Addictions

Question 1

What is tolerance?

Answer 1

Reduced responsiveness to a drug caused by previous drug administration

Question 2

What drugs does tolerance develop in?

Answer 2

Opiods
Ethanol
Barbituates
Benzodiazepines

Question 3

What are the 2 mechanisms underlying tolerance?

Answer 3

Dispositional tolerance

Pharmacodynamic tolerance

Question 4

What is dispositional tolerance?

Answer 4

Less drug reaches active site

Question 5

What are the causes of dispositional tolerance?

Answer 5

Decreased rate of absorption
Drug metabolised faster
Increased rate of excretion

Question 6

What is pharmacodynamic tolerance?

Answer 6

Drug has less action at active site

Question 7

What are the causes of pharmacodynamic tolerance?

Answer 7

Down regulation or internalisation of drug receptors

Reduced signalling downstream of receptors

Question 8

Why is tolerance associated with withdrawal?

Answer 8

Body depends on drug to maintain new “normal” state, and develops into physical dependence to avoid withdrawal effects

Question 9

What is the reward pathway?

Answer 9

Neurones project from central tegmental area to nucleus accumbent and prefrontal cortex
When VTA neurones stimulates, dopamine released, causing sensation of pleasure

Question 10

What drugs tap into the reward pathway?

Answer 10

Heroin
Amphetamine
Cocaine

Question 11

What effects does heroin have on the reward oathway>

Answer 11

Increases firing rate of dopaminergic neurones

Question 12

What effect do amphetamines have on the reward pathway?

Answer 12

Increase dopamine release

Question 13

What effect does cocaine have on the reward pathway?

Answer 13

Inhibits dopamine uptake

Question 14

What effect does interaction with he reward pathway have on drug use?

Answer 14

Produces craving, physical component of addiction

Question 15

What are the routes by which cocaine can be taken?

Answer 15

Smoking- almost immediate effects
Injecting- 15-30secs
Smorting- 3-5mins

Question 16

What are the withdrawal effects of cocaine?

Answer 16

Depression
Irritability
Agitation
Craving
Hyperphagia
Hypersomnia

Question 17

What ar the routes of administration of amphetamines?

Answer 17

Sniffed
Swallowed
Injected

Question 18

What are the types of opiates?

Answer 18

Opium
Morphine
Heroin
Methadone
Codeine and dyhydrocodeine

Question 19

What are the routes of administration of heroin?

Answer 19

SNorting
Smoking
Injecting

Question 20

What are the side effects of opiates?

Answer 20

Initial- N&V, headache
Medium- phlebitis, anorexia, constipation
Long term- tolerance, withdrawal, social and health problems

Question 21

What are the signs and symptoms of opiate withdrawal syndrome?

Answer 21

Craving
Insomnia
Yawning
Muscle pain and cramps
Increased salivary, nasal and lacrimal secretions
Dilated pupils
Piloerection

Question 22

What are the negative effects of steroids?

Answer 22

Acne, stretch marks, baldness
Feminisation in males- hypogonadism, gynaecomastia
Virilisation in females- hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning
Increased cholesterol and hypertenson
Growth deficits
Liver disease
Irritability and anger
Hypomania and mania

Question 23

What are the withdrawal symptoms of steroids?

Answer 23

Depression and suicidality