drugs of abuse

Question 1

drugs of abuse

Answer 1

1) typically fall into DEA 1 and 2

Question 2

tolerance

Answer 2

1) repeated use leading to reduced efficacy

Question 3

dependence

Answer 3

1) physiological or psychological changes after ceasing use
- physiological: craving
- physical: withdrawal signs

Question 4

addiction

Answer 4

1) recurrent use over the past 12 months
- relapse and remission

Question 5

withdrawal

Answer 5

1) long acting drugs
- longer milder withdrawal
2) short acting
- intense withdrawal
3) spontaneous
- unassisted cessation
4) precipitated withdrawal
- use of antagonist

Question 6

treatment for substance abuse

Answer 6

1) behavior is not treatable just pharmacologically
2) has to be a holistic approach
- detoxification
- maintenance therapy
- behavior treatment -

Question 7

relative potential for dependance

Answer 7

1) narcotics and CNS stimulants are high
2) CNS depressants less
- except ethanol
3) hallucinogens are low

Question 8

reinforcing mechanisms

Answer 8

1) drugs may disrupt reward center by directly stimulating dopamine neurons
- which hallucinogens do not do, so they do not result in addiction
2) altering activity of secondary neurotransmitters such as acetylcholine, GABA, glutamate, serotonin, or norepinephrine

Question 9

marijuana

Answer 9

1) federally illicit but legal in CA
2) schedule 1 drug
- can have some medical benefit : analgesia, antiemetic ,MS disease control
3) low addiction potential
4) species: 3 of them
- some are hallucinogenic, some are not

Question 10

cannabis receptors

Answer 10

1) endogenous receptors
- central tegmental reward area
- also cerebellum, cerebral cortex, hippocampus, hypothalamus, basal ganglia
- anandamide - endogenous ligand

Question 11

marijuana effects

Answer 11

1) lasts 1-4 hours depending on route
2) hallucinogenic, euphoric, psychedelic, drowsiness, sedation
3) appetite stimulating
4) death rare
5) short term memory loss
6) mild spatial temporal hallucination

Question 12

psychodelic hallucinogens

Answer 12

1) LSD, mescaline, psilocybin
2) could be used for PTSD
3) act at serotonin 2A receptors
4) alto consciousness and perception

Question 13

phencyclidine and ketamine

Answer 13

1) antagonism of excitatory glutamate / NMDA
2) low risk of addictions, schedule II PCP, ketamine schedule III

Question 14

ketamine

Answer 14

1) anesthesia and profound analgesia yet, patient not asleep, respiration unaltered
2) overdose rarely lethal

Question 15

stimulants

Answer 15

1) rapid rush, increased alertness and euphoria
2) duration of several hours
3) highly, highly addictive
4) possible tachycardia, myocardial infarction and stroke
5) heavy crash
6) INTERACTIONS WITH EPINEPHRINE
- 24 hours after last drug dose
- BP and pulse monitoring

Question 16

methamphetamine

Answer 16

1) meth mouth
- similar to sjorgens, xerostomia
2) lack of oral hygiene
3) high potential for addiction

Question 17

MDMA ( molly)

Answer 17

1) hallucinogenic amphetamine
2) empathogen
3) bruxism and trismus
4) profound hyperthermia
5) schedule 1 drug

Question 18

depressants and othersods

Answer 18

1)1) codeine, oxycodone, morphine, heroin, fentanyl
2) target, mu, kappa, and lambda CPCR
3) 4-6 hours depending on dose
4) high risk of dependency
- heroin is schedule I
- others are schedule II
- less than 90 mg codeine is schedule III

Question 19

opiods effect

Answer 19

1_ intense euphoria, rush, heavy feeling
2) overdose potential high
3) unconsciousness, respiratory depression ,death
- naloxone or nalmefen should be administered
4) long term treatment is
- methadone, buprenorphine
- naltrexone

Question 20

depressents for treatment

Answer 20

1) diazepam, temazepam, used for sedative hypnotic and anxiolytic actions
- euphoria
- potentiate GABA receptor function
- dependence and tolerance
- withdrawal tolerance develop quickly
-withdrawal syndrome includes anxiety, seizures, irritability, insomnia, anterograde amnesia
2) schedule I

Question 21

dental considerations for treating illicit drug users

Answer 21

1) skin lesions - track marks
2) febrile illness
2) thorough questioning of patient
4) physician consult
5) risk of AIDS, endocarditis, hepatitis
6) etc.