Cocaine

Question 1

What is the working cocaine hypothesis? (4)

Answer 1

contains the use of MOP and KOP receptors

MOP/KOP antagonists can be used for treatment of cocaine dependence and prevention of relapse

(buprenorphine is KOP antagonist, Naltrexone is a non-selective opioid antagoist)

Buprenorphine is more effective in compliance supporting therapeutic KOP antagonist role

Question 2

Name the two novel treatments for cocaine and their mechanisms (5)

Answer 2

Target opioid system

to reduce MOP/KOP therefore preventing reward system

inhibit the downregulation of D2 (cocaines effect) to support the protective role of KOP in cocaine addicition

KOP agonists treat as KOP is anti reward

Stress may be induced by KOP agonism and stress is known to induce relapse

Question 3

What are the medical uses of Cocaine and the mechanism behind it (2)

Answer 3

use in nasal surgery

vasoconstriction and blockade of VgNa+ channels

Question 4

What is the pharmacology of cocaine? (1)

Answer 4

binds and blocks reuptake transporters of NA and DA

Question 5

What are the psychological effects of cocaine? (4)

Answer 5

euphoria

rambling talk/garrulousness

increased motor actvity

increase in pleasurable activities

Question 6

What are the effects of high doses of cocaine and how do they differ to another key psychostimulant? (3)

Answer 6

aggressive stance

similiar to amphetamine

less hallucinations, delusions and stereotyped behaviour

Question 7

Describe the metabolism of cocaine (2)

Answer 7

rapid

in liver

Question 8

What are the most severe adverse effects? (3)

Answer 8

serious CVS events - dysrhythmias, aortic dissection, myocardial or cerebral infarction or haemorrhage

effects brain development in utero (Volpe 1992)
decrease in brain size
increase limb and neuro malformations
increase in brain lesions - ischaemic and haemorrhagic

psychological dependence