drug abuse

Question 1

what is the reward pathway

Answer 1

mesolimbic dopamine system

Question 2

Disulfiram

Answer 2

inhibits ALDH–>so most alcohol will be converted to aldehyde (fairly toxic)–> will restrain someone from drinking, bc if they drink more they will get sick.

Question 3

Alcohol tx

Answer 3

produce sedation and sleep

Question 4

ETOH MOA

Answer 4

1. Potentiate effects of GABA at GABA-A receptors (ethanol binding site at GABA-A)
   a. Results in increased Cl ion flux& hyperpolarization
2. INHIBIT glutamate-activated NMDA receptors (excitatory)
   a. NMDA receptors are located in prefrontal cortex and limbic system so it affects cognitive function, learning, memory

Question 5

what should you not mix alcohol with

Answer 5

CNS depressants

Question 6

what is usually given to a patient that is coming in to ER with alcohol poisoning? why?

Answer 6

vitamin B 1; avoid

“Wernicke-Korsakoff syndrome”

Question 7

Symptoms of Wernicke-Korsakoff syndrome

Answer 7

due to deficiency of vit B1 and excessive alcohol:

• Ocular disturbances: nystagmus and paralysis of external eye muscle
• Memory impairment: amnesia
• Movement difficulties: ataxia and apraxia

Question 8

what does long term consumption of ETOH lead to

Answer 8

ETOH tolerance, withdrawal, addiction

Question 9

when liver combines cocaine and ETOH, it produces what?

Answer 9

Cocadethylene

Question 10

what drugs should be given for acute alcohol withdrawal?

Answer 10

benzodiazepine (oxazepam, diazepam)

Anticonvulsant(carbamazepine)

Question 11

what should be given for chronic alcoholism? what are their effects?

Answer 11

Disulfiram (anatabuse)–inhibits ALDH: produce acute sensitivity to ETOH–hangover liek symptoms

Naltrexone:opioid antagonist that blocks reinforcing properties of ETOH and reduce rate of relapse

Question 12

what are the two most commonly abused benzo?

Answer 12

diazepam and alprazolam(xanax)

Question 13

What drugs are considered “date rape drugs”

Answer 13

Flunitrazepam, GHB (gamma hydroxybutyric acid) aka Ecstasy

Question 14

Opioids need to bind to what for euphoria effects? dysphoria?

Answer 14

mu-opioid receptors–>euphoria

Kappa opioid–>dysphoria

Question 15

what is used for opioid overdose? MOA?

Answer 15

Naloxone:

ii. Mu opioid competitive antagonist reverese the effects of morphine or heroin within minutes

Question 16

what drug is used primarily for maintenance of opioid addiction

Answer 16

naltrexone

Question 17

what is used to treat opioid WITHDRAWAL and addiction

Answer 17

Methadone

Question 18

where is Alcohol metabolized

Answer 18

90% metabolized in liver

10% metabolized in kidneys and lung (hence breathalizer)

Question 19

what can block EtOH–>aldehyde

Answer 19

Fomepizole

Question 20

how “black outs” or memory occur when drunk?

Answer 20

blocking of NMDA receptors in certain parts of the brain

Question 21

which barbiturate is commonly abused?

Answer 21

pentobarbital

Question 22

what is one of the main things that GHB cause?

Answer 22

Amnesia

Question 23

which group of drug is most addictive?

Answer 23

Psychostimulants

Question 24

What is Cocaethylene?

Answer 24

liver mixes EtOH and cocaine and produces Cocaethylene –> intesnsifies euphoric effects–>DEATH

Question 25

which drug causes the strongest psychological dependence? aka addiction

Answer 25

cocaine

Question 26

Amphetamine side effects

Answer 26

MI, cerebro vascular sizure, hemorrhage, seizure death Sympathomimetic effect: mydriasis, tachycardia, hypertension-- due to vesicular release of NE

Question 27

What is crystal meth? and what is its effect

Answer 27

Methamphetamine; can release 3x more dopamine than other amphetamine

Question 28

whats the diff between cocaine and meth

Answer 28

cocaine last for 20-30 min, meth lasts for 6-24 hrs

Question 29

What does Methyphenidate clinically treat?

Answer 29

ADHD and narcolepsy

Question 30

Methyphenidate MOA?

Answer 30

DA/NE ruptake blocker

Question 31

MDMA (Ectasy) MOA

Answer 31

interferes with SERT to release serotonin from presynaptic terminal

Question 32

MDMA acute toxicity vs chronic toxicity

Answer 32

Acute: hyperthermia and dehydration Chronic: neurotoxicity and irreversible brain damage

Question 33

which group of drugs is least addicting? why?

Answer 33

Psychedelic (hallucinogens); bc its doesnt affect the mesolimbic system

Question 34

which drug depends on affinity of 5HT2 receptors correlated with the potency as hallucingen

Answer 34

LSD:lysergic Acid diethylamide, and Psilocybin

Question 35

What is ketamine used as? what are its effects

Answer 35

DISSOCIATIVE anesthesia and analgesic hallucination, impaired memory, visual alteration

Question 36

Ketamine MOA

Answer 36

blocks NMDA-glutamate receptor of prefrontal cortex

Question 37

LSD/Psilocybin MOA

Answer 37

release glutamate via thalamic excitation. It targets 5HT2a receptors

Question 38

what are the top opioids of addiction?

Answer 38

Morphine Oxycodone Codeine Heroin

Question 39

what is used for opioid overdose

Answer 39

naloxone

Question 40

what tx is used for long term opiate use?

Answer 40

Methadone and Naltrexone

Question 41

THC MOA

Answer 41

THC binds to cannabinoid receptors--> inhibit GABA-A disinhibits DA neurons in VT

Question 42

what is THC used for

Answer 42

chronic pain relief

Question 43

what is the synthetic THC used for chronic pain

Answer 43

Dronabinol

Question 44

Bupropion

Answer 44

used for smoking cessation

Question 45

Varenicline

Answer 45

competes bindining with nicotine @ NAChR receptor