Addictions Flashcards

1
Q

There are two sides to addiction:

A

Tolerance –> Physical Dependence

Reward Centres –> Psychological Craving

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2
Q

Define tolerance?

A

Reduced responsiveness to a drug due to past administration

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3
Q

What are the 2 main mechanisms of tolerance?

A
  • Dispositional

- Pharmacodynamic

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4
Q

What’s dispositional tolerance?

A

LEss drug reaching the active site due to changes in absorption, metabolism, excretion etc

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5
Q

What’s Pharmacodynamic tolerance?

A

Less effect of drug at the active site due to e.g. internalisation of receptors or less efficient receptors

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6
Q

How does tolerance cause dependence?

A

Physiological changes in response to the drug use causes you to depend on the drug to maintain your normal homeostasis
When the drug’s taken away you swing too hard the other way and get withdrawal

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7
Q

What do withdrawal symptoms look like?

A

Pretty much the opposite of whatever the drug’s effect is e.g. diarrhoea when you stop opiates

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8
Q

Describe how the brains “reward centres” work?

A

The Ventral Tegmental Area projects VTA neurons to the nucleus accumbens & prefrontal cortex releasing dopamine

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9
Q

How do drugs cause craving?

A

Basically they trigger some part of our reward pathways, usually increasing dopamine, triggering it’s release or decreasing it’s reuptake

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10
Q

What types of cocaine are there?

A

Cocaine hydrochloride is what you snort and inject

Cocaine freebase aka crack is what you smoke

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11
Q

What are the effects of cocaine?

A

Euphoria, confidence, energy and decreased appetite/sleep

Dangers include airway damage, convulsions, resp failure, arrhythmia, MI, HTN, toxic confusion & paranoid psychosis

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12
Q

What happens when you withdraw from cocaine

A

Think the opposite of the effects:

  • Low mood & irritability
  • Agitation
  • Craving
  • Hypersomnia
  • Hyperphagia
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13
Q

How do you take amphetamine?

A

Snort, swallow or inject

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14
Q

Effects of amphetamine?

A

Similar to cocaine but longer.

Risks toxic confusions, convulsions & amphetamine psychosis

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15
Q

What are the forms of heroin?

A

Diamorphine or Diamorphine Chlorine

Comes in powder or tar and can be snorted, smoked or injected

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16
Q

Heroin gives an intense but transient pleasure rush, what are the side effects though?

A

N&V + headache
Resp depression + hypotension (big cause of deaths)

Longer term patients develop:

  • Phlebitis
  • anorexia
  • Constipation (big reason for hospilisation)
  • Social problems
17
Q

What do you get when you withdraw from heroin?

A
Craving
Insomnia & yawning
Muscle pain & cramps
Increased secretion from nose, lacrima and saliva
Dilated pupils
Piloerection (hence cold turkey)
18
Q

Why do we give people methadone?

A

Best case scenario is they remain opiate dependant but they are able to get their life together because its normalized, regulated, reduces IV misuse and so eliminates most of the social problems

19
Q

What’s the big problem with buying mandy?

A

only 1/2 are mdma, the others are either nothing active, lsd, amphetamine or ket etc

20
Q

What are the effects of MDMA?

A

Euphoria, increased sociability etc

Nausea
Dry mouth
HTN & high temp
Dehydration
Anxiety, panic & Psychosis
21
Q

What are anabolic steroids prescribed for?

A

Hypogonadism
Muscular dystrophy
Anaemias
Wasting in aids

22
Q

What are the side effects of hypogonadism?

A

acne, stretch marks and baldness
Cholesterol & HTN
Growth deficits (closes epiphysis)
Cholestatic jaundice & liver tumours

Virilisation in women – Hirsutism, deep voice, clitoral enlargement, menstrual irregularities & hair thinning