Drug Abuse Flashcards

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1
Q

Two parts of the definition of tolerance

A

Decrease in intensity and durational response.

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2
Q

Think of ___ and ___ drugs that induce metabolism.

A

warfarin or phenobarbitol

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3
Q

Define user response after tolerance?

A

Increase dose or use more often or both.

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4
Q

Repeated use causes _____ state such that sudden withdrawl produces effects, often opposite of the drug

A

Physical dependence

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5
Q

Short duration of drug withdrawal (high intensity) - two drugs.
Long duration of drug withdrawal (high intensity) - two drugs.

A

Short: alcohol, heroin

Long: chlordiazepoxide, methadone

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6
Q

What is the most powerful reinforcing factor in drug seeking/taking behavior?
Compulsion requiring continuous or periodic use for pleasure or to avoid discomfort.

A

Psychologic dependence

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7
Q

***Addiction triad:

A

Tolerance
Physical dependence
Psychological dependence

A chronic brain disorder

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8
Q
Categories of drugs:
Uppers include...
Downers include...
All arounders include...
Other...
A

Uppers - nicotine, stimulants
Downers - depressants (alcohol/S-H) and narcotics (opioids)
All arounders - hallucinogens
Other - marajuana

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9
Q

Typical of what class?
 CNS
 Tolerance, Psychological, Physical Dependence
 Eye signs - Glazed look, nystagmus, ↓corneal reflex, droopy lids

A

sedative-hypnotics (and alcohol)

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10
Q

Sedative hypnotics:

** Describe withdrawal, overdose, and acute use.

A

Withdrawal - life threatening**

Acute use – do not function well

Overdose – BDZ antidote, others none. Support

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11
Q

What class:

  • alcohol
  • barbiturates (reds, yellows, blues…)
  • benzodiazepines
  • gasoline, glue, freon, spray paint, shoe polish, dust remover (Huffing)
  • other sedative hypnotics - methaqualone
A

sedative-hypnotics

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12
Q

Class:

  • diazepam “very dry martini”
  • alprazolam (trade name?)
  • triazolam
  • clonazepam
  • rohypnol (also known as? What category?)
  • alprazolam vs. clonazepam
A

alprazolam = Xanax

rohypnol = date rape drug, Category 2

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13
Q

What is GHB

A
  • Colorless
  • Odorless
  • Few drops in drink → unconscious
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14
Q

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
A

Narcotics

  • heroin crosses BBB
  • codeine used to be in cough syrup
  • Hydrocodone - Category 2 (1 scrip, written)
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15
Q

What narcotic has a black box warning?

A

oxycontin

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16
Q

medical personnel abuse of narcotics - anesthesiologists v. others.

A

anesthesiologists - fentanyl

others - morphine

17
Q
` HIGH DEGREE
` Analgesia
` Euphoria
` Mental clouding
` Respiratory depression
` Nausea &; Vomiting

MINIMAL
` Miosis (pupil constriction)
` Constipation

tolerance characteristics of what drug class?

A

High degree v. minimal degree of tolerance of narcotics

18
Q

Miosis = abuse of ?

A

narcotic/heroin

19
Q

**respiratory depression, coma, death - pathognomonic for ___ overdose

A

narcotic/heroin

20
Q

Do users of narcotics (heroin) or sedative-hypnotics (alcohol) function well?
Withdrawal of narcotics v. sedative-hypnotics.

A

narcotics function well and withdrawal is NOT life threatening

21
Q

Overdose tx:
Narcotics
Benzos
Alcohol/barbituates

A

Narcotics - naloxone
Benzos - flumazenil
Alcohol/barbituates - none

22
Q

Four long term mangements of narcotic abuse. Name the MOA

  • Methadone
  • Naltrexone
  • Buprenorphine
  • Buprenorphine + naloxone
A
  • Methadone - Mu agonist, analgesic, oral
  • Naltrexone - Mu antagonist, oral
  • Buprenorphine - Weak mu agonist
  • Buprenorphine + naloxone - Once daily sublingual
23
Q
\_\_\_class
` Cocaine (freebase, crack, rock)
` Methamphetamine (speed, crank, crystal meth)
` Ephedrine, pseudoephedrine
` Amphetamine (Adderall…)
` Methylphenidate (Ritalin)
` Caffeine
` Nicotine
A

stimulants

24
Q

**what is a new, very popular stimulant?

A

Bath salts (psychoactive)

$5 insanity, flakka, gravel - E-cig vaporized

25
Q
**Symptoms of \_\_\_class"
` talkativeness
` paranoia
` restlessness and insomnia
` muscle tremors
` memory lapses and mental confusion
` hallucination
A

stimulants

26
Q

Mydriasis signifies ____ class

Miosis signifies ____ class

Bug eyes, walleye appearance - eyeball protuberance.

Glazed look, nystagmus, ↓corneal reflex, droopy lids

Red sclera

A

Mydriasis - cocaine and methamphetamine (stimulants; inc SNS, dry eyes)

Miosis (pupil constriction) - narcotics

Bug eye - PCP

Droopy - sedative-hypnotics (alcohol)

Red sclera - Marijuana (vessel)

27
Q

Beta blockers are absolutely contraindicated in management of acute OD ____? What is preferred?

A

In Stimulant Class overdose, CCBs are preferred.

28
Q

hyperthermia is in ___ OD

A

stimulant

29
Q

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

A

hallucinogens

30
Q

What is a mild stimulant and mild halliginogen?

A

Methylene Diamene Amphetamine (MDA) and Methyl Diamene Amphetamine (MMDA)

31
Q

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?

A

ecstasy

Cause of death: constriction of vessels in heart and brain, dehydration, hyperthermia, may cause hypercarbia

32
Q

Veterinary medicine, also date rape drug

A

ketamine

33
Q

Bug eyes, walleye appearance - eyeball protuberance

A

PCP (phencyclidine - PeaCe Pill)

34
Q
What drug?
Acute use: Hyperactivity, paranoia, analgesia, combativeness, hallucinations (extremely strong - require straight jacket)
Chronic use: Psychosis
Overdose: Haloperidol, other lavage
Withdrawal: Close observation
A

PCP

35
Q

What is a stimulant, depressant, and hallucinogen?

A

Marijuana

36
Q

Does prolonged use of marijuana produce permanent changes?

A

No permanent changes

37
Q

What are three medical uses of marijuana?

A
N/V (cancer/chemo)
Wasting disease (AIDS, CA)
38
Q

Acute use: Function well, hyperactive
Chronic use: Paranoia, psychoses
Overdose: Convulsions, arrhythmias, body temperature
Withdrawal: Bromocriptine, TCAs

A

stimulants