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pharm exam 3 > drug abuse > Flashcards

drug abuse Flashcards

1
Q

what is the reward pathway

A

mesolimbic dopamine system

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2
Q

Disulfiram

A

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.

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3
Q

Alcohol tx

A

produce sedation and sleep

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4
Q

ETOH MOA

A
  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
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5
Q

what should you not mix alcohol with

A

CNS depressants

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6
Q

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

A

vitamin B 1; avoid

“Wernicke-Korsakoff syndrome”

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7
Q

Symptoms of Wernicke-Korsakoff syndrome

A

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
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8
Q

what does long term consumption of ETOH lead to

A

ETOH tolerance, withdrawal, addiction

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9
Q

when liver combines cocaine and ETOH, it produces what?

A

Cocadethylene

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10
Q

what drugs should be given for acute alcohol withdrawal?

A

benzodiazepine (oxazepam, diazepam)

Anticonvulsant(carbamazepine)

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11
Q

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

A

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

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12
Q

what are the two most commonly abused benzo?

A

diazepam and alprazolam(xanax)

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13
Q

What drugs are considered “date rape drugs”

A

Flunitrazepam, GHB (gamma hydroxybutyric acid) aka Ecstasy

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14
Q

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

A

mu-opioid receptors–>euphoria

Kappa opioid–>dysphoria

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15
Q

what is used for opioid overdose? MOA?

A

Naloxone:

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

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16
Q

what drug is used primarily for maintenance of opioid addiction

A

naltrexone

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17
Q

what is used to treat opioid WITHDRAWAL and addiction

A

Methadone

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18
Q

where is Alcohol metabolized

A

90% metabolized in liver

10% metabolized in kidneys and lung (hence breathalizer)

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19
Q

what can block EtOH–>aldehyde

A

Fomepizole

20
Q

how “black outs” or memory occur when drunk?

A

blocking of NMDA receptors in certain parts of the brain

21
Q

which barbiturate is commonly abused?

A

pentobarbital

22
Q

what is one of the main things that GHB cause?

A

Amnesia

23
Q

which group of drug is most addictive?

A

Psychostimulants

24
Q

What is Cocaethylene?

A

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

25
Q

which drug causes the strongest psychological dependence? aka addiction

A

cocaine

26
Q

Amphetamine side effects

A

MI, cerebro vascular sizure, hemorrhage, seizure death

Sympathomimetic effect: mydriasis, tachycardia, hypertension– due to vesicular release of NE

27
Q

What is crystal meth? and what is its effect

A

Methamphetamine; can release 3x more dopamine than other amphetamine

28
Q

whats the diff between cocaine and meth

A

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

29
Q

What does Methyphenidate clinically treat?

A

ADHD and narcolepsy

30
Q

Methyphenidate MOA?

A

DA/NE ruptake blocker

31
Q

MDMA (Ectasy) MOA

A

interferes with SERT to release serotonin from presynaptic terminal

32
Q

MDMA acute toxicity vs chronic toxicity

A

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

33
Q

which group of drugs is least addicting? why?

A

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

34
Q

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

A

LSD:lysergic Acid diethylamide, and Psilocybin

35
Q

What is ketamine used as? what are its effects

A

DISSOCIATIVE anesthesia and analgesic

hallucination, impaired memory, visual alteration

36
Q

Ketamine MOA

A

blocks NMDA-glutamate receptor of prefrontal cortex

37
Q

LSD/Psilocybin MOA

A

release glutamate via thalamic excitation. It targets 5HT2a receptors

38
Q

what are the top opioids of addiction?

A

Morphine
Oxycodone
Codeine
Heroin

39
Q

what is used for opioid overdose

A

naloxone

40
Q

what tx is used for long term opiate use?

A

Methadone and Naltrexone

41
Q

THC MOA

A

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

42
Q

what is THC used for

A

chronic pain relief

43
Q

what is the synthetic THC used for chronic pain

A

Dronabinol

44
Q

Bupropion

A

used for smoking cessation

45
Q

Varenicline

A

competes bindining with nicotine @ NAChR receptor

pharm exam 3 (9 decks)

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