Drugs of Abuse Flashcards
What are the three types of tolerance?
metabolic, functional, behavioral
what does functional tolerance lead to?
physical dependence
what are the two types of dependence?
psychological, physical
What is the mechanism of drugs of abuse?
no one mech. many increase effects of dopamine in a “reward circuit”
What are the opioids (4)?
heroin, morphine, methadone, codeine
How do the opioids work?
increase mu receptor (endorphin)
What are the sympathomimetics (4)?
amphetamine, methamphetamine, cocaine, caffeine (espresso)
what do amphetamine, methamphetamine, and cocaine do?
increase catecholamine transmission
what about caffeine?
decrease adenosine (increase cAMP, increase calcium)
What are the depressants (3)?
ethanol, pentobarbital, diazepam
What about the depressants?
increase GABA
What are the nicotine drugs? what about them?
tobacco products. acetylcholine (CNS pre-synaptic?)
What are the psychedelics (4)?
LSD, mescaline, PCP (phencyclidine), ketamine
What do LSD and mescaline do?
decrease serotonin transmission
What do PCP and ketamine do?
sigma receptors? decrease NMDA
What are the inhalants (3)?
nitrous oxide, amyl nitrite, butyl nitrite
how do the inhalants work?
GABA??
What is the designer drug? how does it work?
MDMA = ecstasy. alters serotonin, catecholamines
Cannabinoids?
THC = marijuana, cannabinoid ligands
What are the effects of amphetamine and cocaine (5)?
euphoria, anorexia, insomnia, increased motor activity, reduced feeling of fatique
How do amphetamine and cocaine work?
interact with reuptake systems for DA, NE, and 5-HT
Which reuptake system is responsible for the reinforcing qualities of amphetamine and cocaine?
the DA system
Which reuptake system is responsible for the euphoric effects of amphetamine and cocaine?
the NE system
Why does amphetamine have additional effects? what are they?
causes release of DA from cytoplasm into the synapse. larger increase in extracellular DA and increased motor and psychotic effects. also more sustained duration of effect
abuse potential for amphetamine and cocaine?
very great
toxicity of amphetamine and cocaine?
arhrythmias and convulsions
what’s the toxicity of opioids? treat with __?
coma: Naloxone
toxicity of sympathomimetics (amphetamine and cocaine)? treat with___?
sympathetic storm, seizures and stroke (cocaine). amphetamine: sedate with Haloperidol, cocaine: propranolol, diazepam, or Ca channel blockers
toxicity of general depressants? how to tx?
coma, respiratory failure. tx with mechanical ventiliation, positive inotropic drug:dopamine, hemodialysis or hemoperfusion
nicotine toxicity?
none
cannabinoids toxicity?
none
psychedelics and diliriant hallucinogens toxicity? tx?
anxiety, psychosis. tx with support, Physostigmine may be used after Scopolamine
phencyclidine toxicity? tx? what’s contraindicated in acute toxicity?
seizures. suction if secreted into stomach, acidify urine, Diazepam for seizures. ANTIPSYCHOTICS are CONTRAINDICATED in acute toxicity (possible synergy of serious side effects).
inhalants toxicity? tx?
asphyxiation arrhythmias. mechanical ventilation and antiarrhythmics
opioid withdrawal? tx?
withdrawal syndrome: runny nose, tearing, gooseflesh, spasms, muscle aches, hyperventilation, hyperthermia, vomiting, diarrhea, hostility, anxiety. tx with low levels of long acting drug (Methadone)
sympathomimetics withdrawal? tx?
nothing has proven value
general depressants withdrawal? tx?
convulsion, D.T. tx with low levels of a long acting drugs (Phenobarbital or Diazepam). also propranolol or Clonidine (may reduce sympathetic storm)
nicotine withdrawal? tx?
anxiety, craving. tx: replacement therapy (nicotine), substitution therapy (Verenicline), Bupropion
Cannabinoids and psychedelics withdrawal?
none aside from social readjustment
alcohol withdrawal?
antiabuse, Naltrexone
