Abuse

Question 1

• Drugs of abuse effect what pathway?
• Reward is what?
• Reinforcing stimulus is?
• Addiction: What replaces normal reward pathway? Steps? (4)
• Natural reward pathway?
• Pathologic reward pathway?
• Drug addiction related to amount of DA where?

Answer 1

• Mesolimbic (VTA-NA)
• Stimulus brain interprets as positive
• Incr. prob that paired behaviors will be repeated
• Reactive reward; Amyg acts on VTA acts on NA (crave, impulsive choice, reward sensitivity, drug seek)
• PFC acts on Amyg and NA; Amyg acts on VTA which release DA on NA
• Amyg.
  8. ) and VTA act on eachother; VTA on NA
• Available at NA

Question 2

• Lifetime risk of alcohol abuse? Dependence?
• Lifetime drug abuse? Dependence?
• # 1,3,9 of actual and ? deaths?
• Alcohol missed? Drugs?
• Why teens at risk?
• CAGE?
  1. ) Opoids: MOA? Acute toxicity? (3) Treatment? Tolerance/ Dependence? Withdrawal? (3) Treatment? (4)
  2. ) CNS Depressants: MOA? Acute toxicity? Treatment? (3) Withdrawal? (2) Treatment? (2) 3 alcohol treatments?

Answer 2

• 17%; 13%
• 8%; 3%
• preventable
• 90%; 40%
• NA fully developed but not PFC
• cut down, angry, guilt, eye opener
  1. ) mu agonist (Gi); Resp. depression, pinpoint, coma; Nalaxone; Rapid; Not life threatening, like flu; clonidine for flu like and methadone, Buprenorphine (partial agonist); natraxone
  2. ) Incr. GABA/Decr. Glu; Resp. depression; Alcohol = Thiamine, BDZ = flumazenil, Barb = supportive; Risk of mortality; start with BDZ then move down; Antabuse, Naltraxone, Campral (incr. GABA)

Question 3

3. ) CNS stim: MOA? Acute toxicity? (3) Treatment? (3) Tolerance for? (3) Not for? Treatment?
4. ) Nicotine: Acute toxicity? (4) Treat? Chronic treatment? (3)
5. ) Hallucigans: MOA? Acute toxicity treatment?
6. ) Dissoc. Anesthetics: MOA? Ketamine can lead to? (3) Treatment?
7. ) Cannibinoid: MOA?
8. ) Anti Chol. ex?

Answer 3

3. ) Increase DA; Psychosis/ High BP/HR; CVS, Vasodil, BDZ’s; Euphoria, ahnorexia, hyperthermia; paranoia; CBT
4. ) Nausea/diar/cramp, conv.; Emetics; Bupropion, NRT, Varenicline (partial a4b2 agonist)
5. ) 5HT2 rec. agonists; BDZ’s;
6. ) NMDA antag; Incr. HR/BP/Violent; BDZ
7. ) CB1/2 agonist
8. ) Clonidine

Question 4

• Test for acute alcohol? Co-curring? (4)
• PCP toxicity? (4)
• MDMA withdrawal causes?
• 4 parts of motivation interviewing?
• Cross tolerance?
• Cross dependence?
• Tolerance and dependence? Addiction and physical dependence?

Answer 4

• AST>ALT; Hep., Panc., W-K syndrome; necrosis of mamillary due to no thymine
• Agitation, belig., nystagmus, psychosis
• Destroys serotenergic neurons
• Open ended Q’s, Affirmations, Reflective listening, Summarizing
• Tolerance to one leads to other
• One drug can supress withdrawal from another
• Not always the same