Drugs of Abuse

Question 1

Reduction in the response to a drug after repeated administrations

Answer 1

Tolerance

Question 2

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

Answer 2

Pharmacokinetic tolerance

Question 3

When is the most reinforcing effect of abussive drugs

Answer 3

1) When there is an increase in plasma/brain concentration

Question 4

What are the only abusive drugs that in withdrawal there is a risk of death?

Answer 4

1) Benzodiazepines
2) Barbiturates
3) Ethanol

Question 5

What drug causes these withdrawal symptoms?

Dysphoria, depressed mood, sleepiness, extreme craving, bradycarda

Answer 5

Cocaine

Question 6

Rapid tolerance developing with repeated use on a single occasion; tolerance not retained between sessions

Answer 6

Acute tolerance

Question 7

Increase in the response of a drug after repeated administrations

Answer 7

Sensitization

Question 8

What should you think if pt. comes in complaining of “Bugs crawling under skin” and anxeity with dysphoria?

Answer 8

Chronic Cocaine Abuse

Question 9

What does cocaine have drug interactions with?

Answer 9

1) Opioids

2) Ethanol

Question 10

What occurs when cocaine is used with ethanol?

Answer 10

1) Formation of cocaethylene

2) Has a longer half life

Question 11

What are the major toxicities with cocaine?

Answer 11

1) Cardiovascular collapse
2) Arrhythmia
3) Seizures (due to local anesthetic effect)
4) Coma

Question 12

What are the symptoms of amphetamine toxicity?

Answer 12

1) Paranoid psychosis
2) Violence
3) Sympathetic arousal

Question 13

Approved uses for amphetamine

Answer 13

1) Narcolepsy

2) ADHD

Question 14

What amphetamines are used for narcolepsy?

Answer 14

1) Low abuse amphetamines
2) Modafanil
3) Armodafanil

Question 15

What is the reward pathway?

Answer 15

1) Ventral tegmental area
2) Nucleus accumbens
3) Frontal cortex

Question 16

What drug causes these withdrawal symptoms?

Irritability, anxiety, dysphoria, difficulty concentrating, decreased HR, increased appetite, weight gain

Answer 16

Nicotine withdrawal syndrome

Question 17

Treatment for quitting nicotine

Answer 17

1) Nicotine replacement
2) Bupropion (atypical antidepressant)
3) Varenicline

Question 18

MOA of Varenicline

Answer 18

1) Partial nicotine agonist

Question 19

Adverse effects of Varenicline

Answer 19

1) Nausea
2) Sleep disturbance
3) Enhancement of suicidal thoughts

Question 20

Non competitive NMDA receptor antagonist

Answer 20

1) Phencyclidine (PCP)

2) Ketamine

Question 21

LSD
Phencyclidine
Ketamine
Methylenedioxy-methamphetamine

Answer 21

Hallucinogens

Question 22

What drug should you think if a pt. comes in with know intoxication along with vertical and horizontal nystagmus?

Answer 22

Phencyclidine (PCP)

Question 23

Adverse effect of nitrate/nitrite inhalants?

Answer 23

1) Headace

2) Peripheral blood pooling

Question 24

Rapid onset benzodiazepine

Answer 24

Flunitrazepam

Question 25

Opioid antagonists?

Answer 25

1) Naloxone

2) Naltrexone

Question 26

What drug would cause these withdrawal symptoms?

Rhinorrhea, Lacrimation, Yawning, Chills, Hyperventilation, Mydriasis, Yawning

Answer 26

Opioid withdrawal

Question 27

MOA of cocaine

Answer 27

Blocks reuptake of dopamine

Question 28

Treatment for opioid withdrawal

Answer 28

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)

Question 29

Weak Mu receptor partial agonist

Answer 29

Tramadol

Question 30

Mu partial agonist that is used for opioid detox

Answer 30

Buprenophrine

Question 31

MOA of flumazenil

Answer 31

GABA antagonist

Question 32

MOA of fomepizole

Answer 32

Inhibitor of alcohol dehydrogenase

Question 33

When should flumazenil never be given?

Answer 33

When a pt. takes a benzo consistently; may induce seizures