drugs of abuse

Question 1

opioids, reinforcing effects, NE involved, acute toxicities and tx, tolerance and dependence, withdrawal tx for withdrawal, relapse prevention.

Answer 1

agonist at u opioid receptor [Gi/o], euphoria,sedation
respiratory depression miosis->death arrtythmias, convulsions–> Tx=naloxone (IV/SC). tolerance develops quickly, but not miosis or constipation, dependence develops rapidly, withdrawal rarley life threatening, irritibility, insomnia, tachycardia, cramps diarrhea HTN, muscle aches. Tx=clonidine, methadone, relapse- buprenorphin, naloxone, naltrexone

Question 2

CNS depressants reinforcing effects, NE involved, acute toxicities and tx, tolerance and dependence, withdrawal tx for withdrawal, relapse prevention.

Answer 2

ethanol, Benzos, Barbiturates. anxiolysis, sedation, loss of inhibition. respiratory depression, coma, death (rare w/ BZD). Tx- supportive for etoh and barbs, Flumazenil for BZD
tolerance Barb>etoh>BDZ. dependent within weeks.
wothdrawal- mortality risk due to seizures Tx- use benzo and dose taper. relapse- acamprosate naltrezone, disulfiram

Question 3

CNS stimulants reinforcing effects, NE involved, acute toxicities and tx, tolerance and dependence, withdrawal tx for withdrawal, relapse prevention.

Answer 3

cocaine, amphetamins, methamphetamine, methylphenidate. euphoria, fatigue, arousal and confidence, apetite suppression. SNS overactivity w/ increase HR BP temp chest pain arrhythmias, mi, paranoid psychosis Tx- CV support, vasodilatros BDZ for agitation and seizures, tolerance to euphoria anorexia, hyperthermia, SUPERSENSITIVITY to paranoia, dependence is arguable, withdrawal, sleepiness, fatigue, depression, hyperphagia, craving. relapse- largely behavioral

Question 4

nicotine reinforcing effects, NE involved, acute toxicities and tx, tolerance and dependence, withdrawal tx for withdrawal, relapse prevention.

Answer 4

nicotinic cholinergic receptor agonist, increased alertness. acute tox rare, unless ingested by children, Tx CV support emetics, gastric lavage charcoal. tolerance to subjective effects and nausea, moderate dependence. withdrawal- irritibility, hostility, anxiety, increase appetite, weight gain
relapse-nicotine replacement, buproprion, varenicline

Question 5

hallucinogens reinforcing effects, NE involved, acute toxicities and tx, tolerance and dependence, withdrawal tx for withdrawal, relapse prevention.

Answer 5

altered sensory perception hallucinations intense arousal, mood elevation (MDMA-insight and selfknowledge enhanced). severe anxiety, intense depression visual distrubances (MDMA-increase ADH–>hyponatremic)

Question 6

marijuana reinforcing effects, NE involved, acute toxicities and tx, tolerance and dependence, withdrawal tx for withdrawal, relapse prevention.

Answer 6

euphoria, mellowness, changes in perception, mood, motivation. minimal possible anxiety impaired coordination and tracking behavior acute psychosis. tolarance develops rapidly and dissapears rapidly. abuse potential moderate, withdrawal not clinically significant due to long halflife, mild symptoms. Tx none

Question 7

anticholinergics reinforcing effects, NE involved, acute toxicities and tx, tolerance and dependence, withdrawal tx for withdrawal, relapse prevention.

Answer 7

y

Question 8

ethanol MOA

Answer 8

increases GABA, inhibit GLU-NMDA

Question 9

BZD MOA

Answer 9

Increases Gaba channel in presence of GABA

Question 10

Barbiturates

Answer 10

Increases GABA function with or w/o GABA, inhibits GLU AMPA

Question 11

Cocaine

Answer 11

inhibits monamine reuptake transporters

Question 12

amphetamine, methylphenidate, methamphetamine

Answer 12

stimulate monoamine release

Question 13

Indoleamines (LSD, Psilocybin, bufotenine)

Answer 13

partial agonist at 5HT2 receptors

Question 14

Phenylethylamines (MDMA,Mescaline)

Answer 14

partial agonist at 5HT2 + DA relaseing

Question 15

Phenylcyclidine, katamine, NO, Dextromethorphan

Answer 15

GLU NMDA antagonist

Question 16

marijuana

Answer 16

CB-1 agonist