Drugs of Abuse 1 Flashcards
Positive reinforcement pathway can drugs of abuse involves the ______
Ventral tegmental area
During drug withdrawal dopamine levels decrease and patients develop ______.
depression
Respiratory depression happens in _____ OD.
heroin
What is the antidote for acetaminophen overdose?
Glutathione precursor
Drug abuse maintains and sustaines the ______ pathway
positive reinforcement
Describe the domapmine reward pathway in regards to drugs of abuse.
stimulate the ventral tegmental area → dopamine producing neurons are stimulated→ activation of the mesolimbic dopamine system.
Drug withdrawal (acute abstinence) is associated with _____. Long-term chronic abstinance is associated with ______.
- Withdrawal syndrome
- Craving
Chronic drugged state (drug-taking) leads to tolerance & dependence. What are the adaptive changes?
increases adenylyl cyclase and dopamine transporters
Drugs of abuse cause addiction which leads to abuse, _______ (2),
dependence and tolerance
Define pharmacokinetic tolerance
Metabolic tolerance: Stimulation of metabolism allows for increased drug elimination with long-term use.
Define pharmacodynamic tolerance
Cellular tolerance: biochemical adaptation-changes in NT levels and receptor numbers and activity.
EtOH facilitates the action of ____ and inhibits activation of _____receptors.
- GABA
- NMDA
EtOH causes which physiological reactions: slurred speech, unsteady gait/coordination, _______ (5)
- Decrease cognition
- Decrease myocardial contractility
- Vascular smooth muscle relaxation
- Nystagmus
- Mood changes
Tolerance of EtOH develops due to _____ (2).
- CNS adaptation
- increase rate of ethanol metabolism
Cross-tolerance of EtOH to which 2 sedative hypnotic drugs?
BZD & barbituates
EtOH can lead to gut wall inflammation, bleeding, scarring as well as pancreatitis, peripheral neuropathy, ________ (4).
- Wernicke-korsakoff syndrome
- Gynecomastia
- Testicular atrophy
- Edema
EtOH inhibits ______ leading to hypoglycemia.
gluconeogenesis
Alcohol withdrawal symptoms include insomnia, tremor, _______ (4).
- Tachycardia
- Seizures
- Delusions
- Hypertension
Fetal alcohol syndrome can lead to intrauterine growth retardation, ______ (3).
- Microcephaly
- Growth deficiency
- Under development of the mid face
(facial abnormalities associated with heavy consumption during the first trimester)
In fetal alcohol syndrome alcohol and fatty acids are synthesized to ______, which ends up in the newborns meconium.
Fatty acid ethyl esters (FAEEs)
What is the most common clinical feature of newborns with fetal alcohol syndrome?
Microcephaly
What level of alcohol will cause:
- Emesis and stupor?
- Coma?
- Death?
- 300 micrograms/dL
- 300-400 micrograms/dL
- >500 microgram/dL
_____(alcoholism tx) inhibits acetaldehyde dehydrogenase.
Disulfiram
______(alcoholism tx) lowers activity of receptors for glutamate → maintenance of abstinence
Acamprosate
______ for alcohol withdrawal to prevent delirium or seizures.
Benzodiazepines
_______ for alcohol withdrawal to reduce tremors and reduction of heart rate and blood pressure
Propranolol
Cocaine is metabolized by plasma_____.
cholinesterases
Source of cocaine:
Leaves of erythroxylon coca
Physical forms of cocaine
- Hydrochloride salts
- Freebase
Which physical form of cocaine can be taken IV or intranasally?
- hydrochloride salt
- powdered
Cocaine mechanism of action
- Blocks dopamine transporter
- Blocks NE and serotonin re-uptake
(Rapidly absorbed, metabolized and eliminated)
______ is the metabolite that ends up in urine of a cocaine user.
Benzoylecgonine
The physical effects of cocaine are increase energy, decrease appetite, _____ (6).
- CNS stimulation (alertness)
- Dilated pupils
- Heart stim: (Tachycardia, arrhythmias)
- Increased BP (constriction of blood vessels)
- Increase temperature
- Euphoria or agitation
What are the signs and symptoms of a cocaine user (6)?
- Chronically inflammed runny nose
- Irritation of the nasal septum
- Loss of smell sensation
- Nosebleeds
- Dysphagia
- Hoarseness
- Ingested cocaine→ _____ (physical symptoms)
- IV users→______ (physical symptoms)
- severe bowel gangrene
- allergic reactions
(Lack of appetite, weight loss and malnourishment)
Maternal complications of cocaine use (4)
- Malignant hypertension
- Cardiac ischemia
- Cerebral infarction
- Sudden death
Fetal effects of maternal cocaine use?
- Spontaneous abortion and death
- High risk of premature rupture of membranes, preterm labor and delivery, IUGR, abruptio placentae
Effects of maternal cocaine use on newborns?
- Cognitive and neurobehavioral problems
- Visual problems
- Suckling problems
- Irritability
- Tremors
- Lack of coordination
