Drug Abuse- Egleton Flashcards by Bina Malapur

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

dopamine

nucleus acumbens

How well did you know this?

Not at all

Perfectly

what abuse drugs have a direct impact on brain

cocaine

amphetamines

How well did you know this?

Not at all

Perfectly

what is being abused more, prescription or street drugs

prescription

How well did you know this?

Not at all

Perfectly

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

opioids

pain killers

How well did you know this?

Not at all

Perfectly

what are street name drugs for opioids

heroine
opium
krokodil

How well did you know this?

Not at all

Perfectly

what happens to a patient when they overdose with opioids

decreased respiratory rate
decreased bowel sounds
constricted pupils

How well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

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 well did you know this?

Not at all

Perfectly

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

How well did you know this?

Not at all

Perfectly

what drug is used for prevention of relapse of opioids

Naltrexone

How well did you know this?

Not at all

Perfectly

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)

How well did you know this?

Not at all

Perfectly

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 well did you know this?

Not at all

Perfectly

How is oxycodone taken

crushing pills, then swallowing, snorting, or injecting

- usually combined with acetaminophen - potential liver issues

How well did you know this?

Not at all

Perfectly

what is detected in the urine with Heroin

6-monoacetlymorphine

How well did you know this?

Not at all

Perfectly

how does heroin get metabolized to morphine

deacetylmorphine –> 6-monoacetylmorphine –> morphine

How well did you know this?

Not at all

Perfectly

what products of heroin give the effects

6-monoacetylmorphine

morphine

How well did you know this?

Not at all

Perfectly

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

heroin

How well did you know this?

Not at all

Perfectly

what is cheese heroin

black tar heroin

tylenol PM

How well did you know this?

Not at all

Perfectly

Desomorphine

Krokodil

How well did you know this?

Not at all

Perfectly

why is it called Krokodil

leaves users with scaly skin

How well did you know this?

Not at all

Perfectly

how do sedatives typically work

increasing GABA signaling or promoting endogenous opioid signlaing

How well did you know this?

Not at all

Perfectly

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 well did you know this?

Not at all

Perfectly

how is over dose Benzodiazepines treated

antidote Flumazenil for severe overdose

supportive care
IV diazepam

How well did you know this?

Not at all

Perfectly

what are symptoms of aburpt withdrawal of Benzodiazepines

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

How well did you know this?

Not at all

Perfectly

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

what makes amphetamines the most abused drugs on college campuses

increases vigilance, wakefullness | decreases fatigue, appetite

what are acute adverse effects of Meth

anxiety, insomnia | high doses--> convulsions

what are chronic adverse effects of meth

paranoid schizophrenia like state hallucinations delusions

what organ systems can meth impact

cardiovascular | GI

what are long term effects of emth

"meth mites"- phantom itch leading to scratching | "meth mouth" - reduced blood flow, dental hygiene

withdrawal symptoms of meth

mental depression, fatigue, ravenous hunger

using meth builds a tolerance to what

euphoria and anorectic and toxic CNS effects

if one were to overdose on Meth what would happen

``` tachycardia hypertension dilated pupils hyperthermia diaphoresis ```

what is the treatment for overdose of Meth

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

what is the name for the designer drug "Esctasy" "E"

MDMA

MOA for MDMA

indirect serotonergic agonist | -increase release of 5-HT; blocks reuptake of 5-HT

MDMA enhances what

pleasure, sexuality

what is a side effect of MDMA

dehydration

what is the toxicity of MDMA

narrow margin of safety cardiac arrhythmias convulsions renal failure

what are some psychiatric effects

``` psychosis depression ( long term use) ```

what is mechanism of action for cocaine

blocks reuptake of NE, DA, 5-HT | blocks Na+ channels: blocks slows down nerve conduction

what is the CNS stimulation of cocaine

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

what are 4 metabolites of cocaine

Banzoylecgonine Ecgonine Norcocaine Cocaethylene

which cocaine metabolite is metabolized byP450

norcocaine

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

Cocaethylene - formed only in presence of alcohol - crosses BBB

what is the biggest toxicity with cocaine

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

How does one treat agitation from cocaine use

Benzodiazepim

How does one treat hypertension from cocaine use

Benzodiazepine Phentolamine NO BETA BLOCKERS

How does one treat myocardial infarction from cocaine use

aspirin nitroglycerin phentolamine NO BETA BLOCKERS

what is used during withdrawal to reduce craving of cocaine

Bromocriptine

is the most common drug cocaine is mixed with

Levamisole

what are some effects of using Levamisole with cocaine

MAOI and COMT inhibitory action | induce neutropenia and agranulocytosis

what is crack

free base form of cocaine

ivory wave, white lightning, charlie, cloud 9

bath salts

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

mephedrone, MDPV, and methylone

bath salts are similar to what other drug

amphetamines

African immigrants usually abuse what drug

Khat

what drugs is the principal alkaloid of plants of genus nicotiana

nicotine

what are some properties of nicotine

lipid soluble tertiary amine | - rapidly absorbed, distributed

what is nicotine's metabolite

continine

the tar in the cigarette does what

accelerates metabolism of nicotine and other drugs

what is the MOA of nicotine

activates cholinergic nicotinic receptors

what is the toxicity of Nicotine

central respiratory paralysis | severe hypotension caused by medullary paralysis

what happens during withdrawal of nicotine

peak 1-2 days after quitting | then decreases over a period of weeks

what can caffeine treat? what form of caffeine?

idiopathic apnea of prematurity | caffeine citrate

what is caffeine sodium benzoate used for in adults

treatment of spinal puncture headaches

Methylxanthine

caffeine

what is the MOA of caffeine

- translocation of extracellular calcium - increase cAMP, cGMP via inhibition of PDE - blockade of adenosine receptors

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

decrease fatigue | increase mental alertness via stimulation of cortex

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

increase anxiety and tremors

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

what is MOA for LSD ( lysergic acid diethylamide)

agonist at 5-HT1 and 5-HT2

what are clinical symptoms of LDS

visual Hallucinations with brilliant colors and mood alterations occur

what drug can be used to treat what in LDS

Haloperidol blocks hallucinations

Special K

Ketamine

"angel dust"

phencyclidine

what is the MOA for ketamine and phencyclidine

antagonizes glutamate action

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

Native American Church Mescaline LSD

what is the number one abused hallucinogen abused in the world

cannabis

what does cannabis have inside of it

delta9-tetrahydrocannabinol | THC

what is a THC drug and what is it used for

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

Marijuana vs. Hashish-Hashoil

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

MOS of NBome

5-HT2A agonist