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Psychiatry > Drugs of Abuse > Flashcards

Drugs of Abuse Flashcards

1
Q

Define drug abuse

A

Drug abuse in its broadest sense can be defined as the use of a drug in a manner that deviates from the approved medical patterns within a given society.

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2
Q

Decrease in response to a drug as a result of repeated treatment with that drug.

A

Tolerance : can be dispositional, pharmacodynamic, behavioral or cross-tolerance

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3
Q

Describe drug dependence

A

Physical - Physical symptoms are produced by drug withdrawal

Psychological - Compulsive feelings of the need to take a particular drug

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4
Q

What’s the difference between substance USE disorders and substance INDUCED disordres?

A

Substance Use Disorders

– Substance Abuse

– SubstanceDependence

Substance-Induced Disorders

– Substance Intoxication – Substance Withdrawal – Substance Induced

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5
Q

How are substance USE disorders classified?

A

By drug class

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6
Q

Define General Substance Use Disorder

A

A problematic pattern of substance use within a 12 month period manifest by two or more symptoms that cause impairment in functioning.

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7
Q

What are the criteria symptoms for substance use disorder

A

Taken in larger amounts or for longer than intended.

Persistent desire or unsuccessful efforts to cut down use.

Great deal of time spent in activities necessary to obtain the substance, use the substance, or recover from it’s effects.

Important social, occupational, or recreational activities are reduced or given up because of substance use.

Craving or a strong desire or urge to use the substance.

Psychological and/or physiological dependence are not necessary for diagnosis

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8
Q

What are the Criteria for Cannabis Use Disorder

A

Problematic pattern leading to clincally significant impairment or distress seen in 12 mo period, at least 2 of following:

  1. Cannabis often taken in larger amounts or over longer period then intended
  2. Perisistant disre or unsuccesful efforts to cut down or control use
  3. Great amt time spent to obtain, use and recover from cannabis
  4. Craving or strong desire to use
  5. Recurrent cannabis use may result in failure to fulfill major obligations
  6. Continued use despite persistant or recurrent social or interpersonal probelms cause or exaccerbated by effects of cannabis
  7. give up certain activities bc of it
  8. use in situations that are physically hazardous
  9. continue to use even though you know you have pyschological problems exacerbated by it
  10. Tolerance: need more to get high or diminished effect w/ continued use
  11. withdrawal from use
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9
Q

What is the highest drug of abuse in highschoolers

A

Marijuanna/Hashish

synthetic marijuianna; then we see prescribed and OTCs abused

**more common in males

*12th grade >>> 8th grade

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10
Q

What is the potent compound in cannabis

A

delta 9 THC

much more potent in oils

*potency directly related to THC (cannibidiol also effects potency but doesn’t cause high)

More THC, less cannibidiol and vice versa

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11
Q

Cannabis is Rapidly metabolized by____ to 11-OH-∆9-THC, which is highly active in man. Then metabolized to 9-nor-COOH-THC which is inactive.

Metabolites excreted in :

A

liver

urine and feces. They are detectable in urine for many days.

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12
Q

What is the onset of aciton of cannabis and how long does it take to leave body?

A

Smoked it reaches brain in 15 to 30 seconds. 3-5 times more potent smoked than when ingested. Oral onset of action is about 30 min.

Metabolized and redistributed in fat. Slowly leaves body.

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13
Q

What is the duration of action and plasma 1/2 life of cannabis

A

Duration of action 1 to 6 hours

– plasma half-life - 20-50 hours; 20% remains in body after 5 days and is not detectable at 30 days

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14
Q
  • unique distribution in brain. High densities in cerebellum hippocampus and basal ganglia. Low in hypothalamus.

Affinity for receptor correlates with psychoactive potency of cannabinoid agonists.

A

CB1 Receptor (endogenous lingands for this exsist!)

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15
Q

What is the result of activation of the CB1 receptor to THC

A

Negatively coupled to adenylyl cyclase via Gi. Generally inhibits transmitter release.

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16
Q

What are endogenous agents in our bodies that bind to CB1 receptor

A

Anandamide and 2-arachidonylglycerol

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17
Q

What is Rimonobant

A

CB1 antagonist; blocks affect of THC and used for weight loss; but increases thoughts of suicide

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18
Q

Effects of marijuana use

A
  • Euphoria
  • Memory Impairment
  • Perceptual-Motor alterations
  • Cardiovascular
  • Pulmonary
  • Reproductive
  • Psychopathological Effects
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19
Q

How is memory affected by THC use?

A

Impiar short term memory, hard to recall material learned when high

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20
Q

What type of motor effects are seen with marijuana use

A

Strong link to driving accidents

alcohol is #1

cannabis #2

21
Q

CV effects of cannabis use

A

Dose related tachycardia and othorstatic hypotension, exacerbated angina

can also produce severe hypertension

22
Q

Pulmonary effects of cannabis use

A

Bronchodialation, lung irritant (constriction), decrease alvelar macrophage acivity and decrease activity of ciliary function

23
Q

Effect of marijuana on repro

A

Lowers testosterone levels and sperm counts.

