DRUGS OF ABUSE Flashcards
What are different theories of drug abuse?
Psychodynamic factors
Genetic factors
Neurochemical factors
What are the major NTs?
Opioids & Catecholamines
What neurons project to the cortical and limbic regions in the nucleus accumbens?
Dopaminergic neurons in the ventral tegmental area
What is the largest grp of adrenergic neurons that could mediate the effects of opiates & opioids?
Locus coeruleus
What is the main cause of drug abuse & dependence?
Drug abuse& dependence
What is the time of detectability of alcohol, amphetamine, cannabis, & methamphetamine?
ALcohol = 6-24 hrs
Amphetamine = 1-4 days
Cannabis: 15-30days
Methamphetapine = 3-5 days
What are different toxins that can induce potential health consequence if abused?
Stimulants
Cannabinoids
Opioids & Morphine derivatives
Depressants
Hallucinogens
What are effects of Stimulant withdrawal?
Depression
INC appetite
Psychomotor retardation
Emotional rxn
Slowed movements
Sleep disturbances
Miosis
What are effects of Psychoactive drugs?
Distortion of a person’s sensory perception, mood, & though, enhancement of feelings & Introspection
What are diff effects of LSD & Mescaline?
INC body temperature, Heart rate, BP, loss of appetite, sleeplessness, numbness, weakness, tremors
What are effects of MDMA?
INC effect of serptonin & catecholamines (life-threatening of tachycardia)
What are withdrawal symptms of depressants?
Anxiety, tremors, seizures, insomnia
What are questions to ask in the CAGE qnnaire?
Have you every felt you should Cut down on ur drinking?
Have ppl Annoyed u by criticizing ur drinking?
Have u ever felt bad or Guilty abt ur drinking?
Have u ever had a drink 1st thing in the morning to “Steady your nerves” or get rid of hangover ((eye opener)?
What score should one get that would mean high sensitivity for identifcatio of excessive drinking & alcoholidsm?
2 or higher
What is the retrospect of CAGE Qnnaire?
Last 12 months
What are the different molecular interactions that mediate effects of ethanol?
GABA receptor system
NMDA receptor system
Serotonin receptor system
What is the effect of ethanol to GABA receptro system?
INC action of GABA -> Sedative, ANticonvulsant, Anxiolytic
What is the effect of ethanol to NMDA receptor system?
Potent inhibitor of NMDA receptor function —> sedative, anticonvulsant, anxiolytic
What is the effect of ethanol to Serotonin receptor system?
Can reinforce intoxicating effect of ethanol
Where is alcohol absorbed?
Small intestine & colon
What enzymes break down alcohol to acetaldehyde?
CYP2E1& Catalase
Which of the 2 enzymes responsible for alcohol breakdown is used when there are large amts of alcohol & what if its only a small fraction of alcohol?
Catalase: small fraction
CYP2E1: large amts
Why is it that women have more alcohol in the body than men?
Women = have > subcutaneous fat -> alcohol concentrated in the body fluids
When do seizures occure from alcohol ingestion?
Wihtin 24 hrs
When does delirium tremens occur?
Within 24 hrs to 72 hrs after onset of abstinence
What are the different symptoms assoc with delirium tremens?
High fever
Marked confusion
Severe autonomic hyperactivity
Anxiety
Agitation & mental fluctuation
WHat are tx of delirium tremens?
Tx symptomatically
Thiamine
Fluid recplacement
Tx hyperthermia
Sedate w/ diazepam
Control seizure
Treat psychosis
What condition can occur due to thiamine def?
Wernicke-Korsakoff
Wernicke’s encephalopathy: severe acute def of VItamin B1 (thiamine)
Korsakoff’s psychosis = chronic neurologic sequela of Wernicke’s encephalopathy
What drugs are not advised to interact with alcohol?
2nd gen cephalosporins
Metronidazole
Trimethoprim
Sulfamethoxazole
Isoniazid
What is the effect of analgesics + alcohol?
INC risk of ulcer or GI bleed
What are drugs for alcohol dependence?
Acamprodate
Disulfram
Naltrexone
What is the MOA of Acamprodate
NMDA gutamate receptor modulator
What is the MOA of Disulfram?
irreversible inhibitrs acetaldehyde dehydrogenase
what is the MOA of Naltrexone?
Long acting antagonist at var opioid receptor sites (u opioid receptor) -> blocks the craving mechanism
Wha type of food will retard aborption in the GIT?
Carbs
What is stimulated with ingestion of stimulants?
Mesolimbic dopamine system
What is the MOA of COcaine?
Increases synaptic acitvity by binding to Dopamine transporter
What stimulant increased synaptic activity by vesicular monoamine transporter?
