B7-079 Pharmacology of Used and Misused Substances Flashcards
used as analgesics, cough suppressants, and antidiarrheals
opioids
opioids [4]
morphine
oxycodone
fentanyl
heroin
[…] strongly influences the magnitude of euphoria of opioids
route of administration
(IV> intranasal > oral)
[…] preparations of opioids are particularly prone to causing dependence
time-release
(oxycontin)
cross the placenta, so fetal addiction can occur
opioids
produce really profound tolerance, from the first dose
opioids
tolerance to opioids develops to all pharmacologic effects except [2]
miosis
constipation
opioid withdrawal is not particularly life threatening, but can cause severe
dehydration
(“everything wet”: vomiting diarrhea, lacrimation, rhinorrhea)
why are you more likely to overdose on opioids following withdrawal?
tolerance to respiratory depression is one of the first things to reverse
oral opioid agonist
methadone
mu opioid partial agonist
buprenorphine
antagonizes the euphoric effects of full mu agonists
buprenorphine
mu agonist with lower risk of overdose
buprenorphine
prototype opioid antagonist
naloxone
used for acute opioid overdose
naloxone
IV administration of [,..] can precipitate opioid withdrawal symptoms
naloxone
(due to instant blocking of mu receptors)
parenteral only, so only used for acute opioid overdose
naloxone
oral/IM depot opioid antagonist
naltrexone
used to prevent relapse in recovering (already abstinent) individuals
naltrexone
used for management of opioid withdrawal symptoms
lofexidine
(maintains withdrawal symptoms)
stimulate the sympathetic nervous system and reticular activating system
sympathomimetics/psychostimulants
systemic effects of sympathomimetics/psychostimulants [3]
pupillary dilation
increased BP
increased HR
inhibits dopamine re-uptake
cocaine
can be used as a topical anesthetic for mucous membranes
cocaine
cocaine has a […] duration of action
short
10-30 min
less associated with tolerance (due to short DOA) than other addictive drugs, but cravings can be very strong
cocaine
amphetamines [3]
d-amphetamine
methamphetamine
methylphenidate
amphetamines can be used clinically to treat [3]
ADHD
narcolepsy
obesity
release and block the re-uptake of dopamine, norepinephrine, and serotonin
amphetamines
longest lasting amphetamine with more pronounced central effects
methamphetamine
(why it has greater misuse)
side effects of amphetamines [3]
insomnia
anorexia
weight loss
long term use of amphetamines can lead to
psychosis
amphetamine derivative with greater serotonergic activity
MDMA
can cause hyperthermia at high doses
MDMA
causes jaw clenching, tachycardia, and muscle aches
MDMA
can cause depletion of serotonin, which can be permanent with repeated use
MDMA
experimental treatment for PTSD
MDMA
classes of hallucinogens [2]
psychedelics
dissociative
psychedelics [3]
lysergic acid diethylamide (LSD)
mescaline
psilocybin
derived from mushrooms
psilocybin
derived from peyote cactus
traditionally used for ritual purposes
mescaline
halos, color tails, objects morphing are examples of […] caused by psychedelics
visual hallucinations
synesthesia, time distortion, and parasthesias are examples of […] caused by psychedelics
perceptual distubances
alter cognition and perception occurring in a lucid state
psychedelics
rapid tolerance occurs, but do not cause physiological dependence
psychedelics
psychedelics have various effects on the […] system
serotonergic
dissociative hallucinogens [3]
phencyclidine (PCP)
ketamine
dextromethorphan
anesthetic also used as experimental treatment for depression
ketamine
OTC opioid cough suppressant that can cause hallucinations at high doses
dextromethorphan
cause feelings of disconnection from the body and external reality
dissociative hallucinogens
cause emotional withdrawal, apathy and impaired memory
dissociative hallucinogens
dissociative hallucinogens, especially […] can cause hostile behavior
PCP
noncompetitive NMDA antagonists
dissociative hallucinogens
can cause user to be hostile, omnipotent, and resistant to pain
dissociative hallucinogens
particularly PCP and ketamine
causes CNS effects via CB1 receptors
cannabinoids
major active compounds of cannabis [2]
9-tetrahydrocannabinol (THC)
cannabidiol (CBD)
which active compound of cannabis is non-psychoactive?
cannabidiol (CBD)
accumulates in adipose
detectable in urine for 3 weeks after cessation
9-tetrahydrocannabinol (THC)
compound of cannabis that has clinical use as anticonvulsant
cannabidiol (CBD)
opioids cause pupillary […]
constriction
hallucinogens cause pupillary […]
dilation
amphetamines cause pupillary […]
dilation
decreased appetite, weight loss, and insomnia would be signs of […] use
psychostimulant
indirect agonists of dopamine and norepinephrine
amphetamines
(acts on transporter to release and block re-uptake = indirect)
methamphetamine is clinically approved for treatment of
ADHD
obesity
(but not recommended for either)
phencyclidine (PCP) blocks the […] receptor ion channel
NMDA
what neurotransmitter mediates the euphoric and reinforcing effects of all drugs of abuse
dopamine
(mesolimbic pathway from VTA to nucleus accumbens)
tolerance of what effects of oxycodone are typically seen early [3]
sedation
respiratory depression
analgesia
used to prevent relapse in abstinent opioid addicts
naltrexone
used as substitution therapies in opioid addicts [2]
buprenorphine
methadone