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Pharm III Unit I > 9 Drugs of Abuse > Flashcards

9 Drugs of Abuse Flashcards

1
Q

Flesh-eating “zombie” drug that kills you from the inside out

A

Krocodil (Desomorphine)

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2
Q

Abnormal behavior and physical symptoms (withdrawal) occur if drug is withdrawn

A

Physiological dependence

Results from NEUROADAPTATIONS (something changes in the brain)

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3
Q

Dysphoria and intense craving following withdrawal of drug

A

Psychological dependence

Occurs with or without physical dependence

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4
Q

Adverse reactions caused by d/c of a drug

A

Withdrawal

Based on physical neuroadaptations of brain

Release of dynorphin and GABA in the nucleus accumbens

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5
Q

Dose/response curve shifted to the right

A

Tolerance - more drug is required to produce effect

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6
Q

Dose/response curve shifted to the left

A

Sensitization - increase of responsiveness after repeated use (need less to get high)

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7
Q

What type of tolerance:

Genetic lack of sensitivity

A

Innate

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8
Q

What type of tolerance:

Increased metabolism

A

Pharmacokinetic

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9
Q

What type of tolerance:

Receptor downregulation

A

Pharmacodynamic

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10
Q

What type of tolerance:

Adaptation to the degree of intoxication

A

Learned

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11
Q

What type of tolerance:

Adaptation to setting/environment

A

Conditioned

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12
Q

What type of tolerance:

May occur when a drug is used repeatedly over a short period of time

A

Acute

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13
Q

What type of tolerance:

One drug produces tolerance to another

A

Cross

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14
Q

What is the definition of addiction?

A

Compulsive, relapsing drug use in spite of adverse consequences

Neural plasticity alters brain function, drug taken to alleviate craving/dysphoria

Typically psychological in nature but physiological dependence is usually present

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15
Q

Development of addiction depends on …

A

The individual, the drug, and the environment

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16
Q

What is Oniomania?

A

Addiction to shopping

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17
Q

What are some common properties of abused drugs?

A

Cause euphoria

Easy to use

Potency and Purity - effect with small dose

Rapid onset/short action

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18
Q

What is the reward pathway?

A

Mesolimbic dopamine pathway

VTA —> NAc —> Prefrontal cortex

Reinforcement/reward, motivation pathways get hijacked by drug use

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19
Q

Drugs for alcohol addiction

A

Naltrexone
Acamprosate
Disulfiram
Topiramate

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20
Q

Drugs for Opioid addiction

A

Methadone
Buprenorphine
Naltrexone
Naloxone

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21
Q

Drugs for Nicotine addiction

A

Nicotine Replacement Therapy (NRT)
Bupropion (Zyban)
Varenicline (Chantix)

Combined with CBT

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22
Q

Miscellaneous drug for addition

A

Bromocriptine

23
Q

MOA for amphetamines

A

Increased release of DA by REVERSING DA TRANSPORT through the DAT

Used for Narcolepsy and ADHD

Ex: Adderall, Ritalin (methylphenidate)

24
Q

CNS effects of Amphetamines

A

Alertness, euphoria, excitement

Appetite suppression

Aggression, paranoia, delusions

Peripheral - increased BP and Cardiac toxicity (Pulmonary edema and HF)

25
Q

Methamphetamine (ICE, crystal meth) have the same MOA as amphetamines but may produce…

A

Amphetamine psychosis

Chronic use may cause permanent damange to noradrenergic and serotonergic neurons —> long-term personality changes

26
Q

Adverse effects of meth

A

Weight loss, pale skin, body odor, hyperthermia, dental problems, “meth bugs”, seizures, organ damage, stroke, heart attack

Rapid physical and psychological dependence

Craving in abstinence is intense

Withdrawal may be severe and last a long time

27
Q

Which drug has the most life-threatening withdrawal?

A

Alcohol

28
Q

MOA for Cocaine

A

Inhibits DA reuptake

DAT (coke)-blocker

vs. amphetamines that cause release of DA from DAT

29
Q

Effects of cocaine

A

Craving can be severe —> physical and psychological dependence

CNS stimulation—> alertness, euphoria, anxiety, hyperactivity

Peripheral effects: tachycardia, vasoconstriction, HTN, bronchodilation, hyperpyrexia

30
Q

Cocaine has been used medically for…

A

Local anesthesia

Vasoconstrictor

31
Q

What is crack cocaine?

