Addicition Pharmacology

Question 1

Describe the DSM-5 criteria for Substance Use disorder for Abuse

Answer 1

• Hazardous Use
• Social/interpersonal problems related to use
• Neglected major roles to use

Question 2

Describe the DSM-5 criteria for Substance Use disorder for Withdrawal

Answer 2

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

Question 3

Apart from abuse and withdrawal, what other feature has DSM-5 for substance use disorders?

Answer 3

Craving

Question 4

Using the DSM-5 criteria for Substance Use Disorders, what of the criteria needs met for diagnosis?

Answer 4

2 or more of any features

Question 5

What brain areas fo VTA dopamine neurones project to?

Answer 5

NAcc

PFC

Striatum

Question 6

The addiction potential of a drug is often dependent on the route of admin. Describe this in the context of cocaine forms

Answer 6

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

Question 7

What is the molecular mechanism of action of cocaine?

Answer 7

Inhibits dopamine reuptake into cell from synapse by DAT transporter

Potentiates dopamine action

Question 8

What is the molecular mechanism of action of Amphetamine?

Answer 8

Competes with dopamine for VMAT transporter into vesicles.

High intracellular concentration of dopamine results

DAT dopamine transporter reverses, releasing dopamine to extracellular

Question 9

What are the two forms of tolerance?

Answer 9

Metabolic (pharmacokinetic)

Functional (pharmacodynamic)

Question 10

What drug can disrupt the metabolism of alcohol, and has a potential for preventing abuse?

Answer 10

Disulfiram

Inhibits conversion of acetaldehyde to acetic acid

(by acetaldehyde dehydrogenase)

Buildup of toxic acetaldehyde

Question 11

What symptoms does the presence of Acetaldehyde cause?

(breakdown of alcohol)

Answer 11

Nausea

Vomiting

Headache

Hypotension

Question 12

List release prevention drugs for Alcohol

Answer 12

Disulfiram

Acamprosate

Naltrexone

Question 13

How does naltrexone work?

Answer 13

Reduces craving

Probably by antagonising effects of endogenous opoid peptides

Reduces the rewarding effects of alcohol

Question 14

How does acamprosate work?

Answer 14

Antiepileptic medication

Compensates for the increased excitability in the brains of alcoholics during withdrawal

Thought to increase activity of GABAaRs and inhibit glutamate activity

Question 15

What drug works similarly to acamprosate and can alos be used to treat ethanol addiciton?

Answer 15

Topiramate

Question 16

What drug can be used to reduce alcohol craving better than naltrexone, how does it work?

Answer 16

Antagonising endogenous opioid peptides

Longer half-life than naltrexone

Greater oral availability than naltrexone

Does not induce liver toxicity

Question 17

What are the stages in the development of drug dependence?

Answer 17

Acute drug state

Chronic drug state

Short term abstinence

Long term abstinence

Question 18

Describe the three stages of Koob’s addiciton cycle

Answer 18

Binge / intoxication - positive reinforcement

Withdrawal / negative affect - negative reinforcement

Preoccupation / anticipation - craving

Question 19

What animal models represent the binge / intoxication stage of addiciton?

Answer 19

Drug / alcohol self-admin

Conditioned place preference

Brain stimulation reward thresholds

Question 20

What animal models represent the withdrawal / negative affect stage of addiction?

Answer 20

Anxiety-like responses

Conditioned place aversion

Elevated reward thresholds

Increased motivation for self-admin (in dependent animals)

Question 21

Which animal models represent the preoccupation / anticipation stage of addiciton?

Answer 21

Drug induced reinstatement

Cue-induced reinstatement

Stress-induced reinstatement