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Mo-Neuro 4 > Drugs of Abuse > Flashcards

Drugs of Abuse Flashcards

1
Q

Opioids

A

agonists at μ-opioid receptors [Gi]

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2
Q

CNS Depressants

A

enhance GABA and/or inhibit glutamate fxn

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3
Q

CNS Stimulants

A

block DA reuptake or enhance DA release

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4
Q

Nicotine:

A

agonist at nicotinic neuronal receptors

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5
Q

Hallucinogens

A

partial agonist at 5HT2 receptors (DA releaser)

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6
Q

Dissociative Anesthetics:

A

antagonist at NMDA-Glu receptors

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7
Q

Cannabinoids

A

agonist at cannabinoid (CB1-CB2) receptors

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8
Q

Reinforcing Effects of Drugs of Abuse

Opioids

A

Euphoria, sedation, anxiolytic

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9
Q

Reinforcing Effects of Drugs of Abuse

CNS Depressants

A

Euphoria, sedation, loss of inhibition

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10
Q

Reinforcing Effects of Drugs of Abuse

CNS Stimulants

A

Euphoria, decreased fatigue, increased arousal

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11
Q

Reinforcing Effects of Drugs of Abuse

Nicotine

A

Increased alertness

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12
Q

Reinforcing Effects of Drugs of Abuse

Hallucinogens

A

Altered sensory perception, enhanced insight

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13
Q

Reinforcing Effects of Drugs of Abuse

Dissociative Anesthetics

A

Euphoria, heightened emotionality

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14
Q

Reinforcing Effects of Drugs of Abuse

MJ

A

Euphoria, “mellowness”, changes in perception

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15
Q

Opioids - via mu-opioid receptor activation

Respiratory depression-pinpoint pupils-coma

Treatment: ________________

A

naloxone

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16
Q

CNS Depressants - via GABA activation +/- GLU inhibition

Respiratory depression, coma (extremely rare with BDZs)

Benzodiazepines Rx: ____________

A

flumazenil

17
Q

CNS Depressants - via GABA activation +/- GLU inhibition

Respiratory depression, coma (extremely rare with BDZs)

ETOH

A

Treatment

Ethanol: supportive plus fluids-electrolytes-thiamine

18
Q

CNS Stimulants - via activation of NE and DA receptors

SNS overactivity, increased HR-BP-temp, chest pain-MI, psychosis

Treatment: CVS support, ____________________

A

vasodilators for BP

BDZs for agitation-seizures
-reduce sym overactivity

19
Q

Nicotine: rare (insecticide-cigarettes ingestion by children) - via activation of nicotinic-cholinergic receptors

Treatment: CVS support, _____________

A

emetics-gastric lavage-charcoal

20
Q

Tox MDMA: Agitation, hyperthermia, _____________

A

ADH release–> hyponatremia

21
Q

Tox Cannabinoids via activation of CB1 receptors

A

Minimal –>possible anxiety, impaired coordination-tracking, acute psychosis

22
Q 
Which of the following drugs of abuse is least likely to result in a fatality if orally ingested in excessive amounts as a single agent?

Ethanol
Heroin 
Morphine
Oxycodone
Phenobarbital
Diazepam
A 
Ethanol- rd
Heroin  rd
Morphine  rd
Oxycodone  rd
Phenobarbital  rd
Diazepam- generally safe w/o resp comorbid
23
Q

Tolerance to Drugs of Abuse

Cross Tolerance means?

A

Tolerance develops to one drug – then will be seen to other drugs of the same class - same target

Examples

Drug of abuse (heroin)–> cross-tol to medically used drug (hydrocodone) –>both drugs act at u-opioid receptors

Alcoholic patient tolerant to ethanol–> cross-tolerance to benzodiazepines - both drugs act at GABA receptors

24
Q 
A patient who is an alcoholic would be most likely to display cross-tolerance to which of the following drugs?

Lidocaine (Xylocaine)
Hydrocodone (in Vicodin)
Ibuprofen (Motrin)
Diazepam (Valium )
Acetaminophen
A

Diazepam (Valium)

ETOH and Bdz–> Facilitates GABA fxn

25
Q

Dependence on Drugs of Abuse

Opioids

A

Develops rapidly

26
Q

Dependence on Drugs of Abuse

CNS Depressants

A

Appears within weeks

27
Q

Dependence on Drugs of Abuse

Cannabinoids

A

Accumulating evidence for dependence syndrome

28
Q

Tolerance to Drugs of Abuse

Rapid

A

Opioids: Develops rapidly

CNS Depressants–> Rapid to barbiturates

29
Q

Cross Dependence

+ side

A

Ability of one drug to suppress the withdrawal associated with physical dependence on another drug

30
Q

Tolerance and dependence do not necessarily coexist - nor do addiction and physical dependence

A

Tolerance and dependence do not necessarily coexist - nor do addiction and physical dependence

31
Q

The exaggerated expression of drug effects experienced immediately after cessation of treatment

A

withdrawal

32
Q

A state of neuroadaptation produced by repeated drug administration that necessitates continued drug administration to prevent the withdrawal syndrome from occurring.

A

drug dependence

33
Q

A reduced effect of the drug generated by repeated administration of the drug in a particular environment.-

A

tolerance

34
Q

The ability of one drug to suppress the manifestations of another drug’s actions

A

cross dependence

35
Q

Withdrawal SZ

A

↑↑↑ Cl–> wd ↓ Gaba ETOH

↓ Glu–> wd ↑ Glu Benz

36
Q

Opoid wd rx

A

clonide ↓ SNS
methadone cross tol

Rarely life-threatening  insomnia, diarrhea, irritability, cramps, muscle aches, increased BP

37
Q

CNS ↓ wd

A

Significant risk of mortality due to seizures (monitor)

Treatment: substitution with BDZs –> loading dose - then taper to prevent seizures

use benzos for cross, most often wd is from etoh

38
Q

Withdrawal from Drugs of Abuse

Nicotine

A

Treatment: relapse–> nicotine replacement, bupropion, varenicline

39
Q 
Untreated withdrawal from drugs of abuse can produce symptoms that include potentially life-threatening seizures.  Seizures are LEAST likely to occur following withdrawal from which of the following classes of abused drugs?

Alcohol
Barbiturates
Benzodiazepines
Opioid analgesics
A 
Alcohol- cns
Barbiturates- cns
Benzodiazepines- cns
Opioid analgesics- u- least likely

Mo-Neuro 4 (37 decks)

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