Alcohol, Caffeine, Drugs of Abuse - Iszard Flashcards
the signs and symptoms that occur on withdrawal of a drug in a dependent person
abstinence syndrome
compulsive drug-using behavior in which the person uses the drug for personal satisfaction, often in the face of known risks to health, formerly termed psychological dependence
addiction
a drug deemed to have abuse liability that is listed on governmental schedules
controlled substances
a state characterized by signs and symptoms, frequently the opposite of those caused by a drug, when it is withdrawn from chronic use or when the dose is abruptly lowered
dependence
a synthetic derivative of a drug, with slightly modified structure, but no major change in pharmacodynamic action
designer drug
a decreased response to a drug, necessitating larger doses to achieve the same effect
- dose-response curve shifts to the right (relative effect decreases)
tolerance
an increase in response with repetition of the same dose of the drug
- dose-response curve shifts to the left (relative effect increases)
sensitization
adaptive changes that become fully apparent once drug exposure is terminated
- is the evidence of physical dependence
withdrawal
these drugs are examples of what schedule level:
- flunitrazepam, heroin, LSD, mescaline, PCP, MDA, MDMA, STP
schedule 1
- no medical use, high addiction potential
these drugs are examples of what schedule level:
- amphetamines, cocaine, methylphenidate, short acting barbiturates, strong opioids
schedule 2
- medical use, high addiction potential
these drugs are examples of what schedule level:
- anabolic steroids, barbiturates, dronabinol, ketamine, moderate opioid agonists
schedule 3
- medical use, moderate abuse potential
these drugs are examples of what schedule level:
- benzodiazepines, chloral hydrate, mild stimulants, most hypnotics, weak opioids
schedule 4
- medical use, low abuse potential
what drug?
- duration of sx: 1 hour after each serving
- other sx: odor on breath, slurred speech, lack of coordination
alcohol
what drug?
- duration of sx: 20 mins
- other sx: odor on breath/clothes, stained fingers/teeth
tobacco
what drug?
- duration of sx: 2-4 hrs
- other sx: red eyes, odor on breath/clothes, eyelid tremors, increased appetite
marijuana
what drug?
- duration of sx: 5 mins- 8 hrs
- other sx: odor or residue on mouth/clothes, nausea, headache, disoriented
inhalants
what drug?
- duration of sx: 1-16 hrs
- other sx: jittery, talkative, runny nose, dry mouth
stimulants
what drug?
- duration of sx: 1-16 hrs
- other sx: disoriented, drowsy, slow/slurred speech
depressants
what drug?
- duration of sx: 5 mins - 12 hrs
- other sx: spacey, hallucinations, paranoia, memory loss, uncoordinated
hallucinogens
what drug?
- duration of sx: 4-24 hrs
- other sx: sleepiness, droopy eyelids, soft/low voice, euphoria
narcotics
what drug?
- duration of sx: 4-6 hrs
- other sx: cofused, aggressive, sweaty, repetitive
PCP
what are the most commonly abused painkillers?
fentanyl
hydrocodone
oxycodone
what are the most commonly abused depressants?
alprazolam
zolpidem
zalepion
what are the most commonly abused stimulants?
adderal
methylphenidate
overdose effects of what drug?
- agitation, hypertension, tachycardia, delusions, hallucinations, hyperthermia, seizures, death
amphetamines, methylphenidate, cocaine
overdose effects of what drug?
- slurred speech, drunken behavior, dilated pupils
withdrawal effects:
- anxiety, insomnia, delirium, tremors, seizures, death
barbiturates, benzodiazepine, ethanol
overdose effects of what drug?
- constricted pupils, drowsiness, respiratory depression, death
heroin, other strong opioids
what opioid receptor antagonists are used to treat dependence/addiction?
- naloxone (narcan)
- naltrenone
what synthetic opioid is used to treat dependence/addiction?
methadone
what partial u-opioid receptor agonist is used to treat dependence/addiction?
buprenorphine
what nicotinic receptor partial agonist is used to treat dependence/addiction?
varenicline (chantix)
what benzodiazepines are used to treat dependence/addiction?
- oxazepam
- lorazepam
what NMDA receptor antagonist is used to treat alcohol withdrawal?
acamprosate
what drug is the most commonly used to improve mental alertness
- used to treat migraines and headaches after epidural anesthesia
- used to treat asthma, ADHD, memory
caffeine
what enzyme converts alcohol -> acetaldehyde?
alcohol DH (converts both ethanol and methanol)
what enzyme converts acetaldehyde -> acetic acid?
acetaldehyde DH
what are the zero-order kinetics of alcohol metabolism?
- rate remains constant and is independent of concentration/amount of chemical
what is the rate-limiting factor of alcohol metabolism?
the biological system (the body)
why does alcohol not have a true half life?
because its half life increases with dose
what is the first line treatment for methanol poisoning?
ethanol KNOW this
what inhibits alcohol DH?
fomepizole
what inhibits acetaldehyde DH?
disulfram
what can be given to treat hypoglycemia and ketosis in acute alcohol intoxication?
glucose
what should always be given first to a patient of acute alcohol intoxication to protect against Wernicke-Korsakoff syndrome?
thiamine
what is given to a patient with acute withdrawal syndrome, to prevent seizures, delirium, and arrhythmias
benzodiazepines
which drugs are used for the treatment of acute alcohol withdrawal syndrome?
- diazepam (valium)
- lorazepam (ativan)
- oxazepam
- thiamine (B1)
which drugs are used to prevent alcohol abuse?
- acamprosate
- disulfiram (antabuse)
- naltrexone
which drugs are used for the treatment of acute methanol or ethylene glycol poisoning?
- ethanol
2. fomepizole
what is the MOA of naltrexone?
u-opioid receptor antagonist (long-acting)
- reduces the craving for alcohol and the rate of relapse to either drinking or alcohol dependence for the short term (12 weeks)
- pts physically dependent on alcohol and opioids must be OPIOID FREE before initiating therapy
what is the MOA of acamprosate?
weak NMDA-receptor antagonist and GABA-a receptor agonist
what is the MOA of disulfiram?
irreversibly inhibits aldehyde DH and causes extreme discomfort in pts who drink alcoholic beverages (flushing, throbbing headache, nausea, vomiting, sweating, hypotension, confusion d/t accumulation of aldehyde
NOTE: antidote for methanol poisoning (windshield washer fluid, antifreeze = ethylene glycol)
