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Exam - M - Psychiatry (Meg) > Drug Misuse > Flashcards

Drug Misuse Flashcards

1
Q

What is tolerance?

A

Reduced responsiveness to a drug caused by previous administration

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2
Q

What drugs cause tolerance?

A

Opioids
ethanol
barbiturates
benzodiazepines

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3
Q

What are the two types of tolerance?

A

Dispositional tolerance

Pharmacodynamic tolerance

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4
Q

What is dispositional tolerance?

A

This concerns the part between the drug entering the body and reaching its receptor (active site).

Less of the drug actually gets to the active site.

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5
Q

What are some causes of dispositional tolerance?

A

Increased rate of excretion
Decreased rate of absorption
Increased metabolism - to inactive metabolites
Decreased metabolism - to active metabolites

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6
Q

What is pharmacodynamic tolerance?

A

When the same amount of drug reaches the receptor (active site) but it has less of an effect.

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7
Q

What are some mechanisms of pharmacodynamic tolerance?

A

Fever drug receptors
Same amount of drug receptors but less secondary messengers (that don’t produce as much cyclic AMP)
Down regulation of internalised drug receptors

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8
Q

What is the physiology of tolerance which leads to dependence?

A

Drug is given - produces a specific response
Body counteracts this by producing an ‘adaptive’ response
Tolerance is achieved

Drug is removed which takes away its action on the body
Body is still producing the ‘adaptive’ response - might produce withdrawal symptoms

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9
Q

What withdrawal effect does a drug have?

A

Usually the opposite of the acute effect.

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10
Q

Write an example where an acute effect is constipation and write the withdrawal effect?

A

Person takes medication - gets constipation
Adaptive response is to make stools easier to pass
Homeostasis is maintained
Person comes off medication - body is still producing adaptive response.
since theres no constipation, easier passing stools results in diarrhoea.

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11
Q

What are the acute and withdrawal effects of opioids?

A

Acute - constipation

Withdrawal - diarrhoea

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12
Q

What is the acute and withdrawal effect of barbiturates?

A

Acute - anticonvulsant

Withdrawal - convulsion

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12
Q

What is the acute and withdrawal effect of barbiturates?

A

Acute - anticonvulsant

Withdrawal - convulsion

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13
Q

What is the acute and withdrawal effect of cocaine?

A

Acute - elevated mood

Withdrawal - Depressed mood

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14
Q

What is the main neurotransmitter involved in the reward pathways?

A

Dopamine

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15
Q

How does the reward pathway work?

A

Neurones in the VTA are stimulated and dopamine is released - this causes sensation of pleasure and reward.

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16
Q

How is the reward pathway usually activated?

A

Eating
Drinking
Sex

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17
Q

How is a psychological craving developed?

A

By activation of the reward centre/pathway.

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18
Q

How does heroin affect the reward pathway?

A

Increases firing of dopaminergic neurones

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19
Q

How does amphetamine affect the reward centre?

A

Increases dopamine release

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20
Q

How does cocaine affect the reward pathway?

A

Inhibits dopamine uptake.

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21
Q

Which gene has been found to be associated with an addictive personality?

A

A1 allele

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22
Q

What are the two main components of drug addiction?

A

Psychological - stimulation of the reward pathways

Physical - build up of tolerance

23
Q

How long do the effects of cocaine last for?

A

15-90 minutes

24
Q

how does cocaine work?

A

it blocks the reuptake of dopamine, norepinephrine and serotonin. (mostly dopamine).

25
Q

What are the effects of cocaine?

A 
euphoria
vasoconstriction
high blood pressure
tachycardia
hyperthermia
confidence 
dilated pupils
increased energy
suppress appetite 
less desire for sleep
anaesthetic effect
26
Q

What are the withdrawal symptoms of cocaine?

A 
depression
anxiety
cravings
hunger 
sleeping
vivid dreams (increase in REM sleep)
fatigue
reduced concentration
More serious:
Suicical ideations 
nausea
vomiting
sensation of insects crawling over body
27
Q

How long does cocaine take to be metabolised?

A

1hr by the liver.

28
Q

How is a cocaine overdose treated?

A

Sedative + keep cool

29
Q

What is a mixture of cocaine and alcohol called?