A

Allows for inhalation rather than typically intranasal administration

Very fast onset but wears off faster

Also called “freebasing” b/c it is separated from HCl (it’s a free base…)

Led to “crack lung” and “crack babies”

32
Q

Effects of chronic cocaine use

A

Reduction in overall brain activity

Anxiety, insomnia, paranoia, hallucinations, repetitive behaviors

“Cocaine bugs”

Nasal congestion and perforated nasal septum

Intense physiological dependence

Severe withdrawal (more than meth but less than alcohol)

33
Q

Cocaine overdose

A

Ventricular tachycardia and fibrillation

Stroke or cerebral hemorrhage

Seizures

All because your body is being flooded by DA

34
Q

How to treat cocaine addiction

A 
Detox and withdrawal
Abstinence
Long-term support systems
12-step programs
Avoid environmental cues
BROMOCRIPTINE decreases cravings by keeping DA at moderate, normal level
35
Q

MOA for nicotine

A

Activates nicotinic receptors in the CNS/periphery —> increased serotonin and DA release

36
Q

CNS effects of nicotine

A

Mild euphoria, increased arousal, appetite suppression

Intense psychological/physical dependence

37
Q

Nicotine ______ CYP450s

A

Induces

38
Q

Treatment for nicotine addiction

A

NRT
Bupropion (Zyban)
Varenicline (Chantix)
CBT

39
Q

MOA for Ecstasy

A

MDMA - 3,4-Methylenedioxymethamphetamine

Increases 5HT activity by blocking reuptake and stimulating 5HT receptors

Produces feelings of peacefulness, empathy, closeness, and trust

May be followed by confusion, depression, anxiety, paranoia

40
Q

Adverse effects of MDMA

A

Increased BP/HR

Hyperthermia, dehydration, kidney failures —> fatalities

Persistent memory loss

41
Q

MOA of Marijuana

A

Delta-9-tetrahydrocannabinol is the active ingredient

Stimulates presynaptic CB1 receptors to inhibit transmitter (ACh) release

Produces state of euphoria, well being, altered sense of time, difficulty concentrating, introspection, tranquility

42
Q

What kind of dependence do you get with marijuana?

A

No physical dependence but psychological dependence possible (no brain changes)

43
Q

Adverse effects of marijuana

A 
Anxiety, decreased memory, impaired cognition
Amotivational syndrome
Cannabinol hyperemesis - cyclic vomiting
Bronchial irritation, risk of cancer
Decreased ovulation and sperm production
Low birth weight and fetal malformations
44
Q

What do we need to know about synthetic cannabinoid agonists?

A

1/9 HS seniors have used them

Psychoactive effects - paranoia, hallucinations, mood swings, aggression and violent outbursts

Elevated HR and BP

Not tested for human effects, not regulated

High rate of ER visits

45
Q

MOA for LSD, mescaline, psilocybin

A

Act on 5HT receptors in the brain

LSD = Lysergic acid diethylamide

Mescaline = peyote

Psilocybin = magic mushrooms

46
Q

What is the main side effect of LSD?

A

Synesthesia - one sensory modality assumes the characteristics of another (colors can be heart or sounds smelled)

47
Q

Why don’t LSD, mescaline, or psilocybin cause dependence?

A

Because they don’t stimulate DA pathways

48
Q

Which drugs of abuse are NMDA receptor antagonists?

A

PCP

Ketamine

49
Q

Which drug of abuse is a GABA receptor weak agonist

A

GHB

50
Q

How do you treat PCP?

A

Haloperidol

51
Q

Non-reactive pupils

A

Red flag for PCP

52
Q

Why do dumb ass kids huff inhalants?

A

Produces sense of euphoria

Cheap and easy to get (don’t have access to better drugs)

53
Q

Inhalant that can cause peripheral neuropathy with chronic use

A

Nitrous Oxide

Think of a dentist dropping his tools

Pharm III Unit I (9 decks)

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