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Integrated studies in metal health > Addiction and Drug use > Flashcards

Addiction and Drug use Flashcards

1
Q

What is the definition of an addiction

A

Continuous involvement with substances and activity despite the negative consequences

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2
Q

What is the difference between a HABIT and an ADDICTION

A

Addiction is a habit that is compulsive

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3
Q

What is a process addiction

A

Behaviours that are addictive due to mood alteration

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4
Q

List the 9 substances that are under the DMS-5 substance abuse

A

Alcohol

Caffeine

Cannabis (e.g., marijuana)

Hallucinogens

Inhalants

Opioid (e.g., heroin)

Sedatives, Hypnotics, or Anxiolytics (e.g., diazepam)

Stimulants (cocaine, methamphetamine)

Tobacco

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5
Q

What is the definition of sensitization

A

Increase in response of a drug with repeated use at the same dose

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6
Q

what is the definition of Compulsion

A

repetitive and persistent habitual acts that are inappropriate to a given situation and frequently lead to adverse consequences.

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7
Q

What is/are the key characteristic trait(s) to becoming an addict

A

Impulsivity

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8
Q

What are the 2 theories of drug addiction

A

1> Negative reinforcement model
2> Positive reinforcement model

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9
Q

What is negative reinforcement model

A

Physical dependence m: Withdrawal

This distinguished by tolerance and physical dependence

eg: Alcohol, barbiturates and opiates

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10
Q

What is the Positive reinforcement model

A

Positive incentive/ Reward theory

Reward and reinforcement

eg: Cocaine, amphetamines Nicotine

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11
Q

What is the dopamine pathway associated with

A

Reward, Pleasure, Euphoria, Motor Function, Decision making

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12
Q

what is the reward pathway

A

An axonal network in the brain that is activated by food, water, sex, exercise and activities (sky diving)

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13
Q

Which NT and anatomical sites are involved in the acute reinforcing effects of drug abuse in the reward pathway

A

DOPAMINE: VTA, nucleus accumbens (NA)

OPIOID peptides: NA, amygdala, VTA

GABA: amygdala, bed nucleus of stria terminalis

GLUTAMINE: NA

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14
Q

Which NT receptors are involved in Reward pathway

A

DA: D1 & D2
5-HT: 5-HT3
Cannabinoids: CB1 and CB2
Opioid peptide: Kappa, Mu and delta receptors

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15
Q

What are the classes of Drugs of abuse

A

Narcotics

Hallucinogenic

Depressants

Stimulants

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16
Q

List Narcotic drugs of abuse

A

OPIATES:
>morphine
>Heroin

OPIOIDS
>oxycodone
>hydrocodone
>codeine
>Fentanyl

17
Q

List the Hallucinogenic drugs of abuse

A

> LSD
PSILOCYBIN
MDMA
MESCALINE
PCP
MARIJUANA

18
Q

List the Depressant drugs of abuse

A

Alcohol
Benzodiazepines

19
Q

List the stimulants drugs of abuse

A

.>DEXEDRINE
>CAFFEINE
>METHEDRINE
>AMPHETAMINE
>COCAINE

20
Q

What are the ways in which drugs of abuse work

A

Direct action on DA receptors or DA transporter

Indirect
> Modulate dopamine via other receptor systems and NT
>Dopamine effect occurs downstream
Example ALCOHOL
-Bind to sub receptor GABA A: Dopaminergic activity is eventually increased in the VTA by inhibiting GABAergic interneurons

21
Q

What is the drugs action of
-Alcohol
-Heroin
-Cocaine
-Nicotine
on the receptors and the reward pathway

A

-Alcohol
>Inhibit GABAergic neurons that project to dopaminergic neurons in the VTA

-Heroin
>Binds to opioid receptors that inhibit GABAergic neurons that project to dopaminergic neurons in the VTA

-Cocaine
>Blocks the function of DAT (by binding to the DAT and slowing transport)

-Nicotine
>Activates cholinergic neurons that project to dopaminergic neurons of the VTA

22
Q

What are the syndrome involved in withdrawal

A

> disturbance of the autonomic nervous system
activation of the thalamus
release of corticotrophin releasing hormone (CRH)
activation of the noradrenergic nucleus locus coeruleus (LC)

  Stress response
  Increase discomfort and anxiety
  Can lead to  further consumption therefore relapse
23
Q

What are is the treatment for Alcohol dependence

A

Naltrexone

Acamprosate

24
Q

What are is the treatment for Heroin dependence

A

Methadone

Buprenorphine

25
Q

What are is the treatment for Tobacco dependence

A

Nicotine gum/Patches

26
Q

What are is the treatment for Psychostimulants dependence

A

Rimonabant

27
Q

How does Disulfiram work to prevent alcohol relapse

A

Block oxidation of ethanol by inhibiting the enzyme aldehyde dehydrogenase in the liver

28
Q

Reasons why Disulfiram isn’t used often

A

The accumulation of the metabolite, acetaldehyde leads to unpleasant side effects

palpitations, throbbing headaches, hypotension, nausea, emesis, flushing, dizziness, chest pains and thirst.

29
Q

What is the dose of Disulfiram

A

500mg per day for 2 weeks
then
250mg per day

30
Q

what is the purpose of disulfiram

A

Prevent relapse

Motivate patient as an adjunct to CBT and abstinence-based rehabilitation

31
Q

How does Naltrexone work to prevent Alcohol relapse

A

It is a Mu-opioid antagonist that block the reinforcing effect of alcohol and reduce craving

32
Q

What is the dose of Naltrexone

A

50mg/d for up to 12 weeks PO
or
380mg every 4 weeks IM

33
Q

What are the main side effects of Naltrexone

A

Nausea
vomiting
Loss of appetite
abdominal pain
Dizziness
Anxiety
dysphoria

34
Q

How does Acamprosate work to prevent Alcohol relapse

A

Agonist of GABA-A and antagonist of Glutamate NMDA
Which mimics the action of alcohol

Administering acamprosate with naltrexone has greater beneficial effects

35
Q

Side effect of Acamprosate

A

Diarrhoea

36
Q

MOA of Heroin

A

Mu-opioid receptor agonist that mimic reinforcing effect of natural enkephalins

37
Q

Withdrawal symptoms of heroin

A

restlessness, spasms of agonizing pain, involuntary twitching of the leg muscles, fever and sweating followed by hypothermia, vomiting and diarrhoea

38
Q

What medication is given to help relieve the withdrawal symptoms of Heroin

A

Loperamide: Diarrhoea
Metoclopramide: Nausea and vomiting
Ibuprofen: Headache
Lofexidine: Hypertension

39
Q

What are the main drug treatments for Heroin addiction

A

Methadone: long-acting πœ‡-opioid receptor partial agonist
>15-40mg daily

Buprenorphine: partial agonist at πœ‡-opioid receptor but also has antagonist activity at πœ… (kappa) opioid receptors

Integrated studies in metal health (10 decks)

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