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pharm - OBG > Drugs of Abuse 1 – General/Cannabis > Flashcards

Drugs of Abuse 1 – General/Cannabis Flashcards

1
Q

Generally speaking, how do the drugs of abuse cause the feeling of euphoria?

A

The hijack the mesolimbic dopaminergic pathway – the central reward pathway

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2
Q

Describe the structure of the central reward pathway.

A

The dopaminergic neurones project from the ventral tegmental area to the nucleus accumbens Dopamine release into the nucleus accumbens will stimulate the feeling of euphoria

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3
Q

Put the routes of administration of drugs in order of speed of absorption.

A

Smoking > IV > Snorting > Oral

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4
Q

Why is smoking slightly quicker than IV injections?

A

Smoking brings the drug to the alveoli where it easily crosses the alveoli and enters the pulmonary circulation There is a shorter distance from the pulmonary circulation to the heart and then to the brain than from the site of IV injection to the heart and then to the brain

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5
Q

What are the different classes of the drugs of abuse?

A

Narcotics/painkillers – e.g. opiate like drugs

Depressants – e.g. alcohol

Stimulant – e.g. cocaine, caffeine

Miscellaneous

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6
Q

What are the active components of the Cannabis sativa plant?

A

Cannabinoids (there are over 60 of them in the plant)

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7
Q

What is the most potent cannabinoid in the plant?

A

Delta-9-tetrahydrocannabinol (Delta-9-THC)

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8
Q

What is another important cannabinoid that appears to counteract some of the negative effects of the potent cannabinoid?

A

Cannabidiol

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9
Q

How has cannabis production changed over the last 10-15 years?

A

There has been an increase in the amount of 9-THC in the cigarette meaning that there is less cannabidiol This suggests that cannabis production is heading towards being morepro-psychotic

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10
Q

What percentage of smoked cannabis will reach the blood stream?

A

Around 30%

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11
Q

Describe the accumulation of cannabis in the brain following administration.

A

Cannabis levels in the brain rise very quickly after administration but, because the brain is highly perfused, the cannabis levels in the brainfall rapidly as well

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12
Q

Describe the accumulation of cannabis in fat following administration.

A

Cannabis is very lipid soluble so it slowly accumulates in the fat This means that cannabis will leak from the store in the fat for a long time after administration

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13
Q

How long will the effects of cannabis last after smoking a joint?

A

Around 30 days (because of the storage in adipocytes)

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14
Q

What is an important metabolite of cannabis?

A

11-hydroxy THC (this is more potent than Delta-9-THC)

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15
Q

What happens to this metabolite (11-hydroxy THC) once it has been produced?

A

It is excreted in the bile into the GI tract but then it undergoes enterohepatic cycling and re-enters the blood stream where it can exert its physiological effects Because of this, plasma Delta-9-THC levels are a poor measure of intoxication

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16
Q

Where are the different cannabinoid receptors found?

A

CB1 – brain - Hippocampus, cerebellum, cortex and basal ganglia CB2 – peripheral immune cells

17
Q

What type of receptor is the cannabinoid receptor?

A

G protein coupled receptor – negatively coupled with adenylate cyclase

18
Q

Name one endogenous cannabinoid.

A

Anandamide

19
Q

Describe how cannabis causes euphoria.

A

Cannabis binds to CB1 receptors on GABA neurones and inhibits the GABA neurones This means that they remove the inhibitory influence of GABA neurones on the dopaminergic neurones of the rewards pathway, hence there is increased firing of the dopaminergic neurones –> euphoria

20
Q

What area of the brain does cannabis interact with that is linked to its psychotic effects?

A

Anterior Cingulate Cortex - responsible forPerformance monitoring and behavioural adjustment There is hypoactivity in the anterior cingulate cortex in chronic cannabis users

21
Q

Which part of the brain does cannabis act on to stimulate food intake?

A

Lateral hypothalamus

22
Q

What are the two main groups of neurones that are involved in stimulating appetite?

A

MCH (melanin concentrating hormone) neurones

Orexin neurones

23
Q

What effect does cannabis have on these neurones?

(MCH and orexin)

A

Cannabis inhibits the inhibitory effect of GABA on MCH neurones, thus leading to increased MCH firing

Cannabis also directly stimulates orexin production This leads to hunger

24
Q

Describe the effect of cannabis on the immune system.

A

Cannabis is a powerful immunosuppressant

25
Q

How does cannabis cause memory loss?

A

It inhibits the production of BDNF (brain derived neurotrophic factor), which is important in the hippocampus in forming memories In general, cannabis has a depressant effect on the hippocampus

26
Q

How does cannabis cause impaired psychomotor performance?

A

It depresses the cerebral cortex

27
Q

How does cannabis cause cardiovascular effects?

A

Cannabis causes calcium influx

(not CBR receptor though)

28
Q

What are the cardiovascular effects of cannabis?

A

tachycardia

29
Q

In which part of the body does cannabis cause a lot of vasodilation?

A

Conjunctivae (bloodshot eyes)

30
Q

Why is it not possible to overdose on cannabis?

A

There is very low expression of CB1 in the medulla (which is where you find the cardio-respiratory centres)

31
Q

What is the upregulation of cannabinoid receptors in the adipocytes associated with?

A

Obesity

32
Q

State 4 drugs that are either cannabinoid agonists or antagonists.

A

Dronabinol - Delta-9-THC

Nabilone - Delta-9-THC

Sativex - Delta-9-THC + cannabidiol

Rimonabant – CB1 antagonist

33
Q

What can cannabinoid receptor agonists be used for?

A

Treatment of nausea due to chemotherapy, Dronabinol, Nabilone

Treat ms pain-sativex

34
Q

What can THC antagonistsbe used for ?

A

Anti-obesity medication (it was removed from the market because it was shown to cause depression and suicidal thoughts) -Rimonabant

pharm - OBG (25 decks)

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