Addicition Pharmacology Flashcards
Describe the DSM-5 criteria for Substance Use disorder for Abuse
- Hazardous Use
- Social/interpersonal problems related to use
- Neglected major roles to use
Describe the DSM-5 criteria for Substance Use disorder for Withdrawal
Tolerance
Used larger amounts/longer
Repeated attempts to quit / control use
Much time spent using
Pysical / psychological problems related to use
Activities given up to use
Apart from abuse and withdrawal, what other feature has DSM-5 for substance use disorders?
Craving
Using the DSM-5 criteria for Substance Use Disorders, what of the criteria needs met for diagnosis?
2 or more of any features
What brain areas fo VTA dopamine neurones project to?
NAcc
PFC
Striatum
The addiction potential of a drug is often dependent on the route of admin. Describe this in the context of cocaine forms
Sharp immediate rise and fall in body concentration associated with addiciton
In order of addictivity:
- IV cocaine HCL
- Smoked ‘cracked’ cocain
- Nasal cocaine
- Oral cocaine leaves
What is the molecular mechanism of action of cocaine?
Inhibits dopamine reuptake into cell from synapse by DAT transporter
Potentiates dopamine action
What is the molecular mechanism of action of Amphetamine?
Competes with dopamine for VMAT transporter into vesicles.
High intracellular concentration of dopamine results
DAT dopamine transporter reverses, releasing dopamine to extracellular
What are the two forms of tolerance?
Metabolic (pharmacokinetic)
Functional (pharmacodynamic)
What drug can disrupt the metabolism of alcohol, and has a potential for preventing abuse?
Disulfiram
Inhibits conversion of acetaldehyde to acetic acid
(by acetaldehyde dehydrogenase)
Buildup of toxic acetaldehyde
What symptoms does the presence of Acetaldehyde cause?
(breakdown of alcohol)
Nausea
Vomiting
Headache
Hypotension
List release prevention drugs for Alcohol
Disulfiram
Acamprosate
Naltrexone
How does naltrexone work?
Reduces craving
Probably by antagonising effects of endogenous opoid peptides
Reduces the rewarding effects of alcohol
How does acamprosate work?
Antiepileptic medication
Compensates for the increased excitability in the brains of alcoholics during withdrawal
Thought to increase activity of GABAaRs and inhibit glutamate activity
What drug works similarly to acamprosate and can alos be used to treat ethanol addiciton?
Topiramate
What drug can be used to reduce alcohol craving better than naltrexone, how does it work?
Antagonising endogenous opioid peptides
Longer half-life than naltrexone
Greater oral availability than naltrexone
Does not induce liver toxicity
What are the stages in the development of drug dependence?
Acute drug state
Chronic drug state
Short term abstinence
Long term abstinence
Describe the three stages of Koob’s addiciton cycle
Binge / intoxication - positive reinforcement
Withdrawal / negative affect - negative reinforcement
Preoccupation / anticipation - craving
What animal models represent the binge / intoxication stage of addiciton?
Drug / alcohol self-admin
Conditioned place preference
Brain stimulation reward thresholds
What animal models represent the withdrawal / negative affect stage of addiction?
Anxiety-like responses
Conditioned place aversion
Elevated reward thresholds
Increased motivation for self-admin (in dependent animals)
Which animal models represent the preoccupation / anticipation stage of addiciton?
Drug induced reinstatement
Cue-induced reinstatement
Stress-induced reinstatement
