Drugs Of Abuse Flashcards
How can you tell if someone is physically dependent on a drug? how does this differ from tolerance?
If sudden cessation of the drug leads to withdrawal syndrome
Tolerance is just a diminution in effect of a drug over time
which pathway in the brain is the prime target of addictive drugs?
mesolimbic dopamine pathway
What term was used in DSM IV to describe what we know as addiction?
dependence
What addictive drug has a withdrawal associated with tremor, nausea, sweating, anxiety and sometimes hallucinations
ethanol
which addictive drug is associated with generalized seizures and delirium tremens? is this withdrawal fatal?
ethanol
fatal in 5-15% in pts with delirium tremens
What 2 drugs can be used to treat alcohol withdrawal?
long half-life benzos: diazepam and chlordiazepoxide
What 2 drugs are preferred in treatment of alcohol withdrawl in the elderly or those with liver failure?
intermediate-acting benzos: Lorazepam and oxazepam
Name the 3 FDA approved drugs for the treatment of alcoholism and how each works
Disulfram: aldehyde dehydrogenase inhibitor - creates aversion (instant hangover)
Naltrexone: opioid antagnoist - reduces cravings
Acamprosate: NMDA receptor antagonist - prevents relapse
Withdrawal from this addictive drug includes tremors, perceptual disturbances, dyspohoria, psychosis and seizures? what is the drug? is it life threatening?
Benzodiazepines or barbituates
yes
What drug is used to treat benzo withdrawal? How?
Diazepam - switched to this (long-acting) then the dose is gradually reduced
what is the mechanism of action for the addictive drugs methlxanthines? name them
block presynaptic adenosine receptors (activation of adenosine receptors inhibits NE release, so blocking adenosine increases NE release)
caffeine (also theophylline and theobromine)
What schedule is cocaine?
schedule II
How does cocaine cause euphoria?
blocks reuptake of dopamine, NE and serotonin
what addictive drug has a mild withdrawal that includes dysphoria, sleepiness, and bradycardia? how do you treat?
cocaine - dont need to treat
What schedule are amphetamines? how do they work?
Schedule II - inc release of catecholamines
What class of drug can be used to treat ADD?
amphetamines
Withdrawal from what drug includes increased appetite, sleepiness, exhaustion, and mental depression? What drugs can be given to help?
Amphetamine withdrawal - can give antidepressants
what is the most widely used CNS stimulant? the second?
caffeine
2nd: nicotine
What is the most abused drug? the second?
Alcohol
2nd: nicotine
Nicotine causes its reward effects by causing the release of what where?
dopamine in the ventral tegmental area
Name two drugs used for treatment of nicotine addiction
Bupropion
Varenicline
which two opioids are most abused among health professionals?
meperidine and fentanyl
withdrawal from what addictive drug includes: dysphoria, lacrimation, rhinorrhea, and yawning? is it life-threatening?
opiods - no
how do you treat opioid addiction?
illicit agent replaced by long-acting opiod and dose is slowly reduced - use methadone or buprenorphine
withdrawal from what type of drugs is caused by a noradrenergic storm? name two drugs used to treat and their MOA
Opioids - heroin
Clonidine and lofexidine - alpha2 agonists
What drug can be used in opioid detox in patients highly motivated to remain opioid free? why only in motivated patients?
Naltrexone - wont satisfy cravings or relieve withdrawal
What drug binds to receptors CB1 and CB2? what type of receptors are these? where is each located?
cannabinoid receptors
G protein linked coupled to Gi
CB1: brain - major one for psych effects
CB2: immune cells
what is dronabinol? name 2 conditions it helps treat
therapeutic THC (cannabinoid) anorexia in AIDS pts and nausea/vomiting in chemo patients (2nd line)
what three drugs are in the LSD-like group?
LSD
Mescaline
Psilocybin
describe the symptoms of LSD addiction and withdrawal
trick! no addiction or withdrawal!
what drug can be given for a “bad trip” on LSD?
diazepam - helps agitation
ketamine is an analog of what street drug?
phencyclidine aka PCP aka angel dust
what addictive drug causes feelings of empathy and intimacy? how does it work?
MDMA - ecstasy
causes release of biogenic amines - mostly serotonin
withdrawal of what drug is characterized by depression lasting several weeks?
MDMA - ecstasy
which addictive drug produces euphoria, analgesia, then loss of consciousness?
nitrous oxide
what two inhalants an be used to enhance erection and are NOT addictive?
amyl nitrite and butyl nitrite
