Drug Abuse- Egleton Flashcards
drugs of abuse either directly or indirectly increase what and where in the brain
dopamine
nucleus acumbens
what abuse drugs have a direct impact on brain
cocaine
amphetamines
what is being abused more, prescription or street drugs
prescription
what class of drugs are morphine, hydocodone, oxycodone, methadone? what are they usually prescribed for?
opioids
pain killers
what are street name drugs for opioids
heroine
opium
krokodil
what happens to a patient when they overdose with opioids
decreased respiratory rate
decreased bowel sounds
constricted pupils
what is the emergent treatment option for opioid users
goal to improve ventilation not mental status
- IV or Im naloxone
- if respiratory depression remains, give more naloxone as bolus
what is the gold standard for maintenance treatment option for opioid? what’s the concern for this method
Methadone
also an opioid so can be abused
how does Buprenophrine work as a maintenance treatment for opioid abuse
- partial Mu agonist kappa antagonist
- must see withdrawal abstinence for at least 24 hours prior to administration
what drug is used for prevention of relapse of opioids
Naltrexone
what is the physical exam of someone who is withdrawing from opioid
pupil dilation
yawning
increased bowel sounds
hypotension ( volume depletion due to diarrhea and vomiting)
what are patient complaints from withdrawing from opioids and what drugs are used to treat it
Dysphoria/restlessness ( clonidine)
Rhinorrhea/lacrimation
myalgias/arthralgias ( NSAIDS of acetaminophen)
nausea/vomiting ( Loperamide)
How is oxycodone taken
crushing pills, then swallowing, snorting, or injecting
- usually combined with acetaminophen - potential liver issues
what is detected in the urine with Heroin
6-monoacetlymorphine
how does heroin get metabolized to morphine
deacetylmorphine –> 6-monoacetylmorphine –> morphine
what products of heroin give the effects
6-monoacetylmorphine
morphine
Nut job, much, frown, slab are street names for what
heroin
what is cheese heroin
black tar heroin
tylenol PM
Desomorphine
Krokodil
why is it called Krokodil
leaves users with scaly skin
how do sedatives typically work
increasing GABA signaling or promoting endogenous opioid signlaing
what sedative is generally safe in overdose unless coupled with other depressant such as alcohol? what symptom is seen
Benzodiazepines
respiratory and CNS depression
how is over dose Benzodiazepines treated
antidote Flumazenil for severe overdose
- supportive care
- IV diazepam
what are symptoms of aburpt withdrawal of Benzodiazepines
tremors, anxiety, perceptual disturbances, dysphoria, seizures, psychosis
what is the “date rape” and “roofie” drug
Flunitrazepam
what happens in overdose of Barbituates? treatment?
respiratory depression and death
no antidote
what drug what Michael Jackson given and one that anesthesiologists abuse
Propofol
what are short term and long term effects of Propofol
short: mild euphoria, hallucinations, disinhibition
long: addiction
what is Gamma-hydroxybutyrate known as
“date rape” drug
what are side effects of Gamma-hydroxybutyrate
drowsiness, dizziness, nausea/vomiting
what is the the toxicity of gamma-hydroxybutyrate
amnesia, seizures, cardiopulmonary depression ; coma, death
what is the MOA for alcohol
stimulates GABA and opioid transmission
what can be used to prevent opioid transmission in alcohol
Naltrexone
what can be given to a patient to prevent drinking
Disulfiram
general MOA of ampthetamines
directly increase level of dopamine in nucleus accumbens
what amphetamine crosses the BBB the best
metamphetamine
what is the specific MOA of ampthetaimes at different doses
increase neurotransmission
low: NE
moderate: NE and DA
high: NE, DA, 5-HT
what are acute effects of meth
increase attention, concentration, focus, talkativeness
increase mood, elation, euphoria, self confidence
decrease appetite