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Neuro 4 > Drugs of Abuse > Flashcards

Drugs of Abuse Flashcards

1
Q

Drugs with dependence liability (signif) share what property?

A

-enhance dopamine activity in the nucleus accumbens

DA neuron cell body in ventral tegmental area, nerve terminal in Nucleus Accumbens

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2
Q

drug abuse

A

Use of a drug for nonmedical reasons that deviates from approved social patterns (alters mood, level of perception, or brain functioning).

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3
Q

metabolic tolerance

A

a change in pharmacokinetics results in lowered drug concentrations at the active site; metabolism the primary mech (eg more rapid enzymatic degradation of the drug)

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4
Q

Pharmacodynamic tolerance

A

lessened response at active site to the same drug concentration; achieved via changes in receptor sensitivity or other adaptive changes

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5
Q

learned tolerance

A
  • reduction in the effects of a drug due to learned compensatory mechanisms
  • behavioral tolerance: describes skills developed due to repeated experiences in attempting to function despite mild-moderate intoxication

-conditioned tolerance: develops when environmental cues (sights, smells, situations) are consistently paired with drug administration

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6
Q

reverse tolerance

A

sensitization (increased response) to drug following repeated doses

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7
Q

cross tolerance

A

after tolerance develops to one drug, it is also seen to other drugs
-used in detox procedures
Ex: heroin and hydrocodone (both @ mu recep)
Ex: ethanol and BDZ (both at GABA recep)

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8
Q

Physical dependece

A

-repeated drug use alters physiological state such that continued admin is needed to prevent withdrawal sx

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9
Q

cross dependence

A

ability of drug to suppress the withdrawal assoc w/ physical dependence of another drug
Ex: benzos are often used to suppress alcohol withdrawal sx

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10
Q

psychological dependence

A

perceived need for a drug (“CRAVING”)

-related to pathologic learning in reward pathway

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11
Q

opioids

A

Heroin, (oxycodone, hydrocodone)

Action in CNS: interaction w/ endogenous opiate receptors (especiall mu); rush feeling related to histamine release

Major effects leading to abuse: euphoria, analgesia, sedation w/ anxiety reduction

Sx of acute toxicity: coma, respiratory distress, pinpoint pupils
Treatment: naloxone (Narcan)–could precip withdrawal

tolerance develops rapidly to most opioids

physical dependence: develops rapidly

withdrawal: sx are not MEDICALLY dangerous, but bothersome

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12
Q

Which route of admin from psychoactive drugs provides most rapid onset of effects in the brain?

A

inhalation (smoking)

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13
Q

MOAs of drugs of abuse

A

opioids: mu opioid receptors (Gi)
CNS depressants: enhance GABA, inhibit glut
CNS stimulants: block DA reuptake or enhance DA release
Nicotine: agonist @ nicotinic neuronal receptors
Hallucinogens: partial agonist at 5HT2 receptors (DA releaser)
Dissociative anesthetics: antagonist at NMDA-Glu receptors
Cannabinoids: agonist at cannabinoid (CB1-CB2) receptors

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14
Q

reinforcing effects of opioids

A

euphoria, sedation, anxiolytic

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15
Q

reinforcing effects of CNS depressants

A

euphoria, sedation, loss of inhibition

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16
Q

reinforcing effects of CNS stimulants

A

euphoria, decreased fatigue, increased arousal

17
Q

reinforcing effects of nicotine

A

increased alertness

18
Q

reinforcing effects of hallucinogens

A

altered sensory perception, enhanced insight

19
Q

reinforcing effects of dissociative anesthetics

A

euphoria, heightened emotionality

20
Q

reinforcing effects of cannabinoids

A

euphoria, mellowness, changes in perception

21
Q

examples of stimulants

A

cocaine
meth
nicotine

cocaine and meth have highest relative risk of addiction

22
Q

ex of drug that blocks reuptake of DA and NE into presyn catecholamine neurons and also blocks Na channels in neuronal membranes

A

cocaine

23
Q

CNS depressants

-action/acute toxicity

A

-via GABA activation +/- glu inhibition
-respiratory depression, coma (extremely rare w/ BDZs)
Treatment:
ethanol: supportive plus fluids-electrolytes-thiamine
BDZs: flumazenil
Barbs: supportive

24
Q

CNS stimulants

-action/acute toxicity

A

-via activation of NE and DA receptors
-tox: SNS overactivity, increased HR/BP/temp, chest pain/MI, psychosis
Treatment: CVS suport, vasodilators for BP, BDZs for agitation/seizures

25
Q

Nicotine

-action/acute toxicity

A

-rare toxicity
-via activation of nicotinic cholinergic receptors
Tox: n/v, diarrhea, CVP collapse, convulsions
Tx: CVS support, emetics, gastric lavage, charcoal

26
Q

Hallucinogens

-action/acute toxicity

A

-actions on 5HT receptors
-LSD-Psilocybin: “bad trip”, severe anxiety
Tx: talking down, BDZs for agitation
-MDMA: agitation, hyperthermia, ADH release–>hyponatremia

27
Q

Dissociative anesthetics

-action/acute toxicity

A

Phencyclidine (PCP), Ketamine
-via block of NMDA Glu receptors
-delirium, increased RR, HR, BP, temp, agitation, violent behavior
Tx: supportive for BP-hyperthermia, agitation (BDZs)

28
Q

Cannabinoids action/acute tox

A

-activation of CB1 receptors

minimal–>possible anxiety, impaired coord-tracking, acute psychosis

29
Q

Tolerance to drugs of abuse

A

opioids: rapid (but not to constipation)

CNS dep: rapid to barbs>ethanol, BDZs (signif to sedation/intox, less to lethal dose)

CNS stim: develops to euphoria, anorex/hyperthermia, can see supersensitivity to paranoia

Nicotine: develops to subjective effects and nausea

hallucinogens: not common

dissociative anesthetics: not well studied

cannabinoids: rapid to most effects, but disappears rapidly

30
Q

Do tolerance and dependence coexist?

A

-not necessarily

nor do addiction and physical dependence

31
Q

Dependence on Drugs of abuse

A

-opioids: develops rapidly (scheduled doses, within 1-2 wks)
-CNS dep: w/in WEEKS
-CNS stimulants: arguable, lack of physiological effects
-Nicotine: moderate devel
-Hallucinogens: does not devel
Dissoc anesthetics: probably none
Cannabinoids: accumulating evidence for dependence

32
Q

Withdrawal

A

characterized by rebound effects on the phsyiological sx that have been modified by chronic drug use

  • Effects generally opposite of the acute effects of the drug
  • Withdrawal sx can be FATAL and may require emergent interventions
33
Q

Withdrawal from opioids

A

rarely life threatening**
insomnia, diarrhea, irritability, cramps, muscle aches, increased BP
Tx: clonidine, methadone

34
Q

CNS depressants withdrawal

A

-significant risk of mortality due to seizures

Tx: substitution with BDZs: loading dose then taper to prevent sz

35
Q

CNS stim withdrawal

A

sleepiness, fatigue, depression, hyperphagia, craving

Tx: largely behavioral

36
Q

Nicotine withdrawal

A

-irritability, hostility, anxiety, increased appetite, weight gain
Tx: relapse–>nicotine replacement, bupropion, varenicline

37
Q

Hallucinogens withdrawal

A

not known, “flashbacks in some former users

38
Q

Withdrawal from cannabinoids

A

not clinically significant (long t1/2)

Tx: usually not needed

Neuro 4 (23 decks)

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