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S3 Case 2 - Mental Health > Drug Abuse, Addiction + Dependence > Flashcards

Drug Abuse, Addiction + Dependence Flashcards

1
Q

What is drug abuse?

A

Use of drugs for non-therapeutic use

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2
Q

What is substance misuse disorder?

A

Persistent use of drugs despite substantial harm + adverse consequences

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3
Q

What is addiction?

A

Compulsion to engage in a behaviour despite substantial harm + adverse consequences

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4
Q

What is dependence?

A

Physiological state in which the person can only function normally in the presence of the drug

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5
Q

What is withdrawal?

A

Removal of the drug produces a physiological disturbance

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6
Q

What are examples of amphetamines?

A

Speed
Ecstasy
Crystal meth
MDMA

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7
Q

What are amphetamines used for?

A

ADHD
Narcolepsy

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8
Q

What does amphetamine-like drugs do?

A

Increase synaptic levels of monoamines by causing non-impulse dependent release
= release of neurotransmitters without release

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9
Q

What does the release of excess monoamine neurotransmitters induce?
Amphetamines

A

“High”
Reward
Locomotor activation

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10
Q

What transporters does monoamine neuronal terminals have?
Amphetamines

A

Dopamine transporter (DAT)
Noradrenaline transporter (NAT)
Serotonin transporter (SERT) 5-HTT

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11
Q

What is the selectivity of amphetamines dependent on?

A

Affinity for each transporter

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12
Q

What does methamphetamine have the highest affinity for?

A

DAT

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13
Q

What does d-amphetamine have affinity for?

A

DAT + NAT

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14
Q

What does ecstasy have affinity for?

A

DAT, NAT + SERT

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15
Q

Describe the mechanism of action for amphetamines

A

Amphetamines enter nerve terminal via plasma membrane transporter
Different affinities for transporters
Amphetamines are transported into vesicles by VMAT2
Cause release of neurotransmitters into cytosol
Membrane transporter reverses release of neurotransmitters
Reuptake of neurotransmitters BLOCKED

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16
Q

Describe how amphetamines activate the reward pathway

A

Increase dopamine release + increase stimulation of D2 + D1 receptors in nucleus accumbens

17
Q

What is the mechanism of action of cocaine?

A

Binds to DAT
Reuptake of DA is blocked
Level of DA increased in synaptic cleft

18
Q

How does cocaine activate the reward pathway?

A

Blocks DA reuptake + increases stimulation of D2 + D1 in nucleus accumbens

19
Q

What are examples of exogenous opioids (synthetics/natural)?

A

Codeine
Pethidine = childbirth
Morphine
Diamorphine (heroin)
Fentanyl
Oxycontin

20
Q

What is the effects of opioids?

A

Analgesia
Sedation
Anaesthetic
Anti-tussive = stop coughing
Reduce GI motility
Depress respiration
Constrict pupils

21
Q

What is tolerance?

A

Response to given concentration of drug is reduced
More drug must be given to achieve same response

22
Q

How does opioids activate the reward pathway?

A

Activate μ receptors
= decrease GABA release
= DA neurones are disinhibited
= fire more

23
Q

Describe the dependence of heroin

A

Produces “high”
Repeat
Addiction
Tolerance develops
More drug
Physical dependence
Relieve withdrawal + psychological dependence

24
Q

Describe the dependence of codeine

A

Therapeutic use
Tolerance develops
More drug needed
Physical withdrawal
Addiction

25
Q

How do you manage opioid withdrawal?

A

Gradual dose reduction
Substitution of longer acting opioid
Change route of administration
Substitution of non-euphoric opioid
Treatment of withdrawal effects (anxiety, diarrhoea)

26
Q

What can reverse opioid overdose?

A

Naloxone = nasal spray

27
Q

Describe the nicotine receptor

A

Pentamer
Open receptor is permeable to Na+ + K+

28
Q

How does nicotine activate the reward pathway?

A

Activates DA neurones directly + indirectly via Glu inputs

29
Q

What is an example of dependence on a non-rewarding substances?

A

Benzodiazepines

30
Q

What can benzodiazepines be used for?

A

Insomnia
Anxiolytic
Muscle relaxant

31
Q

Describe GABA

A

Important neurotransmitter
Actions mediated by GABAa + GABAb
BOTH inhibitory

32
Q

Describe the GABAa receptor complex

A

Pentamer
GABA binds = open
Lets Cl- through = inhibitory
Benzodiazepine bind = enhance function of GABA

33
Q

What must you do with GABA + Benzodiazepines?

A

Limit prescription to 3 days
Reduce dose gradually
Switch to longer half-life drugs
= decreased dependence

34
Q
A

S3 Case 2 - Mental Health (15 decks)

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