Drug Abuse Flashcards
need for markedly increase amounts of the substance to reach intoxication or desired effect
tolerance
termed as substance dependence by the american psych association
addiction
craving or desire for continuous administration of a drug to provide a desired effect or to avoid discomfort
psychological dependence
physiological state of adaptation to a drug which usually results in development of tolerance to drug effects and withdrawal symptoms when the drug is stopped
physiological dependence
natural rewards
nurturing
food
water
sex
contain the NT dopamine which is released in the nucleus accumbens and in the prefrontal cortex
ventral tegmental area neurons
vulnerability is a product of
genes
environment
devt age
usual substanse abuse for doctors
ketamine
in low doses, alcohol causes
euphoria
mild stimulation
relaxation
lowered inhibition
alcohol content of red horse
vol: 7
wt: 5.50
alcohol content of happy horse
vol: 8
wt: 6.35
alcohol content of pale pilsen or light
vol: 5
wt: 4
alcohol content of san mig strong ice
vol: 6.30
wt: 5
general long term effect of chronic alcohol drinkers
weight gain
headache
muscle weakness
mostly affected organ in alcohol consumption
liver
goals of alcohol withdrawal tx
reducing withdrawal symptoms
preventing complications
beginning long term therapy to promote alcohol abstinence
alcohol abuse tx
controls shakiness, anxiety, confusio
Benzodiazepines:
ALPRAZOLAM
TEMAZEPAM
DIAZEPAM- iv only
alcohol abuse tx
for agitation and hallucinations
antipsychotics
2 mg RISPERIDONE
5 mg HALOPERIDOL- cheaper
curbs Fast HR and elevated BP related to withdrawal
reduce the strain of alcohol withdrawal in people with CAD
beta-blockers
cannabinoids
MARIJUANA
HASHISH
marijuana aka
blunt dope ganja grass herb joint bud mary jane pot reefer green trees smoke sinsemilla skunk weed
marijuana is a mixture of
dried shredded leaves, stems, seeds, and or flowers of CANNABIS SATIVA Or CANNABIS indica (hemp)
AE of marijuana- mental disorders
schizophreniform disorders
marijuana taken with alcohol
magnified tachycardia
amplified impairment of psychomotor and driving performance
tx of marijuana abuse
no FDA approved medications
behavioral therapies
hashish aka
boom ganster hash hash oil hemp
opioids
HEROIN
OPIUM
heroin: DIACETYLMORPHINE
smack horse brown sugar dope junk skag skunk white horse china white cheese (with OTC cold meds and antihistamine)
opium- LAUDANUM, PAREGORIC
big o black stuff block gum hop
heroin form of administration
injected
smoked
snorted
opium forms of administration
swallowed
smoked
prosessed form poppy plants
street opioids
known as black tar heroin
opium
street oPioids administration
orally-opium
injected
smoked
acute effects of street opioids
euphoria warm flushing of skin dry mouth heavy feeling in extremities clouded thinking alternate wakeful And drowsy states itching nausea depressed respiration
long term effects of street opioids
addicition physical dependence collapsed veins abscesses infection of heart lining and valves arthritis HIV hep c
street opiods + alcohol
decrease HR and respiration
coma
death
withdrawal sx fr street opioids
restlessness muscle and bone pain insomnia diarrhea Vomiting cold flashes with goose bumps leg movements
street opioids taken during pregnancy result to
spontaneous abortions
low birth wt
prescription opioids
HYDROCODONE
OXYCODONE
CODEINE
acute effects of prescription opioids
pain relief
nausea
constipation
euphoria
prescription opioids when taken by other routes result to
⬆️risk of depressed respiration leading to coma and death
long term effects of prescription opioids
tolerance
addiction
prescription opioids + alcohol
dec HR
respiration
coma
death
8-10% p, 5% of youth have used these prescription opioids
VICODIN
OXYCONTIN
APA guidelines on opioid substitution
METHADONE
BUPRENORPHINE
then gradually taper
abrupt opioid discontinuation with the use of ___ to suppress withdrwal symptoms
CLONIDINE
partial opioid agonist for withdrawal and maintenance
BUPRENORPHINE
dosage of BUPRENORPHINE
2-32 mg SL, daily or 3x a week
AE of BUPRENORPHINE
respi depression
HA
constipation
alpha 2 adrenergic antagonist for withdrawal of opioids
CLONIDINE
CLONIDINE administration for opioid use
0.1-0.3 mg orally every 6 hrs
AE of CLONIDINe
bradychardia
dry mouth
drowsiness
opioid agonist for withdrawal and maintenance
METHADONE
METHADONE admin for opioid use
20-100 mg orally daily
METHADONE AE
constipation
respi depression
opioid antagonist for opioid use withdrawal and maintenance
NALTREXONE
NALTREXONE admin
