Drug Abuse- Egleton Flashcards

1
Q

drugs of abuse either directly or indirectly increase what and where in the brain

A

dopamine

nucleus acumbens

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2
Q

what abuse drugs have a direct impact on brain

A

cocaine

amphetamines

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3
Q

what is being abused more, prescription or street drugs

A

prescription

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4
Q

what class of drugs are morphine, hydocodone, oxycodone, methadone? what are they usually prescribed for?

A

opioids

pain killers

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5
Q

what are street name drugs for opioids

A

heroine
opium
krokodil

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6
Q

what happens to a patient when they overdose with opioids

A

decreased respiratory rate
decreased bowel sounds
constricted pupils

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7
Q

what is the emergent treatment option for opioid users

A

goal to improve ventilation not mental status

  • IV or Im naloxone
  • if respiratory depression remains, give more naloxone as bolus
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8
Q

what is the gold standard for maintenance treatment option for opioid? what’s the concern for this method

A

Methadone

also an opioid so can be abused

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9
Q

how does Buprenophrine work as a maintenance treatment for opioid abuse

A
  • partial Mu agonist kappa antagonist

- must see withdrawal abstinence for at least 24 hours prior to administration

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10
Q

what drug is used for prevention of relapse of opioids

A

Naltrexone

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11
Q

what is the physical exam of someone who is withdrawing from opioid

A

pupil dilation
yawning
increased bowel sounds
hypotension ( volume depletion due to diarrhea and vomiting)

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12
Q

what are patient complaints from withdrawing from opioids and what drugs are used to treat it

A

Dysphoria/restlessness ( clonidine)
Rhinorrhea/lacrimation
myalgias/arthralgias ( NSAIDS of acetaminophen)
nausea/vomiting ( Loperamide)

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13
Q

How is oxycodone taken

A

crushing pills, then swallowing, snorting, or injecting

- usually combined with acetaminophen - potential liver issues

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14
Q

what is detected in the urine with Heroin

A

6-monoacetlymorphine

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15
Q

how does heroin get metabolized to morphine

A

deacetylmorphine –> 6-monoacetylmorphine –> morphine

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16
Q

what products of heroin give the effects

A

6-monoacetylmorphine

morphine

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17
Q

Nut job, much, frown, slab are street names for what

A

heroin

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18
Q

what is cheese heroin

A

black tar heroin

tylenol PM

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19
Q

Desomorphine

A

Krokodil

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20
Q

why is it called Krokodil

A

leaves users with scaly skin

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21
Q

how do sedatives typically work

A

increasing GABA signaling or promoting endogenous opioid signlaing

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22
Q

what sedative is generally safe in overdose unless coupled with other depressant such as alcohol? what symptom is seen

A

Benzodiazepines

respiratory and CNS depression

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23
Q

how is over dose Benzodiazepines treated

A

antidote Flumazenil for severe overdose

  • supportive care
  • IV diazepam
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24
Q

what are symptoms of aburpt withdrawal of Benzodiazepines

A

tremors, anxiety, perceptual disturbances, dysphoria, seizures, psychosis

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25
Q

what is the “date rape” and “roofie” drug

A

Flunitrazepam

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26
Q

what happens in overdose of Barbituates? treatment?

A

respiratory depression and death

no antidote

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27
Q

what drug what Michael Jackson given and one that anesthesiologists abuse

A

Propofol

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28
Q

what are short term and long term effects of Propofol

A

short: mild euphoria, hallucinations, disinhibition
long: addiction

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29
Q

what is Gamma-hydroxybutyrate known as

A

“date rape” drug

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30
Q

what are side effects of Gamma-hydroxybutyrate

A

drowsiness, dizziness, nausea/vomiting

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31
Q

what is the the toxicity of gamma-hydroxybutyrate

A

amnesia, seizures, cardiopulmonary depression ; coma, death

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32
Q

what is the MOA for alcohol

A

stimulates GABA and opioid transmission

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33
Q

what can be used to prevent opioid transmission in alcohol

A

Naltrexone

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34
Q

what can be given to a patient to prevent drinking

A

Disulfiram

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35
Q

general MOA of ampthetamines

A

directly increase level of dopamine in nucleus accumbens

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36
Q

what amphetamine crosses the BBB the best

A

metamphetamine

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37
Q

what is the specific MOA of ampthetaimes at different doses

A

increase neurotransmission

low: NE
moderate: NE and DA
high: NE, DA, 5-HT

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38
Q

what are acute effects of meth

A

increase attention, concentration, focus, talkativeness
increase mood, elation, euphoria, self confidence
decrease appetite

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39
Q

what makes amphetamines the most abused drugs on college campuses

A

increases vigilance, wakefullness

decreases fatigue, appetite

40
Q

what are acute adverse effects of Meth

A

anxiety, insomnia

high doses–> convulsions

41
Q

what are chronic adverse effects of meth

A

paranoid schizophrenia like state
hallucinations
delusions

42
Q

what organ systems can meth impact

A

cardiovascular

GI

43
Q

what are long term effects of emth

A

“meth mites”- phantom itch leading to scratching

“meth mouth” - reduced blood flow, dental hygiene

44
Q

withdrawal symptoms of meth

A

mental depression, fatigue, ravenous hunger

45
Q

using meth builds a tolerance to what

A

euphoria and anorectic and toxic CNS effects

46
Q

if one were to overdose on Meth what would happen

A
tachycardia
hypertension
dilated pupils
hyperthermia 
diaphoresis
47
Q

what is the treatment for overdose of Meth

A

Benzodiazepine

if that does not work: antipsychotics: Chlorpromazine, Haloperidol, droperidol, Ziprasidone

