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System Neuroscience > Drug Dependence > Flashcards

Drug Dependence Flashcards

1
Q

Define Addiction

A

Chronic disease characterised by drug seeking and use that is compulsive, or difficult to control, despite harmful consequences

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2
Q

Define Drug Abuse

A

Pattern of drug use in which the users consume the substance in amounts Use methods which are directly/indirectly harmful to themselves or others

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3
Q

Define drug dependence

A

Adaptive state that develops after repeated drug use and which results in withdrawal symptoms upon cessation of drug use

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4
Q

Define Drug Tolerance

A

The diminishing effect of a drug which results after repeated administration at a set dose

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5
Q

Define Psychological dependence

A

Dependence that involves emotional-motivational withdrawal symptoms (e.g. dysphoria, depression, anhedonia, restlessness)

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6
Q

Define physical dependence

A

Dependence that involves significant physical-somatic withdrawal symptoms (e.g. fatigue, nausea, seizures, pain, delirium tremens)

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7
Q

How many admission to hospital with a primary diagnosis of a drug-related mental health and behavioural disorder?

A

6,549

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8
Q

What are class A drugs?

A

Heroin Methadone Cocaine Crack cocaine Ecstasy LSD Magic mushroom

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9
Q

What are class B drugs?

A

Amphetamines Barbiturates Ketamine Methylphenidate Codeine Cannabis

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10
Q

What are class C drugs?

A

Anabolic steroid Benzodiazepine Gamma hydroxybutyrate Gamma butyrolactone Khat

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11
Q

Which drug is deemed most dangerous?

A

Class A

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12
Q

Which drug is thought to have least capacity for harm?

A

Class C

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13
Q

Opiates

A

Agonists at mu opioid receptors

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14
Q

Cocaine

A

DA,NAd and 5-HT uptake systems

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15
Q

Amphetamine

A

Monoaminergic transmission: uptake system; agonist of tract amine-associated receptor 1 (TAAR1)

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16
Q

Ethanol

A

GABA A and NMDA receptors

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17
Q

Nicotine

A

Nicotinic ACH receptors - agonist

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18
Q

Cannabinoids

A

CB1 receptors - agonist

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19
Q

Phencyclidine, ketamine

A

NMDA glutamate receptors - antagonist

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20
Q

Hallucinogens

A

5-HT2A receptors

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21
Q

Barbiturates and benzodiazepine

A

GABA A receptors

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22
Q

Solvents

A

NMDA receptors, nicotinic ACH receptors

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23
Q

Benzodiazepine

A

Drugs that can be abused but have therapeutic value as hypnotics and anxiolytics

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24
Q

What are the endogenous opioid peptide systems?

A

Proopiomelanocortin-derived Proenkephalin -derived Prodynorphin derived

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25
Q

What are the Opioid receptors?

A

Mu (m1,m2,3) Delta Kappa Nociceptin/ orphanin receptors

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26
Q

What are factors determining the development of addiction?

A

Environment Drug-induced effects Genes

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27
Q

What is essential in reward and the development of drug-dependence?

A

Dopaminergic projection from ventral tegmental area to the nucleus accumbens

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28
Q

What are the stages of addiction cycle?

A

Binge/ intoxication Withdrawal/negative effect Preoccupation/Anticipation

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29
Q

What are the brain areas involved in the development of drug dependence?

A

Ventral tegmental area Nucleus accumbens Amygdala Insula Prefrontal cortex Hippocampus

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30
Q

Which compound is used to treat ADHD?

A

Metyhlphethamine

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31
Q

What is dopamine Involved in?

A

Important for first sensation involved in pleasure and reward

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32
Q

What are many withdrawal symptoms categorised by?

A

High levels of anxiety

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33
Q

What is a common feature of anxiety disorder?

A

Hyperactivity of the limbic structures

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34
Q

What are the fear/panic symptoms?

A

Heart rate/blood pressure Bradycardia, ulcers Panting/ respiratory distress Arousal/vigilance/ attention Increased startled response Freezing/ social interaction Corticosteroid release

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35
Q

When an individual takes crack cocaine, what happens in the prefrontal cortex?

A

The metabolism in prefrontal cortex is changed

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36
Q

What are altered in addicts?

A

Prefrontal circuits

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37
Q

What are the processes associated with prefrontal cortex and which are impaired in addicts ?

A

Self control Emotional regulation Motivation Attention and flexibility Working memory Decision making Awareness and insight Learning and memory Salience attribution

38
Q

What are the core components of addiction?

A

Intoxication Bingeing Withdrawal Craving

39
Q

What is intoxication?

A

Impaired self-awareness

40
Q

What is Bingeing?

A

Loss of control

41
Q

What is Withdrawal?

A

Amotivation and anhedonia

42
Q

What is craving?

A

Drug expectation and attention bias

43
Q

What are the characteristics of physical dependence?

A

Physical symptoms of illness Only seen with some abused drug Relatively shorted lived approx 2 weeks Associated with clear cut abstinence syndrome - symptoms of illness occurring on Withdrawal

44
Q

What are the characteristics of psychological dependence ?

A

Compulsion, need or craving to take the drug Produced by all drugs of dependence Long lasting Produced by some drugs (cocaine, amphetamine, nicotine, caffeine)

45
Q

What are examples of withdrawal symptoms of opiates?

A

Diarrhoea Nausea/ vomiting Abdominal cramps Sweating/ shivering Hypertension Seizures Anxiety/ agitation

46
Q

What are some withdrawal symptoms of Alcohol?