50-100 mg orally, daily or twice a week
NALTREXONE AE
anxiety
nausea
myalgia
d1,2 receptors location
pontine nuclei amygdala olfactory bulb deep cortex peripheral sensory neurons
kappa 1,2,3 receptors location
hypothalamus periaqueductal gray claustrum substantia gelatinosa in spinal cord peripheral sensory neurons
mu 1,2,3 receptors location
lamina 3 and 4 in cortex thalamus striosomes periaqueductal gray rostral ventromedial medulla substantia gelatinosa in spinal cord peripheral sensory neurons intestinal tract
nociception receptor location
cortex amygdala hippocampus septal nuclei habenula hypothalamus spinal cord
delta1,2 receptor functions
analgesia antidepressant effects convulsant physical dependence mu-opioid receptor-mediated respiratory depression
kappa1-3 receptors functions
analgesia sedation miosis inh of ADH release dysphoria
mu 1receptors functions
physical dependence
analgesia
mu 2 receptors functions
respi depression miosis euphoria reduced GI motility physical dependence
mu3 receptors functions
possible vasodilation
nociception receptor functions
anxiety
depression
appetite
development of tolerance to mu agonists
meds for history dependence lasting more than 1year
METHADONE
BUPRENORPHINE
first treatment modality for opioid dependence
METHADONE
newer treatment modality that became available for office-based opioid treatment in 2000
BUPRENORPHINE
opioid receptor agonist at the mu receptor
antagonist at NMDA receptor
METHADONE
believed to be responsible for methadone analgesic properties
R isomer
NMDA antagonist and responsible for toxicities including prolonged QT interval
S isomer
METHADONE is CI in
px with respi depression
acute bronchial asthma
hypercarbia
opioid dependence and detox tx admin
at least 1 yr up to 2 yrs
initial dose 20-30 mg once daily should not exceed 30mg
maintenance 80-120 mg per day with dose adj over the 1st wk based on withdrawal symptoms
partial mu receptor agonist
kappa receptor antagonist
BUPRENORPHINE
the analgesic effect plateaus and no additional benefit is seen by increasing the dose, but an increase in adverse opioid effects is anticipated
ceiling effect
phases of opioid tx
induction
stabilization
maintenance
patients experiencing mild withdrawal symptoms
have avoided opiates for 6 hours
induction phase of office based opioid tx
goal of induction phase of office based opioid tx
determine min dose of BUPRENORPHINE required to prevent further withdrawal sx, reduce cravings, provide minimal AE
no withdrawal symptoms
stabilization phase of office based opioid tx
stabilization phase of office based opioid tx lasts
one to two months
longest phase of tx
psychosocial and family issues addressed
maintenance phase of office based opioid tx
medication assisted BUPRENORPHINE tx lasts up to
6 months to 2 yrs or more
BUPRENORPHINE or BUPRENORPHINE/NALOXONE is given
every 2-3 days
stimulants
cocaine
amphetamines
methamphetamines
cocaine aka
blow bump c candy charlie coke crack flake rock snow toot
cocaine forms of admin
snorted
injected
smoked
amphetamines aka
BIPHETAMINE DEXEDRINE bennies black beauties crosses hearts LA turnaround speed truck drivers uppers
amphetamines forms of admin
swallowed
snorted
smoked
injected
methamphetamine aka
ice black beauties DESOXYN meth ice crank chalk crystal fire glass go fast speed
methamphetamine forms of admin
swallowed
snorted
smoked
injected
stimulant (cocaine, amphetamine, methamphetamine) effects
euphoria hyperactivity alertness sense of enhanced energy anorexia
overdose of stimulants complications
hyperthermia, heat stroke hypertensive crisis CVA acute MI intestinal infarctions rhabdomyolysis acute renal failure
chronic use of stimulants effects
weight loss cardiomyopathy paranoia psychosis steriotypic behavior- picking at skin "cocaine bugs"
standard pharmacological mgt of stimulant overdose
neuroleptics
high doses of BENZODIAZEPINES
crash period in stimulant withdrawal
depression
anxiety
aggitation
intense drug craving
intermediate withdrawal phase of stimulant withdrawal
fatigue
loss of physical and mental energy
decreased interest in the surrounding environment
late withdrawal phase of stimulant withdrawal
brief periods of intense drug craving
club drugs
ecstasy- METHYLENEDIOXYMETHAMPHETAMINE
GHB- GABBA-HYDROXYBUTYRATE
ROHYPNOL
appetite suppressant
both stimulant and hallucinogen
METHYLENEDIOXYMETHAMPHETAMINE
Ecstasy effect lasts
3-6 hours
ecstasy aka
MDMA adam clarity eve lover's speed peace uppers
ecstasy forms of admin
swallowing
snorting
injecting
moa of ecstasy
reverses the action of serotonin transporter
