Addiction Flashcards
Common Pathway for Drugs of Addiction
- inc. DA release in the nucleus accumbens
- more intense and more direct effect on DA release causes greater addiction potential
Naltrexone
- opioid tx
- blocks effects of heroin
- poor retention
- some groups with strong contingency: physicians, people on parole)
Opioids: MOA, effects, toxicity, tolerance, withdrawal
- MOA: agonists of mu-opioid receptors (Gi)
- effects: euphoria, sedation, anxiolytic
- toxicity: via mu receptor activation, resp. depression, pinpoint pupils, tx with nalaxone
- tolerance: develops rapidly, not to constipation
- withdrawal: rarely life threatening, insomnia, diarrhea, irritability, cramps, inc. BP (tx: clonidine, methadone)
CNS Depressants: effects, toxicity, tx, tolerance, withdrawal
- effects: euphoria, sedation, loss of inhibition
- toxicity: via GABA activation/Glu inhibition, resp. depression, coma
- tx: ethanol- supportive plus fluids, thiamine, BDZ- flumazenil, Barbs- supportive
- tolerance: rapid to barbs>ethanol, benzos, significant to sedation/intoxication, less to lethal dose
- withdrawal: significant risk of mortality due to seizures (tx: substitution w/ BDZs then taper)
CNS Stimulants: effects, toxicity, tx, tolerance, withdrawal
- effects: euphoria, dec. fatigue, inc. arousal
- toxicity: via activation of NE and DA receptors, SNS overactivity, inc. HR/BP/temp, chest pain-MI, psychosis
- tx: CVS support, vasodilators for BP, BDZs for agitation/seizures
- tolerance: develops to euphoria/anorexia/hyperthermia, but can see supersensitivity to paranoia
- withdrawal: sleepiness, fatigue, depression, hyperphagia, craving (tx: largely behavioral)
Nicotine: Effects, toxicity, tx, tolerance, withdrawal, quitting
- stimulant
- agonist at nicotinic neuronal receptors
- effects: inc. alertness
- toxicity: rare, via activation of nicotinic-cholinergic receptors, NVD, CVP collapse, convulsions
- tx: CVS support, emetics, gastric lavage, charcoal
- tolerance: develops to subjective effects and nausea
- withdrawal: irritability, hostility, anxiety, inc. appetite, weight gain (tx: nicotine replacement, bupropion, varenicline)
- quitting: bupropion, gum, patch, varenicline (chantix)
Hallucinogens: effects, toxicity, tx, tolerance, withdrawal
- effects: altered sensory perception, enhanced insight
- toxocity: via activation of 5HT receptors, LSD-psilocybin: bad trip, severe anxiety, MDMA: agitation, hyperthermia, ADH release, hyponatremia
- tx: talking down, BDZs for agitation
- tolerance: not common, since repeated use minimal
- withdrawal: not known, flashbacks
Dissociative Anesthetics: effects, toxicity, tx, tolerance, withdrawal
- antagonist at NMDA-Glu receptors
- Phencyclidine (PCP), ketamine
- effects: euphoria, heightened emotionality
- toxicity: via block of NDMA Glu receptors: delirium, RR/HR/BP/temp, agitation, violent behavior
- tx: supportive for BP-hyperthermia, BDZs
- tolerance: not well studied
- withdrawal: not observed
Cannabinoids: effects, toxicity, tx, tolerance, withdrawal
- euphoria, mellowness, changes in perception
- toxicity: via activation of CB1 and CB2 receptors, minimal possible anxiety, impaired coordination-tracking, acute psychosis
- tolerance: rapid to most effects, also disappears rapidly
- withdrawal: not clinically significant, tx not usually needed
Buprenorphine
- opioid tx (subutex, suboxone)
- partial agonist
- can precipitate withdrawal
Cocaine
-stimulant
Amphetamine
-stimulant
Methamphetamine
-stimulant
Barbiturates
-depressant
Benzodiazepine
-depressant
Heroin
- opioid analgesic
- depressant
marihuana
- cannabiboid
- depressant
Methadone
-opioid tx
Clonidine
-opioid tx
Disulfiram
- antabuse
- EtOH tx
Flumazenil
- BDZ receptor antagonist
- used in tx of BDZ overdose toxicity
- not effective for BARB or EtOH toxicity
VTA releases DA onto _____ neurons and pleasure is perceived, identifying stimulating activity as one to be repeated.
-nucleus accumbens
Drugs with _____ half lives have higher abuse potential.
-shorter
True/False: Tolerance and dependence must always coexist. So to addiction and physical dependence.
False