Amphetamine
What are chronic effects of cocaine?
Rapid/irregular heartbeat
DEC appetite/weight
Sustained high BP
What is an effect of over toxicity?
<3 fialure
What are tx os stimulants?
Calming techniques
Restrain
Hydrate & monitor vitals
Benzodiazepines: tachycardia & anxiety
What is an important effect of AMphetamine toxicity?
<3 failure, delirium, psychosis, rapid breathing
Loss of coortdination
Irritability
Anxiety
Restlessness
Delirium
Aggressiveness
What is a drug that can eliminate Amphetamines?
Ammonium chloride -> bcos it acidifies Amphetamine in the urine
What is the MOA of Methylphenidate, a drug taken by those who want t oconcentrate?
Non-competitive inhibitor of dopamine transporter & noradrenaline transporter
What are clinical uses of Methyllphenidate?
ADHD
Narcolepsy
What are effects of excess Methylphenidate?
Psychosis
Seizures
Stroke
<3 failure
What is an intervention of cocain use?
Repleting dopamine stores -> abstince over time
What is the MOA of hallucinogens?
Agonist of 5HT2 receptors
What are diff drug interactions of Hallucinogens?
MAO Inhibtors
Protease inhibtor
Cranberry juice
What r the diff hallucinogens?
Ketamine
LSD
LSA = “morning glory seeds”
Phencyclidine = “angel dust”
Ecstasy/3,4-methylene Dioxymethamphetamine (MDMA)
3,4-Methylene-Diocyamphetamine (MDA) = “love drug”
Cannabinoids
What is THC exogenous or endogenous cannabinoids?
Exogenou
Long term use of cannabinoid can result to ?
Amotivational syndrome = deterioration of personal habits & loss of insight
What is the MOA of “angel dust” or Phencyclidine?
Antagonist of NMDA receptor
What are the diff receptors that Opioids act on?
Mu
Delta
Kappa subtypes
What are precursors of endogenous eopiate-like susbtances?
POMC
Proenkephalin
Prodynorphin
What can happen in Opioid overdose?
Respiratory depression
CV complications
Coma
Death
What are the signs of Discontinued syndrome of Opioids?
Yawning
Runny nose
Sneezing
Lacrimation
Dilated pupils
Elevated BP
Tachycardia
What are diff prescribed Opioids & related drugs?
Fentanyl = pain
Hydrocodone = cough syrups
Meperidine
Dextromethorphan = cough syrups
COdeins = pain relief, euphoria, drowsiness, confusion
What are the diff drugs for opioid dependence?
Buprenorphine/Naloxone = moderate to sever pain
Methadone = severe pain
What is the mOA of Methadone?
Mu opioid receptor agonist
What is the MOA of Buprenorphine/Naloxone?
Partial mu opioid receptor agonist & kappa opioid receptor antagonist
What is an antagonist of all opioid recepotrs?
Naloxone
In what case is Buprenorphine used for?
Less dependent users, less chaotic lifestyles
-> there is risk of QT prolongation -> need to be monitored
What antibiotic when combined with Opioids can prolong analgesia?
Erythromycin
What drug is. Used as a tx of narcolepsy in Europe?
Oxybate/Gamma-Hydroxybutyrate
What is known as a date-rape drug? Onset of action?
Fulnitrazepam or “roofies”
Duration: 30 mins
what are the diff effects of Flunitrazepam?
Dizziness, impaired motor skills “rubber legs”
Slowed breahting, DEC BP, PR
Impaired memory & judgement, rapid loss of consciousness
What is the mOA Of Nicotine/tobacco?
Stimualtes nicotinic Ach receptors —> release of chemical messengers (Ach, NE, epinephrine, dopamine, B-endoprhins) —> relaxation
What are symptoms of nicotine consumption?
Restlessness
Agitation
Diaphoresis
Abdominal pain
Nausea
Vomiting
What r diff drugs for Nicotine dependence?
Nicotine replacements: Patchy, Spray , gum, lozenges
Bupropion & Varenicline
What increases 1/2 life of Nicotine?
Methanol
What are tx for abuse of alcohol?
- Acamprosate = reduce symptoms of rebound withdrawal
- Disulfiram = interferes with degradation of alcohol -> acetaldehyde accumulation
- Naltrexone = blocks opioid receptors
What are tx for abuse of Opioids?
Methadone & Burenorphine = suppress of withdrawal symptoms & relieve cravings
Naltrexone = blocks effect of heroin
What is the tx for Nicotine abuse?
Bupropion
What is tested in drug test kit?
Marijuana, Phencyclidine
Cocaine, amphetamine
Opioids
