group based on the interaction with opioids
Increased CNS depression, particularly respiratory depression.
Sedative-hypnotics
Identify what drug group based on the interaction with opioids:
Increased sedation, variable effects on respiratory depression. Accentuation of cardiovascular effects (antimuscarinic and α-blocking actions).
Antipsychotic agents