strongly inc extracellular serotonin concentration
effects of ECSTASY lasting 1 month
confusion
anxiety
HTN
heart or kidney failure
GHB aka
G georgia Georgia home boy grievous soap scoop goop liquid x
CNS depressant that can sedate the body
sometimes used as muscle builder and to enhance sexual performance
GHB
related to VALIUM, XANAX
date rape drug
rohypnol
FLUNITRAZEPAM
rohypnol aka
forget-me pill mexican valium R2 roach Roche roofies roofinol rope rophies
rohypnol forms of admin
swallowing
snorting
rohypnol characteristics
tasteless odorless dissolves easily in carbonated bev effects aggrevated by +alcohol effect of rohypnol lasts 8-12 hrs even without alcohol
dissociative drugs
KETAMINE
PCP AND ANALOGS
DEXTROMETORPHAN
dissociative drugs effects
feeling of being separate from ones body and environment impaired motor fxn or anxiety tremors numbness memory loss nausea
KETAMINE aka
ketalvar sv
k
special k
vitamin k
ketamine forms of admin
injecting
snorting
smoking
moa of ketamine
noncompetitive antagonism of NMDA
ketamine effects
analgesia
impaired memory
delirium
respiratory depression
phenylcyclidine aka
angel dust boat hog love boat peace pill
phenylcyclidine forms of admin
swallowing
smoking
injecting
PCP effects
analgesia psychosis aggression violence slurred speech
PCP overdose tx sedation
HALDOL
BENZODIAZEPINES
DEXTROMETORPHAN aka
DXM
robotripping
robo
triple c
DXM forms of admin
swallowing
DXM effects
euphoria slurred speech confusion dizziness distorted visual perceptions
hallicinogens
LYSERGIC ACID DIETHYLAMIDE
PSILOCYBIN
MESCALINE
indole hallucinogens
LSD
PSILOCYBIN
hallucinogens depend on
surrounding
emotional state
not by increased dose
LSD aka
acid blotter cubes microdot yellow submarine
PSILOCYBIN aka
magic mushroom
purple passion
shrooms
little smoke
amphetamine like hallucinogens
MESCALINE
mescaline aka
buttons
cactus
mesc
peyote
moderate intoxication of hallucinogens
mydriasis diaphoresis tachycardia short attention span tremor htn hyperreflexia fever
untreated hyperthermia in hallucinogen toxicity can lead to
hypotension
coagulopathy
rhabdomyolysis
MOF
other causes of hallucinations
hypoglycemia
alcohol, drug withdrawal
infection
tx for hallucinogen caused agitation, anxiety
HALDOL
BENZODIAZEPINE
androgenic anabolic steroids aka
anadrol oxandrin durabolin depo-testosterone equipoise roids juice gym candy oumpers
androgenic anabolic steroids forms of admin
injected
swallowed
applied to skin
moa of androgenic anabolic steroids
promote growth of skeletal ms (anabolic)
development of male sexual characteristics (androgenic)
those that prersent AAS addiction display a distinctive pattern of
comorbid psychopathology
long term effect of AAS
liver damage
CVD: high BP, inc LDL, dec HDL, cardia hypertrophy, atherosclerosis
aas + alcohol
synergystic in impulsive violent behavior - more research
AAS abuse treatment
restore hormonal system after its disruption
treat specific symptoms
inhalants
hydrocarbons- solvents, paints, aerosols
gases- freon, halon: fire extinguishing agent)
metallic paints- huffing
inhalant effects
dysrhythmias including VF esp when EPI is used
CNS depression
seizures
respi irritation
long tern effects of inhalants
myelin breakdown leading to spasms, tremors, possible permanent motor impairment
liver or kidney damage
TOLUENE in pregnancy
spontaneous abortions
fetal malformations
relatively safe taken by themselves, even in overdose
BENZODIAZEPINES
BENZODIAZEPINE overdose tx
FLUMANEZIL (romazicon)
an imidazobenzodiazepine derivative
FLUMANEZIL
FLUMANEZIL moa
antagonizes the actions of BENZODIAZEPINES on the CNS
competitively inh the activity at the recognition site on the GABA or receptor complex
benzodiazepines
DIAZEPAM (valium) LORAZEPAM (ativan) MIDAZOLAM (dormicum) CHLORODIAZEPOXIDE (librium) CHLORAZEPATE DIPOTASSIUM (tranxene) FLURAZEPAM (dalmane) TRIAZOLAM (halcion) TEMAZEOAM (restoril)
drugs causing BOTH psychic and physical dependence
OPIATES
BARBITURATES
narcotic user
mainlining or junkie
narcotic withdrawal without medical tx
cold turkey
enslavement or narcotic dependence
monkey on my back
LSD user
acid heads
amphetamine user
speed freaks
classic amphetamines
DEXTROAMPHETAMINE
METAMPHETAMINE
METHYLPHENIDATE
moa of classic amphetamines
inc synaptic dopamine primarily by stimulating presynaptic release
amphetamine related substances
EPHEDRINE
PROPANOLAMINE
FENFLURAMKNE
PHENYLPROPANOLAMINE
designer amphetamines
MDMA
MDEA
DOM
moa of designer amphetamines
inc release of catecholamines(dopamine, NE) and serotonin
most potent hallucinogen
LSD