Drug abuse Flashcards
Dependence
withdrawal syndrome- signs/symptoms which occur when a drug is no longer available, drugs of abuse, nonpsychoactive drugs
Addiction
compulsive, relapsing drug use despite neagative consequences, triggered by cravings and contextual cues
3 stages of dependence
chronic exposure- adaptation, tolerance- need for increased dose, withdrawal- changes apparent when drug is terminated
Dopamine hypothesis of addiction
physiologic condition- mesolimbic DA- learning and adaptation; addiction- mesolimbic dopamine- pleasure and rewards center, stimulus and rewards, result- behavior becomes compulsive
Caffeine pharmacology
CNS-stimulant, cardiac, resp, and diuretic effect; therapeutic- asthma, narcolepsy, HA, resp depression in neonatal pop*, behavior effects- increased mental alertness
Caffeine dosing
effects seen with small oral dose- 100-200mg, 1-2 cups coffee, lethal dose- 10 grams/ 100 cups coffee
Caffeinism
clinical syndrome- central and peripheral sx, CNS: anxiety, insomnia, mood changes, peripheral: tachycardia, HTN, arrhythmias, GI disturbances; generally dose related
Caffeine tolerance and dependence
chronic use associated w/ habituation/ tolerance, may produce low-grade withdrawal sx, HA, drowsiness, fatigue, neg mood state, maximaized after 1-2 days and cease withing few days
Nicotine pharmacology
selective agonist of nicotinic AcH receptor causing rewarding effect, effects= early- nausea/vomiting, stimulates hypothalamus to release antidiuretic hormone, reduce nerve fivers in muscle, reduce appetitie, alters taste buds, increases psychomotor activity, memory
Effects of nicotine on periphery
inc heart rate, blood pressure, cardiac contractility, vasodilates nom-atherosclerotic coronary arteries
Nicotine tolerance and dependence
clearly induces both physiological and psychological dependence, w/drawal syndrome is not life threatening
Nicotine toxicity
nicotine- responsible for acute pharm effects and withdrawal signs; tar- responsible for disease associated long term tobacco use, life is shortened by 14 mins for every cigarette smoked
Nicotine cardiovascular disease
CO- dec o2 delivery to heart muscle, nicotine- inc myocardial O2 demand d/t cardiac stimulation, both inc the incidence of atherosclerotic and thrombosis in coronary arteries, atherosclerosis also occurs elsewhere- strokes
Nicotine Pulmonary disease
smokers syndrome- diff breathing, wheezing, chest pain, lung congestion, inc susceptibility to RTI, impairs ventilitation, reduces immune effects of lungs
Nicotine Cancer
major cause of lung ca, mouth, laryngeal, throat, bladder, pancreatic, uterine, cervical
Nicotine pregnancy
adversely effects developiing fetus, low birth weight, preterm delivery, cig smoke reduces O2 delivery to developing fetus, cessation early in preg appears to reverse these effects
Approaches to smoking cessation
Gum, inhaler, lozenge, nasal spray, transdermal, drugs
Bupropion (Zyban)
antidepressant may mimic nicotinic effects on DA and norepinephrine, start 1-2 weeks prior to target wuit date, Day 1-3 150mg orally once daily, Day 4- 150 mg orally BID, continue 7-12 weeks
ADRs of bupropion
tachycardia, HA, insomnia, dizziness, wt loss, nausea, pharyngitis
Varenicline (Chantix)
a4B2 nAcHR partial agonist works on DA neurons of the VTA preventing nicotine from exerting action, start 1 week prior to quit date, day 1-3: .5 mg orally twice every day, D 4-7: .5 mg orally BID, Day >8: 1 mg orally BID for 11 weeks
ADRs of varenicline (Chantix)
HA, insomnia, abnormal dreams, suicidal ideation, angina