48
Q

what is the name for the designer drug “Esctasy” “E”

A

MDMA

49
Q

MOA for MDMA

A

indirect serotonergic agonist

-increase release of 5-HT; blocks reuptake of 5-HT

50
Q

MDMA enhances what

A

pleasure, sexuality

51
Q

what is a side effect of MDMA

A

dehydration

52
Q

what is the toxicity of MDMA

A

narrow margin of safety
cardiac arrhythmias
convulsions
renal failure

53
Q

what are some psychiatric effects

A
psychosis
depression ( long term use)
54
Q

what is mechanism of action for cocaine

A

blocks reuptake of NE, DA, 5-HT

blocks Na+ channels: blocks slows down nerve conduction

55
Q

what is the CNS stimulation of cocaine

A

increase mental awareness, euphoria
prolongation of DA effects in limbic system –> euphoria
chronic cocaine intake–> DA depletion –> triggers craving for cocaine

56
Q

what are 4 metabolites of cocaine

A

Banzoylecgonine
Ecgonine
Norcocaine
Cocaethylene

57
Q

which cocaine metabolite is metabolized byP450

A

norcocaine

58
Q

What is the only active metabolite of cocaine? when does it form? what is special about it

A

Cocaethylene

  • formed only in presence of alcohol
  • crosses BBB
59
Q

what is the biggest toxicity with cocaine

A

cardiac failure: rapid elevation of blood pressure which can lead to stoke, irregular heartbeat, cardiac arrest

60
Q

How does one treat agitation from cocaine use

A

Benzodiazepim

61
Q

How does one treat hypertension from cocaine use

A

Benzodiazepine
Phentolamine
NO BETA BLOCKERS

62
Q

How does one treat myocardial infarction from cocaine use

A

aspirin
nitroglycerin
phentolamine
NO BETA BLOCKERS

63
Q

what is used during withdrawal to reduce craving of cocaine

A

Bromocriptine

64
Q

is the most common drug cocaine is mixed with

A

Levamisole

65
Q

what are some effects of using Levamisole with cocaine

A

MAOI and COMT inhibitory action

induce neutropenia and agranulocytosis

66
Q

what is crack

A

free base form of cocaine

67
Q

ivory wave, white lightning, charlie, cloud 9

A

bath salts

68
Q

Designer drugs of bath salts are availbale legally in some states and can be a combination of what

A

mephedrone, MDPV, and methylone

69
Q

bath salts are similar to what other drug

A

amphetamines

70
Q

African immigrants usually abuse what drug

A

Khat

71
Q

what drugs is the principal alkaloid of plants of genus nicotiana

A

nicotine

72
Q

what are some properties of nicotine

A

lipid soluble tertiary amine

- rapidly absorbed, distributed

73
Q

what is nicotine’s metabolite

A

continine

74
Q

the tar in the cigarette does what

A

accelerates metabolism of nicotine and other drugs

75
Q

what is the MOA of nicotine

A

activates cholinergic nicotinic receptors

76
Q

what is the toxicity of Nicotine

A

central respiratory paralysis

severe hypotension caused by medullary paralysis

77
Q

what happens during withdrawal of nicotine

A

peak 1-2 days after quitting

then decreases over a period of weeks

78
Q

what can caffeine treat? what form of caffeine?

A

idiopathic apnea of prematurity

caffeine citrate

79
Q

what is caffeine sodium benzoate used for in adults

A

treatment of spinal puncture headaches

80
Q

Methylxanthine

A

caffeine

81
Q

what is the MOA of caffeine

A
  • translocation of extracellular calcium
  • increase cAMP, cGMP via inhibition of PDE
  • blockade of adenosine receptors
82
Q

what are the effects of 1-2 cups off coffee 100-200 mg caffeine

A

decrease fatigue

increase mental alertness via stimulation of cortex

83
Q

what are the effects of 12-15 cups off ceff 1.5 g coffeine

A

increase anxiety and tremors

84
Q

People who have stomach ulcers, is it okay for them to take caffeine

A

no

85
Q

what is MOA for LSD ( lysergic acid diethylamide)

A

agonist at 5-HT1 and 5-HT2

86
Q

what are clinical symptoms of LDS

A

visual Hallucinations with brilliant colors and mood alterations occur

87
Q

what drug can be used to treat what in LDS

A

Haloperidol blocks hallucinations

88
Q

Special K

A

Ketamine

89
Q

“angel dust”

A

phencyclidine

90
Q

what is the MOA for ketamine and phencyclidine

A

antagonizes glutamate action

91
Q

what religion uses hallucinogens? what hallucinogen do they use and it has similiar effects as what

A

Native American Church
Mescaline
LSD

92
Q

what is the number one abused hallucinogen abused in the world

A

cannabis

93
Q

what does cannabis have inside of it

A

delta9-tetrahydrocannabinol

THC

94
Q

what is a THC drug and what is it used for

A

Dronabinol

used to treat severe nausea and pain caused by some diseases such as AIDS and cancer and appetite stimulant

95
Q

Marijuana vs. Hashish-Hashoil

A

Marijuana: dried plant material
Hashish - exuded resinous mateiral from plant
hash oil - liquid extract from plant material
LIPOPHILIC

96
Q

MOS of NBome

A

5-HT2A agonist