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Neuro IV > Drugs of abuse > Flashcards

Drugs of abuse Flashcards

1
Q

opiate reinforcing effects

A

euphoria, analgesia, sedation with anxiety reduction

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2
Q

opiate CNS action

A

interferes with endogenous mu opioid recepors

histamine release –> “rush” feelings

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3
Q

CNS depressants reinforcing effects

A

euphoria, sedation, anxiolytic, body building effects (GHB)

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4
Q

CNS depressant action

A

enhanced GABA activity
barbiturates and ETOH at high doses –> decreased glutamate
GHB –> complex effects at brain DA systems

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5
Q

CNS stimulant action

A

block catecholamine (esp DA) reuptake, increased catecholamine release

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6
Q

CNS stimulant reinforcing effects

A

elevation of mood, feeling of exhilaration, sense of increased energy and alertness, decreased fatigue and need for sleep, decreased appetite

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7
Q

Nicotine CNS action

A

nicotinic neuronal receptor agonist

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8
Q

Nicotine reinforcing effect

A

mild alerting effect

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9
Q

Hallucinogens CNS action

A

agonist at 5HT2 postsynaptic serotonin receptors

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10
Q

Hallucinogens reinforcing effects

A

altered perception, mood elevation, dissociation from self

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11
Q

Marijuana CNS action

A

cannabinoid receptor agonist (CB1) –> increased dopamine release in nucleus accumbens

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12
Q

Marijuana reinforcing effects

A

euphoria; changes in mood, perception and motivation

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13
Q

anticholinergic CNS action

A

block muscarinic cholinergic receptors

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14
Q

anticholinergic reinforcing effects

A

mood elevation, hallucinations, delirium

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15
Q

inhalants CNS action

A

general CNS depression via altered membrane permeability –> altered GABA/DA neurotransmission

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16
Q

inhalants reinforcing effects

A

euphoria, giddiness, dizziness, lightheadedness, disinhibition, floating sensation, misperception, clouding of thoughts

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17
Q

dissociative anesthetics CNS action

A

NMDA receptor antagonist. blocks reuptake of DA and serotonin. increased DA release in limbic and cortical structures

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18
Q

dissociative anesthetics reinforcing effects

A

lower dose: floating feeling of euphoria and heightened emotionality
Intermediate dose: increased talkativeness, misperceptions of sensory input, feelings of unreality, changes in body image
higher doses: hostile/bizarre behavior

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19
Q

opioid toxicity and treatment

A

toxic symptoms: coma, respiratory distress, pinpoint pupils, arrhythmias, parkinson-like effects (MPTP)

Treatment: establish airway, stabilize cardiopulmonary status. Naloxone (can lead to withdrawal in dependent addicts)

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20
Q

CNS depressant toxicity and treatment

A

Toxicity: confusion, emotional lability, ataxia, hyporeflexia, miosis.
severe = respiratory depression and hypotension –> coma and death

Treatment: supportive measures. Flumazenil (benzo OD). Respiratory support, IV glucose, thiamine, multivitamins, K, MG (ETOH OD)

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21
Q

CNS stimulant toxicity and treatment

A

Toxicity: peripheral sympathetic overactivity.
Severe = chest pain –> MI, fatal arrhythmias, stroke-like CNS vasculature

Treatment: Cardiopulmonary support, gastric lavage, acidify urine (increase excretion)
seizures –> diazepam
BP elevation –> phentolamine (never ever ever use beta blockers)
positive psych sx –> haldol

22
Q

Nicotine toxicity and treatment

A

Toxicity: Due to accidental ingestion of insecticides, children ingesting tobacco
Rapid –> nausea vomiting, abdominal pain, salivation, diarrhea, headache/dizziness
Later –> hypotension, dyspnea, weak and irregular pulse –> terminal convulsions, respiratory failure

Treatment: gastric lavage or induced vomiting, then activated charcoal. respiratory assistance and shock tx

23
Q

Hallucinogens toxicity and treatment

A

Toxicity: exaggerated panic reaction (vital signs); hallucinations –> anxiety. loss of contact with reality; schizophrenia-like sx; severe –> fever, CV collapse, convulsions, rhabdomyolysis

Treatment: stabilize cardiopulmonary function and treat convulsions and hyperthermia. Talk down, supplement with benzos

24
Q

Marijuana toxicity and treatment

A

Toxicity: decreased muscle strength, balance, motor coordination; increased reaction time; increased heart rate; seizures in epileptics; risk for ketoacidosis in diabetics

