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Therapeutics III > Barker Pathophysiology of Substance Use Disorder > Flashcards

Barker Pathophysiology of Substance Use Disorder Flashcards

1
Q

What are the stimulant drugs of abuse?

A

-Cocaine
-Amphetamine
-Meth
-Bath salts
-Ecstasy
-Nicotine

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2
Q

What are the depressant drugs of abuse?

A

-Opioids
-Alcohol
-GHB
-Inhalants

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3
Q

What are the psychedelic drugs of abuse?

A

-LSD
-Psilocybin
-PCP
-Mescaline
-Ketamine

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4
Q

How do you define schedule 1 controlled substances?

A

-No medical use
-High abuse potential
-Safety not guaranteed

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5
Q

Examples of schedule 1 drugs

A

-Heroin
-Marijuana
-THC
-LSD
-GHB
-Psilocybin
-MDMA

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6
Q

How do you define schedule 2 controlled substances?

A

-Medical use
-High abuse potential
-Large risk of dependence

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7
Q

Examples of schedule 2 drugs

A

-Morphine
-Fentanyl
-Cocaine
-Ritalin
-PCP
-Barbituates
-Oxycodone
-Hydromorphone

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8
Q

How do you define schedule 3 controlled substances?

A

-Medical use
-Moderate abuse and dependence

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9
Q

Examples of schedule 3 drugs

A

-Ketamine
-Buprenorphine
-Marinol

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10
Q

How do you define schedule 4 controlled substances?

A

-Medical use
-Low abuse and dependence

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10
Q

Examples of schedule 4 drugs

A

Benzodiazepine

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11
Q

How do you define schedule 5 controlled substances?

A

Lower risk relative to IV

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12
Q

Examples of schedule 5 drugs

A

-Cough suppressants with small amount of codeine
-Lomotil (antidiarrheal opioid with atropine)

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13
Q

Which substances of abuse act directly on G protein-coupled receptors?

A

-Opioids
-LSD, mushrooms (psilocybin, psilocin)
-Marijuana, K2, spice
-Gamma hydroxy butyric acid
-Caffeine

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14
Q

Which receptors do opioids act on?

A

Mu receptors

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15
Q

Which receptors do LSD and mushrooms act on?

A

Serotonin receptors

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16
Q

Which receptors does marijuana, K2, and spice act on?

A

Cannabinoid receptors (CB1)

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17
Q

What receptors does gamma hydroxy butyric acid act on?

A

GABAb

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18
Q

What receptors does caffeine act on?

A

Adenosine receptors

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19
Q

Which substances of abuse act indirectly on G protein-coupled receptors?

A

-Cocaine, amphetamine
-MDMA/ecstasy
-Alcohol

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20
Q

Which receptors does cocaine and amphetamine act on?

A

-Dopamine transporter (dopamine receptors)
-Noradrenaline, serotonin transporters
-Release dopamine, noradrenaline, serotonin -> GPCRs

21
Q

What receptors does MDMA/ecstasy act on?

A

Monamine transporters

22
Q

What receptors does alcohol act on?

A

-GABA channels, 5HT3, NMDAR, nAchR, KiR3
-Causes release of endogenous opioids

23
Q

Which substances of abuse act on ion channels?

A

-Nicotine
-PCP, ketamine
-Benzodiazepines, barbiturates

24
Q

Which receptors does nicotine act on?

A

-Ionotropic acetylcholine receptors (Na+)
-Agonist

25
Q

Which receptors does PCP and ketamine act on?

A

-Ionotropic NMDA receptors (Ca2+, Na+ - K+
-Antagonist

26
Q

Which receptors do benzodiazepines and barbiturates act on?

A

-Ionotropic GABAa receptors (Cl-)
-Positive allosteric modulators

27
Q

What parts of the brain lead to addiction and craving?

A

-Frontal cortex
-Nucleus accumbens
-VTA
-Hippocampus
-Substantia nigra
-Striatum

28
Q

Why does the frontal cortex contribute to addiction?