A

Seizures Sweating Tremors Delirium tremens (delirium/ vivid hallucination) Anxiety/agitation

47
Q

What are examples of treatment of withdrawal symptoms?

A

Clonidine Buprenorphine Carbamazepine

48
Q

What is clonidine?

A

Alpha 2 receptor adrenoceptor agonist Management of Withdrawal symptoms in opiate addiction

49
Q

What is Buprenorphine?

A

Partial opiate mu receptor agonist Kappa opiated receptor antagonist Management of withdrawal symptoms in opiate addiction

50
Q

What is carbamazepine ?

A

Anticonvulsant Drug Sodium channel blocker Reduces seizures associated with alcohol withdrawal

51
Q

What are sensitive genes ?

A

Go up and down Indication of stimulation

52
Q

What is spines?

A

Where information arrived on dendritic spine important for information processing

53
Q

What does exposure to drug change?

A

Architecture of Cell

54
Q

How are abnormalities in brain caused?

A

Long term exposure to cocaine/morphine

55
Q

What does drug dependence induce

A

Long lasting changes in gene expression Metabolic changes Changes in neurotransmission Global change in brain activity Structural changes

56
Q

What can Alcohol modulate in the brain?

A

Both excitatory and inhibitory transmission

57
Q

What happens when you apply ethanol and NMDA?

A

Decrease excitatory of glutamate receptors

58
Q

Apply ethanol and GABA

A

Enhance function of chloride channel

59
Q

How can transmission in brain be altered by both excitatory and inhibitory neutrotransmission?

A

Dose dependent manner and pattern manner

60
Q

Why is the first phase of alcohol an CNS depressant,?

A

Enhances gabaminertic transmission

61
Q

What happens to an Individual that keeps using alcohol?

A

Adaptation in synapse both glutaminergic and gabaminergic

62
Q

What is alcohol abuse?

A

Social drug

63
Q

What is acute alcohol intoxication?

A

Euphoria developed followed by depressed mood, slurring of speech, ataxia, general incoordination , pupillary dilation

64
Q

What does acute alcohol ingestion lead to?

A

Depressed excitatory transmission Potentiated inhibitory transmission.

65
Q

What happens to brain of chronic alcoholics?

A

Brain shrinks - loss of grey matter 12%

66
Q

What are the treatment for alcohol addiction?

A

Naltrexone Acamprosate Disulfiram

67
Q

Naltrexone

A

Antagonist at mu opioid receptors Rewarding effects of alcohol Reduce relapse

68
Q

Acamprosate

A

Modulator of glutamtergic transmission Partial co-agonist at NMDA glutamate receptors Reduces insomnia, anxiety, restlessness and dysphoria

69
Q

Disulfiram

A

Interferes with alcohol metabolism Acetylaldehyde cannot be transformed into Acetate - build up in body Flushing, nausea, confusion and irregular heartbeat

70
Q

What is ecstasy?

A

Amphetamine

71
Q

What are the multiple targets for MDMA?

A

5-HT uptake system Dopamine uptake system 5-HT2 receptors H2 histamine receptors Alpha 2 adrenergic receptors

72
Q

What does long term recreational use of ecstasy affect?

A

Cognitive processes - metabolic changes in the brain

73
Q

What are the acute MDMA toxicity?

A

Body temperature elevation Disseminated inteavascular coagulation Rhabdomolysis (blocked by danteolene) Increased renal reabsorption of water Hypontraemia and cerebral oedema I

74
Q

What does prolonged exposure to MDMA lead to?

A

Loss of serotonin fibres

75
Q

What receptors does Cannabis have?

A

CD1 and CD2 —> G protein coupled receptors

76
Q

What does THC cannabinoids bind to?

A

CB1 and CB2 receptors

77
Q

Where is CB1 receptor concentrated in?

A

Central nervous system

78
Q

Where are CB2 receptors located?

A

Peripheral organs and are associated with immune system

79
Q

Where are CB1 distributed?

A

Neocortex, hippocampus, basal ganglia, brainstem

80
Q

What is cannabinoids intoxication symptoms?

A

Hypothermia, rigid immobility, decreased motor activity

81
Q

What is the brain rich in?

A

Cannabinoids

82
Q

If cannabinoids knocked out?

A

Lose all affects of cannabis

83
Q

What does long term use of cannabis increase the risk of?

A

Schizophrenia and major depression

84
Q

What is inhaled cannabis?

A

Marijuana

85
Q

Why do people use cocaine?

A

Euphoria Inflated sense of self and increased self-importance Sense of escaping reality Intense burst of energy

86
Q

What are the effects of cocaine?

A

Vasoconstriction, pupillary dilatation, hyperthermia, Increased heart rate, increased blood pressure, tremors, restlessness, anxiety, paranoia, vertigo

87
Q

What are the modes of use of cocaine?

A

Inhalation, orally, intranasally, intravenously

88
Q

What are the long term effects of cocaine/ crack addiction?

A

Cardiovascular issues: heart attack and stroke Marked cognitive decline Persistent psychotic symptoms Major depression and anxiety

89
Q

What are general principles of treatment of drug addiction?

A

Detoxification, counselling, medication, treatment for co-occurring mental health issue, long term follow up to prevent relapse

90
Q

What are treatment of nicotine addiction?

A

Nicotine replacement therapy: patches, spray, gum and lozenges

91
Q

What are medication of treatment of nicotine addiction

A

Bupropion: antidepressant drug; inhibitor of dopamine reuptake) Varenicline

92
Q

What are the components of comprehensive drug addiction treatment?

A

Vocational services, mental health services, medical services, educational services, HIV/AIDS services/ legal services, family services

System Neuroscience (17 decks)

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