Drugs of Abuse

Question 1

Opioids: examples

Answer 1

• oxycodone
• hydrocodone
• heroin
• meperidine

Question 2

CNS depressants: examples

Answer 2

• barbiturates
• benzodiazepines
• alcohol

Question 3

CNS stimulants: examples

Answer 3

• methamphetamine
• cocaine
• nicotine
• MDMA

Question 4

Nicotine: examples

Answer 4

well, just nicotine…cigarettes, dip, e-cigarettes. all that bad stuff.

Question 5

Hallucinogens: examples

Answer 5

• Indoleamines
• Phenylethylamines
• LSD
• Mushrooms
• Mescaline (Peyote)

Question 6

Cannabinoids: examples

Answer 6

apparently marijuana is legal in colorado. not that it matters to me at all…nope…i wouldn’t know anything about that.

Question 7

Anticholinergics: examples

Answer 7

• atropine
• Jimson weed
• OTC antihistamines

Question 8

Opioids: CNS action/NT & risk of tolerance/dependence

Answer 8

• Interaction w/endogenous opioid receptors
• Tolerance/dependence develops rapidly

Question 9

CNS depressants: CNS action/NT & risk of tolerance/dependence

Answer 9

• MOA: enhancement of GABA activity
• Tolerance
  • barb = high
  • benz = low
  • etoh = moderate
• All 3 ==> dependence

Question 10

CNS stimulants: CNS action/NT & risk of tolerance/dependence

Answer 10

• MOA: Cause release or block reuptake of catecholamines
• Stimulant use ==> tolerance
  • Supersensitivity to movements.
• Some possible physical dependence.
• Strong psychologic dependence

Question 11

Nicotine: CNS action/NT & risk of tolerance/dependence

Answer 11

• MOA: agonist at nicotinic neuronal receptors
• ==> tolerance
• moderate physical dependence
  
  • moderate-strong psychological dependence

Question 12

Hallucinogens: CNS action/NT & risk of tolerance/dependence

Answer 12

• MOA: Agonists at 5HT2 postsynaptic receptors; DA release
• Tolerance
  
  • tolerance can develop to larger doses for behavioral effects (but not CV effects)
• Little observed dependence

Question 13

Cannabinoids: CNS action/NT & risk of tolerance/dependence

Answer 13

• MOA: Agonist at CB1 receptor in CNS
• Tolerance appears rapidly, disappears rapidly
• No physical dependence

Question 14

Anticholinergics: CNS action/NT & risk of tolerance/dependence

Answer 14

• MOA: Blocks muscarinic cholinergic receptors
• Tolerance - yes
• Dependence Unknown

Question 15

Opioids: Acute toxicity rxn + tx

Answer 15

• Rxn: Coma, resp distress, pinpoint pupils
• Tx: Airway/breathing/CV support, nalaxone

Question 16

CNS depressants: Acute toxicity rxn + tx

Answer 16

• Rxn: Confusion, talkativeness, ataxia, miosis
  
  • Barbs → coma
• Tx:
  
  • Barb → supportive
  • Benzo → flumazenil
  • EtOH → supportive

Question 17

CNS stimulants: Acute toxicity rxn + tx

Answer 17

• Rxn: rapid pulse, BP, inc temp, sweat, increase motor, paranoid psychos
• Tx:
  
  • Cardiopulm supp
  • diazepam
  • phentolamine
  • haloperidol

Question 18

Nicotine: Acute toxicity rxn + tx

Answer 18

• Rxn:
  
  • N/V
  • salivation
  • ab pain, diahhrea
  • HA
  • dizziness
  • convulsions
  • resp fail
  • death
• Tx: Gastric lavage

Question 19

Hallucinogens: Acute toxicity rxn + tx

Answer 19

• Rxn:
  
  • Anxiety, paranoia,
  • confusion
  • hallucination
  • convulsions
  • CV collapse
  • renal failure
• Tx: Stabilize, isolate, benzodiazepines

Question 20

Cannabinoids: Acute toxicity rxn + tx

Answer 20

• Rxn: Tremors, ↓ musc strength + balance +coord, can’t drive
• Tx: general support, quiet room w/min stimuli

Question 21

Anticholinergics: Acute toxicity rxn + tx

Answer 21

• Rxn: disorientation, delirium, flush, dry skin, fever, memory loss
• Tx: Physostigmine and benzos

Question 23

Opioids: Withdrawal severity + tx/relapse prevention

Answer 23

• Rxn: Bothersome, not dangerous.
  
  • flu-like, sleepiness, sweat, diarrhea, vomit, hypertension
• Tx: Clonidine for w/drawal sx
  
  • methadone
  • buprenorphine
  • naltrexone

Question 24

CNS depressants: Withdrawal severity + tx/relapse prevention

Answer 24

• Rxn: Lethal! Seizures. Insomnia, excitability, sweating, nausea, vomiting, weakness, tremors
• Tx: Initiate reduction/substitution, monitor for seizures, attend to nutrition and electrolyte balance
  
  • Anxiety tx: buspirone
  • Prevent abuse: disulfiram

Question 25

CNS stimulants: Withdrawal severity + tx/relapse prevention

Answer 25

• Rxn: Mild. Sleepiness, hyperphagia, depression
• Tx: Resolves on own.
  
  • TCAD
  • Topiramate (anticonvulsant)
  • Modafinil (improves sleepiness)

Question 26

Nicotine: Withdrawal severity + tx/relapse prevention

Answer 26

• Rxn: Irritability, hostility, anxiety, depression, weight gain
• Tx:
  
  • Nicotine replacement
  • bupropion
  • chantix = partial nicotinic agonist
  • Nicotine conjugatve vaccine = agonist @ periphery, but not @ CNS

Question 27

Hallucinogens: Withdrawal severity + tx/relapse prevention

Answer 27

• No clinical withdrawal syndrome known, can have flashbacks

Question 28

Cannabinoids: Withdrawal severity + tx/relapse prevention

Answer 28

• Rxn: Not common, fatigue, anxiety, nausea, malaise, HA
• Tx: None needed unless become depressed → antidepressants

Question 29

Anticholinergics: Withdrawal severity + tx/relapse prevention

Answer 29

• No widthrawal syndrome