Drugs of Abuse 1

Question 1

Positive reinforcement pathway can drugs of abuse involves the ______

Answer 1

Ventral tegmental area

Question 2

During drug withdrawal dopamine levels decrease and patients develop ______.

Answer 2

depression

Question 3

Respiratory depression happens in _____ OD.

Answer 3

heroin

Question 4

What is the antidote for acetaminophen overdose?

Answer 4

Glutathione precursor

Question 5

Drug abuse maintains and sustaines the ______ pathway

Answer 5

positive reinforcement

Question 6

Describe the domapmine reward pathway in regards to drugs of abuse.

Answer 6

stimulate the ventral tegmental area → dopamine producing neurons are stimulated→ activation of the mesolimbic dopamine system.

Question 7

Drug withdrawal (acute abstinence) is associated with _____. Long-term chronic abstinance is associated with ______.

Answer 7

• Withdrawal syndrome
• Craving

Question 8

Chronic drugged state (drug-taking) leads to tolerance & dependence. What are the adaptive changes?

Answer 8

increases adenylyl cyclase and dopamine transporters

Question 9

Drugs of abuse cause addiction which leads to abuse, _______ (2),

Answer 9

dependence and tolerance

Question 10

Define pharmacokinetic tolerance

Answer 10

Metabolic tolerance: Stimulation of metabolism allows for increased drug elimination with long-term use.

Question 11

Define pharmacodynamic tolerance

Answer 11

Cellular tolerance: biochemical adaptation-changes in NT levels and receptor numbers and activity.

Question 12

EtOH facilitates the action of ____ and inhibits activation of _____receptors.

Answer 12

• GABA
• NMDA

Question 13

EtOH causes which physiological reactions: slurred speech, unsteady gait/coordination, _______ (5)

Answer 13

1. Decrease cognition
2. Decrease myocardial contractility
3. Vascular smooth muscle relaxation
4. Nystagmus
5. Mood changes

Question 14

Tolerance of EtOH develops due to _____ (2).

Answer 14

1. CNS adaptation
2. increase rate of ethanol metabolism

Question 15

Cross-tolerance of EtOH to which 2 sedative hypnotic drugs?

Answer 15

BZD & barbituates

Question 16

EtOH can lead to gut wall inflammation, bleeding, scarring as well as pancreatitis, peripheral neuropathy, ________ (4).

Answer 16

1. Wernicke-korsakoff syndrome
2. Gynecomastia
3. Testicular atrophy
4. Edema

Question 17

EtOH inhibits ______ leading to hypoglycemia.

Answer 17

gluconeogenesis

Question 18

Alcohol withdrawal symptoms include insomnia, tremor, _______ (4).

Answer 18

1. Tachycardia
2. Seizures
3. Delusions
4. Hypertension

Question 19

Fetal alcohol syndrome can lead to intrauterine growth retardation, ______ (3).

Answer 19

1. Microcephaly
2. Growth deficiency
3. Under development of the mid face

(facial abnormalities associated with heavy consumption during the first trimester)

Question 20

In fetal alcohol syndrome alcohol and fatty acids are synthesized to ______, which ends up in the newborns meconium.

Answer 20

Fatty acid ethyl esters (FAEEs)

Question 21

What is the most common clinical feature of newborns with fetal alcohol syndrome?

Answer 21

Microcephaly

Question 22

What level of alcohol will cause:

• Emesis and stupor?
• Coma?
• Death?

Answer 22

• 300 micrograms/dL
• 300-400 micrograms/dL
• >500 microgram/dL

Question 23

_____(alcoholism tx) inhibits acetaldehyde dehydrogenase.

Answer 23

Disulfiram

Question 24

______(alcoholism tx) lowers activity of receptors for glutamate → maintenance of abstinence

Answer 24

Acamprosate

Question 25

\_\_\_\_\_\_ for alcohol withdrawal to prevent delirium or seizures.

Answer 25

Benzodiazepines

Question 26

\_\_\_\_\_\_\_ for alcohol withdrawal to reduce tremors and reduction of heart rate and blood pressure

Answer 26

Propranolol

Question 27

Cocaine is metabolized by plasma\_\_\_\_\_.

Answer 27

cholinesterases

Question 28

Source of cocaine:

Answer 28

Leaves of erythroxylon coca

Question 29

Physical forms of cocaine

Answer 29

* Hydrochloride salts * Freebase

Question 30

Which physical form of cocaine can be taken IV or intranasally?

Answer 30

* hydrochloride salt * powdered

Question 31

Cocaine mechanism of action

Answer 31

* Blocks dopamine transporter * Blocks NE and serotonin re-uptake (Rapidly absorbed, metabolized and eliminated)

Question 32

\_\_\_\_\_\_ is the metabolite that ends up in urine of a cocaine user.

Answer 32

Benzoylecgonine

Question 33

The physical effects of cocaine are increase energy, decrease appetite, _____ (6).

Answer 33

1. CNS stimulation (alertness) 2. Dilated pupils 3. Heart stim: (Tachycardia, arrhythmias) 4. Increased BP (constriction of blood vessels) 5. Increase temperature 6. Euphoria or agitation

Question 34

What are the signs and symptoms of a cocaine user (6)?

Answer 34

1. Chronically inflammed runny nose 2. Irritation of the nasal septum 3. Loss of smell sensation 4. Nosebleeds 5. Dysphagia 6. Hoarseness

Question 35

* Ingested cocaine→ _____ (physical symptoms) * IV users→\_\_\_\_\_\_ (physical symptoms)

Answer 35

* severe bowel gangrene * allergic reactions (Lack of appetite, weight loss and malnourishment)

Question 36

Maternal complications of cocaine use (4)

Answer 36

1. Malignant hypertension 2. Cardiac ischemia 3. Cerebral infarction 4. Sudden death

Question 37

Fetal effects of maternal cocaine use?

Answer 37

1. Spontaneous abortion and death 2. High risk of premature rupture of membranes, preterm labor and delivery, IUGR, abruptio placentae

Question 38

Effects of maternal cocaine use on newborns?

Answer 38

1. Cognitive and neurobehavioral problems 2. Visual problems 3. Suckling problems 4. Irritability 5. Tremors 6. Lack of coordination