Drugs of Abuse Flashcards
Reduction in the response to a drug after repeated administrations
Tolerance
Tolerance type that occurs due to changes in distribution or metabolism of a drug causing a decreased concentration of drug at the site of action
Pharmacokinetic tolerance
When is the most reinforcing effect of abussive drugs
1) When there is an increase in plasma/brain concentration
What are the only abusive drugs that in withdrawal there is a risk of death?
1) Benzodiazepines
2) Barbiturates
3) Ethanol
What drug causes these withdrawal symptoms?
Dysphoria, depressed mood, sleepiness, extreme craving, bradycarda
Cocaine
Rapid tolerance developing with repeated use on a single occasion; tolerance not retained between sessions
Acute tolerance
Increase in the response of a drug after repeated administrations
Sensitization
What should you think if pt. comes in complaining of “Bugs crawling under skin” and anxeity with dysphoria?
Chronic Cocaine Abuse
What does cocaine have drug interactions with?
1) Opioids
2) Ethanol
What occurs when cocaine is used with ethanol?
1) Formation of cocaethylene
2) Has a longer half life
What are the major toxicities with cocaine?
1) Cardiovascular collapse
2) Arrhythmia
3) Seizures (due to local anesthetic effect)
4) Coma
What are the symptoms of amphetamine toxicity?
1) Paranoid psychosis
2) Violence
3) Sympathetic arousal
Approved uses for amphetamine
1) Narcolepsy
2) ADHD
What amphetamines are used for narcolepsy?
1) Low abuse amphetamines
2) Modafanil
3) Armodafanil
What is the reward pathway?
1) Ventral tegmental area
2) Nucleus accumbens
3) Frontal cortex
What drug causes these withdrawal symptoms?
Irritability, anxiety, dysphoria, difficulty concentrating, decreased HR, increased appetite, weight gain
Nicotine withdrawal syndrome
Treatment for quitting nicotine
1) Nicotine replacement
2) Bupropion (atypical antidepressant)
3) Varenicline
MOA of Varenicline
1) Partial nicotine agonist
Adverse effects of Varenicline
1) Nausea
2) Sleep disturbance
3) Enhancement of suicidal thoughts
Non competitive NMDA receptor antagonist
1) Phencyclidine (PCP)
2) Ketamine
LSD
Phencyclidine
Ketamine
Methylenedioxy-methamphetamine
Hallucinogens
What drug should you think if a pt. comes in with know intoxication along with vertical and horizontal nystagmus?
Phencyclidine (PCP)
Adverse effect of nitrate/nitrite inhalants?
1) Headace
2) Peripheral blood pooling
Rapid onset benzodiazepine
Flunitrazepam
Opioid antagonists?
1) Naloxone
2) Naltrexone
What drug would cause these withdrawal symptoms?
Rhinorrhea, Lacrimation, Yawning, Chills, Hyperventilation, Mydriasis, Yawning
Opioid withdrawal
MOA of cocaine
Blocks reuptake of dopamine
Treatment for opioid withdrawal
1) Do nothing (they won’t die)
2) Detox pt. with methadone or buprenorphine
3) Treat with clonidine (alpha 2 agonist; remember alpha-2 is inhibitory G protein)
Weak Mu receptor partial agonist
Tramadol
Mu partial agonist that is used for opioid detox
Buprenophrine
MOA of flumazenil
GABA antagonist
MOA of fomepizole
Inhibitor of alcohol dehydrogenase
When should flumazenil never be given?
When a pt. takes a benzo consistently; may induce seizures