Treatment: general support and reassurance in low stimuli room

25
Dissociative anesthetics toxicity and treatment
Toxicity: most difficult to manage (2-6wk recovery due to ion trapping of weak base PCP in stomach) Initial: delirium, tachypnea, hypertension, tachycardia, hyperpyrexia, muscle rigidity, increased DTRs, blank stare Later: stupor --> coma, seizures --> death from resp/cardiac complications Treatment: manage symptoms. Benzos for agitation, antipsychotics for PROLONGED psychotic behavior
26
Inhalants toxicity and treatment
Toxicity: similar to ETOH Treatment: general supportive care, control arrythmias, respiratory assistance
27
Anticholinergic toxicity and treatment
Toxicity: disorientation and delirium, dry skin and mouth, flushed face, fever, unreactive pupils, blurry vision, memory impairment Treatment: physostigmine, benzos for behavioral excitation
28
Opiate tolerance/dependence
rapid tolerance with frequent use. rapid physical dependence
29
opiate withdrawal
not medically dangerous. after 1-2wk of multidose days. Early: restlessness, sleeplessness, yawning, nasal discharge, sweating Late: agitation, chilling, anorexia, fever, muscle/joint pain, vomiting, diarrhea, abdominal cramps/muscle spasms, tachycardia, hypertension
30
Opiate withdrawal treatment
clonidine --> alleviated sympathetic overactivity methadone/codeine --> substitution to alleviate sx Buprenorphine (subutex) = partial mu agonist --> minimal withdrawal sx Naltrexone (Revia) = opioid antagonist --> blocked reinforcing actions of heroin, no effect on craving or protracted withdrawal syndrome
31
CNS depressant tolerance/dependence
rapid tolerance to barbiturates, moderately rapid to ETOH, less with benzodiazepines physical tolerance develops. EEG changes and insomnia after 1 week of ordinary usage
32
CNS depressant withdrawal
induced seizures --> significant risk of morbidity and mortality Symptoms: rebound hyperexcitability. Severe = grand mal seizures, fever, delirium
33
CNS depressant withdrawal treatment
tapered reduction/substitution (with barbiturate or benzo) Buspar for anxiety Carbemazepine/watchful waiting for seizures
34
CNS stimulant tolerance/dependence
Tolerance to anorexia, euphoria, hyperthermia. Supersensitivity to effects on movement and psychomimetic/paranoia effects Dependence: strong PSYCHOLOGICAL dependence
35
CNS stimulant withdrawal
No obvious physiological sx. Only intense craving and drug seeking initially, with eventual normalized sleep and mood
36
CNS stimulant withdrawal treatment
behavioral. TCADs and bupropion --> relieve depression and reduce craving Topiramate --> reduced relapse rate Modafinil --> reduced cocaine-induced euphoria, relieved cocaine withdrawal sx
37
Nicotine tolerance/dependence
tolerance: yes for subjective effects (better feeling after a period of abstinence) and nausea Physical dependence: moderate
38
Nicotine withdrawal
irritability/impatience/hostility, anxiety, depressed mood, difficulty concentrating, restlessness, increased appetite. Depression --> often relapse
39
Nicotine withdrawal treatment
nicotine replacement --> suppressed withdrawal without same magnitude of subjective effects sustained release bupropion (Zyban) --> improved anstinence in combination with nicotine replacement varenicline (Chantix) --> ease withdrawal, blocks nicotine effects from cigarettes Nicotine vaccine --> binds nicotine in periphery and prevents CNS effects
40
Hallucinogen tolerance/dependence
tolerance: uncommon due to infrequent repeated use. larger doses increase tolerance to behavioral effects Physical dependence: None
41
Hallucinogen withdrawal
None
42
Marijuana tolerance/dependence
Tolerance: rapid appearance, rapid disappearance Physical dependence: high potential --> preoccupation, compulsion, reinforcement and withdrawal after chronic use
43
Marijuana withdrawal
high lipid solubility --> long half life --> uncommon withdrawal appearance Sx: mild withdrawal syndrome
44
Marijuana withdrawal treatment
usually unnecessary. Heavy users --> depression --> require antidepressants
45
Common inhalants
Glues/adhesives, aerosol propellants, cleaning solutions, paints, paint thinners, correction fluids, nail polish remover, fuels
46
Common dissociative anesthetics
Phencyclidine (PCP), ketamine, very high dose dextromethorphan
47
Common hallucinogens
Indoleamines: LSD, DMT, psilocybin, bufotenine (toad skin) Phenylethylamines: mescaline, MDMA
48
Common CNS stimulants
methamphetamine, cocaine
49
Common CNS depressants
barbiturates (pentobarbital, secobarbital, amobarbital), benzodiazepines, ETOH, GHB, kava (herb)
50
Common opiates
heroin, morphine, oxycodone, meperidine, fentanyl, hydrocodone, codeine

Neuro IV (21 decks)

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