Drugs of Abuse Flashcards
reinforcing properties (euphoria and CNS stimulation) is associated w. what NT
dopamine
acute intoxication is associated w. what NT
opi
GABA
NMDA
5HT
Ach
CB
opioids are agonists at __
CNS depressants enhance __
CNS stimulants block __
opioids: mu receptors
CNS depressants enhance: GABA
DA reuptake
2 most addictive drugs
cocaine
methamphetamine
nicotine and etoh work on
opioid peptides
opiates work on
GABA
etoh and benzos work on
GABA
nicotine works on
DA
etoh works on (3)
glutamate from cortex
opioid peptides
GABA
all drugs w. abuse potential enhance __ activity
dopamine
what 5 drugs produce euphoria
opioids
CNS depressants
CNS stimulants
dissociative anesthetics
cannabinoids
nicotine increases
alertness
t/f: the more intense and more direct a drug’s effect on DA release, the greater the addiction potential
T!
acute liability is increased w.
faster onset of action
__ is correlated w. onset of drug effect
route of administration
2 routes of administration w. fastest onset
inhalation
IV
what route of admin produces most intense rush-like feeling
IV
__ is more effective than oral dt first pass bypass
mucous membrane
route of admin useful in tx programs dt least reinforcing route
oral
2 routes of admin for nicotine that reduce withdrawal
gum
patch
drugs w. __ t½ have higher abuse potential
shorter
2 factors related to increased likelihood for loss of control
quick offset
frequent admin
2 factors related to increased likelihood for loss of control
quick offset
frequent admin
which has a longer half life, heroin or methadone
methadone
withdrawal effects are more severe for drugs w. __
bc they must be administered continuously to __
shorter t ½
prevent withdrawal
type of drug used for tx strategy
long acting w. no antagonist
the more rapidly the target-receptor becomes unoccupied → more severe the withdrawal effects
tx for opioid toxicity
naloxone
CNS depressants of abuse
ethanol
benzos
barbs
tx for:
ethanol toxicity:
benzos:
barbs:
etoh: thaiamine
benzos: flumazenil
barbs: supportive
tx for CNS stimulants (2)
vasodilators
benzos
who is at risk for nicotine toxicity
insecticide
cigarette ingestion by kids
tx for nicotine toxicity
CVS support
emetics
gastric lavage
activated charcoal
hallucinogens produce effects via __ receptor
5HT
2 hallucinogens of abuse
LSD-psilocybin
MDMA
tx for hallucinogen toxicity
talk down
bdz
risk of MDMA toxicity
hyponatremia
dissociative anesthetics of abuse
phencyclidine (PCP)
ketamine
tx for dissociative anesthetic abuse
CVS support → avoid hyperthermia
benzos
cannabinoids act on __ receptor
CB1
lessened response at active target site to the same drug concentration
pharmacodynamic tolerance
tolerance is due to
changes in receptor sensitivity
change in pharmacokinetics that results in lowered drug Cp at active site
metabolic (dispositional) tolerance
increase in metabolism is primary mechanism
tolerance develops to one drug → tolerance will be seen w. other drugs of same class
cross tolerance
resistance to same target
heroin has cross tolerance w.
hydrocodone
both mu
etoh has cross tolerance w.
benzos
both GABA
tolerance to opioids develops __
except with what effect
rapidly
constipation
tolerance to CNS depressants low to high (3)
barbs -> develops rapidly
etoh
benzos
tolerance to CNS stimulants develop rapidly to __ (3)
but supersensitivity can be seen to __
euphoria, anorexia, hyperthermia
paranoia
withdrawal sx are seen when
drugs stopped abruptly
perceived need for a drug (craving) in absence of any physiological dependence or withdrawal phenomena
psychological dependence
psychological dependence is related to what pathway
pathologic learning in reward pathway
ability of one drug to suppress withdrawal associated w. physical dependence on another drug
cross dependence
cross dependence is related to __
rather than __
pharm effects at targets
chemical effects
overwhelming concern w. use of drug and securing supply
extreme compulsive drug use
t/f: tolerance and dependence do not necessarily coexist
T!
t/f: addiction and physical dependence do not necessarily coexist
T!
development of dependence:
opioids:
CNS depressants:
CNS stimulants:
opioids: rapidly
CNS depressants: w.in weeks
CNS stimulants: arguable → no physiologic effects w. withdrawal
withdrawal effects are generally __ of the acute effects
opposite
if a drug causes elevated sz threshold, __ can be seen during withdrawal
spontaneous sz
if a drug relieves fatigue and elevates mood, withdrawal is characterized by
lethargy
dpn
risk of mortality w. withdrawal:
opioids:
CNS depressants:
opioids: rarely life threatening
CNS depressants: significant risk dt sz
tx for opioid withdrawal
clonidine
methadone
tx for CNS depressant withdrawal
benzo loading dose → taper
tx for CNS stimulants
behavioral