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Pharmacology Exam III > Drugs of Abuse > Flashcards

Drugs of Abuse Flashcards

1
Q

Hallmark of drug addiction

A

COMPULSIVE DRUG USE - due to brain alterations associated with chronic exposure

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2
Q

Two Types of Dependence

A

Physical

Psychological

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3
Q

Physical dependence - DEPENDENCE

A

when drug is NECESSARY FOR NORMAL PHYSIOLOGICAL FUNCTION

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4
Q

Two Tolerance types

A

pharmocokinetic - associated with METABOLISM

pharmacodynamic - DESENSITIZATION/down regulation/increased receptor internalization

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5
Q

Psychological Dependence - ADDICTION

high risk of?

A

compulsive drug use to induce pleasure/escape from realitY DESPITE NEGATIVE CONSEQUENCES

relapse

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6
Q

Relative Risk of Addiction

A 
1 - non-addictive
2 - slightly
3 - moderate
4 - addictive
5 - highly
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7
Q

Addictive nature of drugs comes from effects on what two areas?

A

ventral tegmentum
reward pathway

DOPAMINERGIC

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8
Q

Ventral Tegmentum acts on what four main areas in the reward pathway?

A

amygdala
nucleus accumbens
pre-frontal cortex
hippocampus

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9
Q

Three mechanisms of increasing DA release

A

activation of Gi protein-coupled receptors - blocks GABA-ergic

Activation of ionotropic receptors or ion channels

Targeting DOPAMINE TRANSPORTER

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10
Q

CNS/Depressants

RR =

A

Alcohol
Benzo’s
Barbiturates
GHB

RR=3

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11
Q

Ethanol effects?

A

sedation, sleep, suppression of inhibitory systems, mild euphoria

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12
Q

Ethanol pharmacokinetics

A

rapidly and completel absorbed from GI tract

BLOOD BRAIN BARRIER AND PLACENTA ARE FREELY PERMEABLE

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13
Q

Ethanol metabolism

Elimination kinetics?

A

90% LIVER
10% GI tract

Excreted through KIDNEY AND LUNGS

ZERO ORDER ELIMINATION

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14
Q

Why do women have higher blood EtOH than men for same dose?

A

DECREASES first pass metabolism

LOWER total body water

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15
Q

3 enzymes of alcohol metabolism

A

ALCOHOL DEHYDROGENASE

MICROSOMAL ETHANOL-OXIDIZING SYSTEM

ALDEHYDE DEHYDROGENASE

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16
Q

Fomepizole

A

alcohol dehydrogenase inhibitor

treats methanol and ethylene glycol poisoning

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17
Q

Disulfiram

A

aldehyde dehydrogenase inhibitor

ecnourages alcoholics to abstain of EtOH

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18
Q

EtOH Mechanism of Action

A

POTENTIATES GABA AT GABA-A receptors

Also INHIBITS GLUTAMATE ACTIVATED NMDA RECEPTORS

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19
Q

Wernicke-Korsakoff Syndrome

A

vitamin B1 deficiency associated with excessive alcohol intake

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20
Q

Cocaine and Alcohol

A

liver combines them to make COCAETHYLENE

produces an intensification of cocaine’s euphoric effects

most common two drug combination that causes death

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21
Q

Management of Chronic Alcoholism

A

Disulfiram

Naltrexone

22
Q

Sedative/Hypnotics RR=

A

RR = 3 moderately addictive

23
Q

Most commonly abused benzo’s (2)

A

Diazepam

Alprazolam

24
Q

Flunitrazepam

A

rohypnol

date rape drug

tasteless when dissolved in a beverage

60 Hour detection window

25
Q

Flumazenil

A

BENZO ANTAGONIST

treatment of overdose and reversing effects of long acting benzo’s

26
Q

Overall mechanism of benzo’s and barbiturates as drugs of abuse

A

DISINHIBITION OF VTA DOPAMINE neurons

ACTIVATION OF MESOLIMBIC REWARD PATHWAY

27
Q

GHB

A

activates reward pathway

causes amnesia

also used as date rape drug

28
Q

Psychostimulants

RR = ?

A 
cocaine
amphetamine
methamphetamine
methylphenidate
MDMA

RR = 5

29
Q

Cocaine associated with what positive effects?

linked to what major negative effect?

A

intense euphoria
increase energy
increased libido/self confidence

linked to CARDIOVASCULAR TOXICITY

30
Q

Cocaine has what characteristic?

A

STRONGEST PSYCHOLOGICAL DEPENDENCE

31
Q

Methamphetamine effects last?

Also has what?

A

6 to 24 hours vs 30 to 60 mins of cocaine

sympathomimetic activity

32
Q

Cocaine MOA

A

blocks DA RE-UPTAKE

INCREASES SYNAPTIC RELEASE

33
Q

Amphetamines MOA

A

cause VESICLE RELEASE OF DA AND NE

REVERSE DA transporter

34
Q

Methylphenidate used for? (2)

A

ADHD

Narcolepsy

35
Q

MDMA MOA

Causes?

A

interferes with 5-HT TRANSPORTERS to release 5-HT

significant depletion of 5-HT for 24 hrs

36
Q

Toxicity of MDMA

A

acute - HYPERTHERMIA AND DEHYDRATION

chronic - neurotoxicity and irreversible brain damage

37
Q

Long term use of psychostimulants causes?

A

TOXIC PSYCHOSIS

INDISTINGUISHABLE FROM PARANOID SCHIZOPHRENIA

38
Q

Psychedelics (4)

RR =

A

Lysergic acid diethylamide
Psiolcybin
Ketamine
Phencyclidine

RR = 1

39
Q

LSD and Psylocibin effects

MOA?

key receptor?

A

hallucinations, illusions, paranoia, euphoria, or depression

RELEASE GLUTAMATE in CORTEX via THALAMIC EXCITATION

target 5-HT-2a receptors –> INCREASES CALCIUM

40
Q

Negative effects of LSD and Psylocibin

A

Flashbacks

Bad trips

Rapid tolerance

No dependence or addiction

41
Q

Ketamine and PCP MOA

A

block NMDA-YPE GLUTAMATE RECEPTORS

DECREASE ACTIVITY OF CORTEX AND LIMBIC SYSTEM

42
Q

Opioids RR

A

RR = 4

43
Q

Most commonly abused opioids (4)

A

codeine
heroin
morphine
oxycodone

44
Q

Naloxone

A

emergency overdose treatment

45
Q

Naltrexone

A

primarily for MAINTENANCE THERAPY

longer acting, slower onset

46
Q

Methadone

A

strong opioid agonist

MILDER WITHDRAWAL SYMPTOMS

47
Q

Dronabinol

A

SYNTHETIC THC approved for chronic pain treatment

48
Q

Cannabinoids RR

A

RR = 2

49
Q

THC/Cannabinoids MOA

A

DISINHIBITS DA NEURONS in VTA via PRE-SYNAPTIC CANNABINOID RECEPTORS

likely involves removing GABA-A inhibition

50
Q

Cannabinoids effects

A

euphoria
relaxation
sense of wellbeing

51
Q

Treatments for nicotine addiction (3)

A

transdermal patch
bupropion
varenicline

Pharmacology Exam III (11 decks)

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