A

It is responsible for decision making and impulsivity

29
Q

Why does the nucleus accumbens contribute to addiction?

A

It is responsible for pleasure and valuation

30
Q

Why does the VTA contribute to addiction?

A

It is the source of dopamine

31
Q

Why does the hippocampus contribute to addiction?

A

It is responsible for memory and learning

32
Q

Why does the striatum contribute to addiction?

A

It is responsible for reward and value

33
Q

What is the dopamine hypothesis of addiction?

A

-“Pleasurable events” release dopamine
-Parkinson patients only develop addiction during treatment
-Dopamine important for assigning value to reward prediction error
-Value provides the drug with an incentive salience
-Salience = state or quality of an item that stands out relative to neighboring items

34
Q

Limits of the dopamine hypothesis

A

-Dopamine not required for reward learning
-Dissociation between liking (direct effect) and wanting (motivation) (you don’t always like what you want)
-Tolerance to pleasurable effect (decreased liking), enhanced craving
-Dopamine does not encode liking, but involved in making reward predictions and learning from the outcome/error

35
Q

The glutamate hypothesis of addiction

A

-Glutamate can increase dopamine activity in NAcc
-Glutamate projection to VTA
-Destruction of this pathway reduces cocaine/morphine reward
-mGluR5 removed in mice show reduced cocaine reward
-NMDA antagonist blocks acquisition of reinforcement learning
-Intra NAcc AMPA injection causes relapse
-Dopamine controls glutamate activity in amygdala

36
Q

What is long term potentiation?

A

Persistent increase in synaptic strength following intense stimulation

37
Q

How does long term potentiation affect addiction?

A

Rewarding substances cause relative increase in glutamatergic AMPA receptors that causes increases in memory retention

38
Q

What is the definition of drug abuse?

A

The use of a drug for a nontherapeutic effect

39
Q

What is the definition of drug misuse?

A

-Inappropriate, illegal, or excessive use of a prescription or nonprescription drug
-Taking more/more frequent than prescribed
-Taking it for different indication
-Taking someone else’s medication

40
Q

What is physical dependence?

A

-Body needs more drug - tolerance
-Cellular adaptations upon repeated activation of receptors
-Body withdraws without drug

41
Q

What are the types of withdrawal symptoms?

A

-Emotional withdrawal symptoms
-Physical withdrawal symptoms
-Dangerous withdrawal symptoms

42
Q

Emotional withdrawal symptoms

A

-Anxiety, depression
-Restlessness, insomnia
-Irritability
-Headaches
-Poor concentration

43
Q

Physical withdrawal symptoms

A

-Sweating
-Racing heart
-Goose bumps = cold turkey
-Muscle spasms = kicking the habit
-Tremors
-Nausea, vomiting, diarrhea

44
Q

Dangerous withdrawal symptoms

A

-Alcohol and tranquilizers
-Grand mal seizures (also tramadol)
-Heart attacks, strokes
-Hallucinations, delirium tremens (DTs)

45
Q

What is psychological dependence?

A

-Addiction
-Mental urge to take drug to function
-Compulsive need/craving
-Even absence of withdrawal

46
Q

What is positive reinforcement?

A

-Drug is “rewarding” or produces positive reinforcement when the user feels pleasure/satisfaction
-Of value, strengthen behavior to repeat
-Just liking is not enough

47
Q

What is negative reinforcement?

A

Reward by escaping negative/painful stimulus or event (NOT same as punishment)

48
Q

What are the risks of drug binges and multi drug use

A

-Use of a depressant with a stimulant to numb the crash of the stimulant (Speedball - heroin+coke)
-Risk of overdose (not aware of some signs)
-More difficult to treat overdose

49
Q

Physiological responses that may lead to fatal overdose

A

-Respiratory depression associated with opioids and alcohol
-Cardiac arrhythmias, brain hemorrhage, stroke associated with stimulants
-Fatal seizures (also risk during withdrawal)
-Choking on vomit

Therapeutics III (42 decks)

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