Drug Abuse Flashcards
Two parts of the definition of tolerance
Decrease in intensity and durational response.
Think of ___ and ___ drugs that induce metabolism.
warfarin or phenobarbitol
Define user response after tolerance?
Increase dose or use more often or both.
Repeated use causes _____ state such that sudden withdrawl produces effects, often opposite of the drug
Physical dependence
Short duration of drug withdrawal (high intensity) - two drugs.
Long duration of drug withdrawal (high intensity) - two drugs.
Short: alcohol, heroin
Long: chlordiazepoxide, methadone
What is the most powerful reinforcing factor in drug seeking/taking behavior?
Compulsion requiring continuous or periodic use for pleasure or to avoid discomfort.
Psychologic dependence
***Addiction triad:
Tolerance
Physical dependence
Psychological dependence
A chronic brain disorder
Categories of drugs: Uppers include... Downers include... All arounders include... Other...
Uppers - nicotine, stimulants
Downers - depressants (alcohol/S-H) and narcotics (opioids)
All arounders - hallucinogens
Other - marajuana
Typical of what class?
CNS
Tolerance, Psychological, Physical Dependence
Eye signs - Glazed look, nystagmus, ↓corneal reflex, droopy lids
sedative-hypnotics (and alcohol)
Sedative hypnotics:
** Describe withdrawal, overdose, and acute use.
Withdrawal - life threatening**
Acute use – do not function well
Overdose – BDZ antidote, others none. Support
What class:
- alcohol
- barbiturates (reds, yellows, blues…)
- benzodiazepines
- gasoline, glue, freon, spray paint, shoe polish, dust remover (Huffing)
- other sedative hypnotics - methaqualone
sedative-hypnotics
Class:
- diazepam “very dry martini”
- alprazolam (trade name?)
- triazolam
- clonazepam
- rohypnol (also known as? What category?)
- alprazolam vs. clonazepam
alprazolam = Xanax
rohypnol = date rape drug, Category 2
What is GHB
- Colorless
- Odorless
- Few drops in drink → unconscious
What class?
- Morphine (heroin) - “pure” white, “Mexican” brown, smack, horse
- Codeine - what used to contain this?
- Oxycodone (OxyContin) (Hillbilly Heroin) – international internet sales
- Hydrocodone – increased abuse. What category?? (Vicodin)
- Hydromorphone (Dilaudid) - drug store heroin, Mr. Brownstone
- Fentanyl - China white. Acetyl fentanyl
Narcotics
- heroin crosses BBB
- codeine used to be in cough syrup
- Hydrocodone - Category 2 (1 scrip, written)
What narcotic has a black box warning?
oxycontin
medical personnel abuse of narcotics - anesthesiologists v. others.
anesthesiologists - fentanyl
others - morphine
` HIGH DEGREE ` Analgesia ` Euphoria ` Mental clouding ` Respiratory depression ` Nausea &; Vomiting
MINIMAL
` Miosis (pupil constriction)
` Constipation
tolerance characteristics of what drug class?
High degree v. minimal degree of tolerance of narcotics
Miosis = abuse of ?
narcotic/heroin
**respiratory depression, coma, death - pathognomonic for ___ overdose
narcotic/heroin
Do users of narcotics (heroin) or sedative-hypnotics (alcohol) function well?
Withdrawal of narcotics v. sedative-hypnotics.
narcotics function well and withdrawal is NOT life threatening
Overdose tx:
Narcotics
Benzos
Alcohol/barbituates
Narcotics - naloxone
Benzos - flumazenil
Alcohol/barbituates - none
Four long term mangements of narcotic abuse. Name the MOA
- Methadone
- Naltrexone
- Buprenorphine
- Buprenorphine + naloxone
- Methadone - Mu agonist, analgesic, oral
- Naltrexone - Mu antagonist, oral
- Buprenorphine - Weak mu agonist
- Buprenorphine + naloxone - Once daily sublingual
\_\_\_class ` Cocaine (freebase, crack, rock) ` Methamphetamine (speed, crank, crystal meth) ` Ephedrine, pseudoephedrine ` Amphetamine (Adderall…) ` Methylphenidate (Ritalin) ` Caffeine ` Nicotine
stimulants
**what is a new, very popular stimulant?
Bath salts (psychoactive)
$5 insanity, flakka, gravel - E-cig vaporized
**Symptoms of \_\_\_class" ` talkativeness ` paranoia ` restlessness and insomnia ` muscle tremors ` memory lapses and mental confusion ` hallucination
stimulants
Mydriasis signifies ____ class
Miosis signifies ____ class
Bug eyes, walleye appearance - eyeball protuberance.
Glazed look, nystagmus, ↓corneal reflex, droopy lids
Red sclera
Mydriasis - cocaine and methamphetamine (stimulants; inc SNS, dry eyes)
Miosis (pupil constriction) - narcotics
Bug eye - PCP
Droopy - sedative-hypnotics (alcohol)
Red sclera - Marijuana (vessel)
Beta blockers are absolutely contraindicated in management of acute OD ____? What is preferred?
In Stimulant Class overdose, CCBs are preferred.
hyperthermia is in ___ OD
stimulant
Examples of ___ class?
` LySergic acid Diethylamide - LSD (take with a cube of sugar lol)
` MethyleneDioxy Amphetamine - XTC, MDA (Molly)
` Psilocybin
` Mushrooms - shrooms
` Peyote - Mescaline
` PCP, Angel Dust, Hog, Naked Butt
hallucinogens
What is a mild stimulant and mild halliginogen?
Methylene Diamene Amphetamine (MDA) and Methyl Diamene Amphetamine (MMDA)
What drug is a social drug, rave parties. Causes Dry mouth, grind teeth, elevated temperatures, obstructive sleep apnea.
What is the likely cause of death?
ecstasy
Cause of death: constriction of vessels in heart and brain, dehydration, hyperthermia, may cause hypercarbia
Veterinary medicine, also date rape drug
ketamine
Bug eyes, walleye appearance - eyeball protuberance
PCP (phencyclidine - PeaCe Pill)
What drug? Acute use: Hyperactivity, paranoia, analgesia, combativeness, hallucinations (extremely strong - require straight jacket) Chronic use: Psychosis Overdose: Haloperidol, other lavage Withdrawal: Close observation
PCP
What is a stimulant, depressant, and hallucinogen?
Marijuana
Does prolonged use of marijuana produce permanent changes?
No permanent changes
What are three medical uses of marijuana?
N/V (cancer/chemo) Wasting disease (AIDS, CA)
Acute use: Function well, hyperactive
Chronic use: Paranoia, psychoses
Overdose: Convulsions, arrhythmias, body temperature
Withdrawal: Bromocriptine, TCAs
stimulants
