Cocaine, Amphetamines, and ADHD Flashcards

1
Q

How do Psychostimulants or CNS Stimulants work, in general?

A

They augment nt action (usually dopamine). They increase dopaminergic activity in the mesolimbic pathway (reward pathway).

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2
Q

What is the reward pathway called?

A

The Mesolimbic pathway.

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3
Q

What law outlawed cocaine and when?

A

The 1914 Harrison Narcotic Tax Act

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4
Q

What is cocaine’s mechanism of action?

A

Blocks the re-uptake of dopamine. (Blocks pre-synaptic transporter). It can also raise the levels of NE and serotonin at high levels.

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5
Q

What are the mechanisms of action for Amphetamines?

A

Amphetamine gets taken into cell by re-uptake transporter. Once in the cell, it interferes with VMAT, stopping the packing of nts back into vesicles, leading to a higher concentration of nts in the cytoplasm. Can cause nt transporter to work backwards and push dopamine into the synapse. Can increase NE and serotonin too.

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6
Q

What occurs when someone takes cocaine?

A

It mimics our stress response. Produce vasoconstriction, hypertension, tachycardia. Increased sense of energy (increased CNS arousal); anorexia, hypothermia. Euphoria.

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7
Q

How does Cocaine affect sodium channels?

A

It blocks sodium channels; can cause local anesthesia properties, cardiac toxicity (alterations in cardiac rhythm)

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8
Q

What is Cocaine salt as a Powder? Is it water-soluble?How can it be taken?

A

Water-soluble, may be administered orally, IV, or nasally.

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9
Q

Why can’t you smoke Powder Cocaine?

A

Because when it is heated, it chemically breaks down.

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10
Q

What is Cocaine in the base form? Is it water-soluble?How can it be taken? Why can it be smoked?

A

Insoluble in water, but soluble in alcohol, acetone. Heating the free-base converts cocaine to a stable vapor that may be inhaled.

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11
Q

Which has the faster onset of action: IV cocaine or smoking cocaine? Which has greater bio-availability?

A

Smoking cocaine. IV cocaine has 100% bio-availability.

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12
Q

Does cocaine cross the blood-brain barrier? Placenta?

A

Yes for both. It can concentrate in the brain longer than its half-life.

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13
Q

How long is the half-life of cocaine in plasma?

A

About 50 minutes.

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14
Q

Where is cocaine metabolized? What is it’s metabolite?

A

Enzymes in the plasma and liver. Major metabolite is Benzoylecgonine.

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15
Q

What happens when ethyl-alcohol and cocaine are used together?

A

They are co-metabolized into Cocaethylene, which acts like cocaine. Increases euphoric effect. Risk of dual-dependency. Increases the severity of withdrawal.

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16
Q

What is the half-life of Cocaethylene?

A

Half-life is 150 minutes.

17
Q

What neural projections does the dopaminergic pathway consist of?

A

Neurons projecting from the VTA (ventral tegmental area) to the NA (nucleus accumbens) and prefrontal cortex. They are likely involved in sensing/processing reward.

18
Q

What is the half-life of methamphetamine?

A

About 12 hours.

19
Q

Where is cocaine metabolized?

A

60% metabolized slowly in liver; 40% excreted unchanged.

20
Q

What is the prevalence of ADHD?

A

10%

21
Q

How many patients with ADHD are treated with stimulants?

A

50%

22
Q

What medication is used in 90% of pxs with ADHD who are using medications?

A

Methylpehnidate

23
Q

What are the 3 dose forms of Methylphenidate?

A
  1. Ritalin 2. Concerta (XR). 3. Daytrana (patch-form).
24
Q

How does Methylphenidate work?

A

Like cocaine, it inhibits pre-synaptic dopamine transporters.

25
Q

Why does Methylphenidate have less abuse potential than cocaine?

A

It enters the brain slower. Detaches slower from the transporter preventing further increase in dopamine.

26
Q

What are the 3 forms of Amphetamine available?

A
  1. Adderall. 2. Adderall XR. 3. Dextroamphetamine (Dexedrine).
27
Q

What is Vyvanese?

A

Lis-dexamphetamine. Equal affinity for receptors, but believed to have less abuse potential.