Inrodents,gonadalweightsaredecreased.

LHRH release is decreased, which decreases levels of FSH and LH.

Prolactin release is decreased in females. Greater incidence of abnormal menstrual cycles.

Hazard to marginally fertile

24
Q

Psychopathological effects of cannabis use

A

Acuteanxietyreaction

Transient paranoid feelings

Exacerbation of schizophrenia

Diffuse acute brain syndrome with high doses – Clouding of consciousness and memory, perceptual and sleep disorders

Amotivational syndrome

25
Q

Is there tolerance and dependence related to marijuana?

A

Yes; both humans and animals

– Restlessness – Irritability and mild agitation – Sleep difficulties
– Decreased appetite and nausea – Craving

26
Q

What is an approved use of cannabis

A

control of nausea and vomiting and AIDS wasting or cancer releated

27
Q

What is synthetic marijuana

A

Sold as K2 or Spice or other names.

Contains synthetic compounds that have THC-like CB1 agonist activity.

Compounds that are not yet DEA scheduled and thus may be “legal”

JWH-018, JWH-073, HU-210 and others

AM-2201>

28
Q

Which receptor does phencyclidine produce its hallucinogenic effects at?

A

at the n-methyl-d-aspartate receptor

29
Q

PharmK for Phencyclidine:

_____absorption

Plasma 1/2 =

Hydroxylated and conjugated in the ___

A

rapid/complete

12-24 hrs and 72 in OD

in liver

*excreated in urein

30
Q

Effects of Phencyclidine on the autonomic and CV systemp

A

Sympathomimetic:

Tachycardia, Hypertension, pothentiation of cathecholamines

**see tolerance

31
Q

What are teh CNS effects of Ketamine and PCP

A

CNS effects are complex and dose related. Ketamine is less potent and has a shorter duration of action than PCP

Small doses - “drunken” state with numbness of extremities

Moderate doses - analgesia and anesthesia

Psychic state crudely resembles sensory isolation except that sensory impulses reach neocortex

Cataleptoid motor phenomenon are observed

Large doses may produce convulsions

32
Q

Non competitive antagonist that act by blocking the NDMA receptor thus block the anion channel

A

PCP and Ketamine

33
Q

What do we see in PCP overdose

A

CNS manifestations: anxiety, aggression, hallucinatins, dysphoria, convulsions, delirum,

Pympathomimetic: tachycardia and HTN crisis

34
Q

How do we tx a PCP overdose

A

Support vitals and provide gastric suction; they slow down motility thus may be able to get shit out,

Acidify urine, give diazepam/ or other antihypertensive adn Haloperidol bc of its anticholinergic effects

35
Q

What is our common hallucinogen?

A

LSD: its an indolemaine

as well as methamphetamines or amphetamines = phenethylamines (more sypmpathmimetic)

36
Q

Pharm K of LSD

A

Less than 1 % crosses Blood-Brain barrier

Onset -15 to 20 minutes, duration - 12 hours

37
Q

Sensory and subjective effects from LSD

A

Sympathomimetic-Tachycardia,increasedBP, psychomotor stimulation

Sensory and subjective effects
– Altered perception - particularly visual – Lability of mood – Impaired judgment

38
Q

What receptor does LSD act on to cause sensory affects?

A

Sensory effects thought to be due to an action at 5- HT2 receptors - agonist or partial agonist.

Tolerance and cross tolerance

39
Q
A
40
Q

What may happen years after LSD use?

What kind of toxic side effects are seen in the body?

A

Flashbacks - days to years later, can be associated with drug use.

Neurotoxicity - 5-HT damage may be associated with phenethylamine type drugs such as MDMA

41
Q

What is MDMA

A

Ecstasy : phenethylamine

42
Q

What does ecstasy make you feel like?

How long doe it take to work?

A

Inducesfeelingsof“well-beingandconnection”, altered time perception

Typical oral dose 100-150 mg

Onset of action 20 - 40 minutes; duration 3-4 hours

43
Q

What are some negative effects of ecstasy

A

Pyschomotorstimulation,restlessness,bruxisim, anorexia, sweating, tremor.

Hangover-anhedonia

Neurotoxicity-serotoninneurons??

44
Q

•Found in brain. It is a precursor and metabolite of GABA

  • May have own receptor
  • Can be made in body from GBL
A

GHB (naturally occuring, can make you feel high)

45
Q

GHBs effect in the body

A

Primarily a depressant - induces a state of relaxation and tranquility and interacts w/ ethanol

46
Q

What do we see in OD and high doses of GHB?

A

Overdose characterized by drowsiness, ataxia, nausea and vomiting

Higher doses - loss of bladder control,

temporary amnesia, clonus and seizures.

47
Q

Common inhalant abused by younger kids

A

toluene from model airplane glue

48
Q

What is Salvia

A

use as a psychedelic for oral use

hort duration of action- 20 to 45 minutes. Creates dream-like experience with open and close eyed visuals. There can be dissociation at high doses with fear panic and perspiration.

49
Q
  • a Kappa opioid agonist.
A

Salvinorin-A

Psychiatry (19 decks)

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