A

Cocaethylene - has a much longer half life

30
Q

How long does cocaine take to work via the different routes of entry?

A

Injection - almost instantly
Inhalation - 3-5 mins
Smoking - almost immediately

31
Q

How long do the effects of crack smoking last for?

A

Very intense - only last 15 mins.

32
Q

What complications can cocaine cause?

A 
Nasal and airway damage
Hypertension
Toxic confusion
Paranoid psychosis
Colvunsions with respiratory failure
Cardiac arrhythmia
MI
33
Q

Which organ can cocaine affect the most?

A

Heart - very cardiotoxic.

34
Q

What are some types of opiates?

A 
Heroin
Methadone
Morphine
Codeine
Dihydrocodeine
35
Q

How do opioids work?

A

They bind to opioid receptors - this blocks pain pathways and cause euphoria.

36
Q

What are the 3 main types of opioid receptors?

A

Mu (main) - mood, analgesia and euphoria
Kappa - analgesia
Delta - analgesia

37
Q

How long is the half life of heroin?

A

30 minutes

38
Q

What are the effects of heroin?

A 
Analgesia
Emotional analgesia
Initially nausea
Euphoria
Pin point pupils
itching
sweating
constipation
reduced libido
menstrual irregularities
reduced cough reflex 
Reduced heart rate
Reduced blood pressure 
Wakefulness decreases
39
Q

Which medication is given in an opioid overdose?

A

Naloxone - opiate antagonist - binds to the opioid receptors so that heroin can’t

40
Q

How can heroin be ingested?

A

Snorting
Smoking
Injecting

41
Q

What are the main effects of heroin in overdose?

A

Respiratory depression
Bradycardia
Hypotension
Death

42
Q

What other substances taken with an opioid increase chances of death?

A

Other respiratory depressants:
Alcohol
Benzodiazepines

43
Q

Which blood borne virus are IV heroin users at the biggest risk of?

A

Hepatitis C

44
Q

What are the withdrawal symptoms of heroin?

A 
Tachycardia
Increased saliva, lacrimal and nasal secretions
Yawning
Insomnia
Cravings
Muscle pain
Tremor
Dilated pupils
Goose Bumps (cold turkey)
Diarrhoea
Sneezing
Sweating
45
Q

How long does ecstasy take to have an effect and how long does it last for?

A

20 mins to căușe effect

last 2-4hrs

46
Q

What are the main side effects of ecstasy?

A 
nausea
dry mouth
hypertension
hyperthermic 
dehydration 
anxiety and panic (in large doses)
drug induced psychosis
47
Q

How many people are legal cannabis users?

A

1 in 7

48
Q

What are the two components which make up cannabis?

A

THC - tetrahydrocannabinol

CBD - Cannabidiol

49
Q

What effects does THC from cannabis cause?

A 
Psychedelic (trip)
Hallucination
everything is exaggerated 
funny jokes 
affects your mental state
50
Q

What effect does the CBD part of cannabis do?

A

Anxiolytic - reduced anxiety

Antipsychotic

51
Q

What ratio of ingredients is best in cannabis?

A

Cannabis with higher CBD and lower THC is safer.

52
Q

what are the effects of high doses of cannabis?

A

Anxiety
Panic
Persecutory ideation
Hallucinatory activity

53
Q

What does cannabis as a whole do at normal doses?

A 
Relaxes or stimulates
Causes euphoria
Increases sociability and hilarity
Increased appetite
Changes in time perception 
Synaesthesia (blending of senses)
54
Q

What are the negative effects of cannabis?

A

Respiratory problems
Toxic confusion
Exacerbation of major mental illness
Cannabis psychosis

55
Q

What is an example of an injectable tanning agent?

A

Melotan

56
Q

What are the side effects of anabolic steroids?

A 
Acne
stretch marks
baldness
feminisation in males - gynaecomastia
Maleisation in females - deep voice, clitoral enlargement, menstrual irregularities, hair thinning, hirsutism 
Increased cholesterol and hypertension
growth deficits
liver disease
irritability and anger 
hypomania
mania
depression or suicidality on withdrawal

Exam - M - Psychiatry (Meg) (24 decks)

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