Drugs of Abuse Flashcards
Physical dependence arises from ______________.
Functional tolerance
How do most of the drugs of abuse work?
Increasing the affects of dopamine in a “reward circuit” involving the midbrain and limbic system
More physical dependence the _____________ the withdrawal.
worse
Examples of opioids
heroin
morphine
methadone
codeine
What do opiods do?
increase u receptor, endorphins
Examples of sympathomimetics
Amphetamine
Methamphetamine
Cocaine (increase catecholamine transmission)
Caffeine (decrease adenosine (increase cAMP and Ca+2))
Examples of depressants
Ethanol
Pentobarbital
Diazepam
Mechanism of depressants
Increase GABA
Examples of nicotine
tobacco producst
Mechanisms of nicotine
Acetylcholine (CNS Presynaptic)
Psychedelics
LSD
Mescaline
PCP (Phencyclidine)
Ketamine
Mechanism of psychedelics
LSD and Mescaline decrease serotonin transport
Inhalants
Nitrous oxide
Amyl nitrite
Butyl nitrite
Examples of designer drugs
MDMA (Ecstasy)
Mechanism of Ecstasy
alters serotonin levels and effects catecholamines
Examples of Cannabinoids
THC (Marijuana)
Cannabinoid ligands
Mechanism of Cannabinoids
high affinity receptor ( G protein coupled)
Variables in the agent used that affect the onset and continuation of drug abuse and addiction are:
availability percieved risk cost purity/potency pharmacokinetics speed of onset and termination of SE mode of administration
Variables of the host that affect the onset and continuation of drug abuse and addiction are:
heredity
psychiatric symptoms
prior experiences/expectations
propensity for risk seeking behavior
Variables in the environment that affect the onset and continuation of drug abuse and addiction are:
social setting
community attitudes
employment or educational oppurtunities
Mechanism of amphetamines and cocaine
Interact with the reuptake systems for monoamine DA, NE, and %-ht. The reinforcing qualities rely most heavily on the DA system, while the NE may contribute to the euphoric effects.
Symptoms of amphetamines and cocaine
euphoria, anorexia, insomnia, increased motor activity and decreased feeling of fatique
Why do amphetamines have additional effects?
depletes DA from the vessicles, causing a no vasicular release of DA producing an increase in motor and pyschodynamic effects and a more sustained duration of effect
What are the toxicities for amphetamines and cocaine?
arrhythmias and convulsions
Treatment for opiods (coma)
naloxone
Treatment for sympathomimetics (sympathetic storm)
amphetamines sedate with haloperidol
cocaine - give propanolol, diazepam or ca channel blockers to help with seizures or stroke
Treatment for depressants (coma, respiratory failure)
mechanical ventilation, positive ionotropic drug: dopamine, hemodialysis, hemoperfussion
Treatment for Nicotine
none
Treatment for cannabinods
none
Treatment for pyschedelics (anxiety and psychosis)
support, physostigmine may be used after, scopolamine
Treatment for phencyclidine (seizures)
diazepam, antipsychotics contraindicated due to toxicitiy
can use haloperidol
Treatment for inhalants
mechanical ventilation, antiarrymics
withdrawal with opiods:
runny nose, tearing, goose flesh, anxiety
TX: low levels of long acting drug (methadone or L-acetyl-methadone)
withdrawal with depressants
convulsions, DT
TX: low levels of long acting drugs (phenobarbital or diazepam)
Propanolol or clonidine may reduce symp. storm
withdrawal with nicotine
anxiety, craving
TX: replacement therapy- nicotine
substitution therapy- varenicline
bupropion
withdrawal with alcohol
TX: anti abuse, naltrexone
