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Pharmacology > Drugs of Abuse > Flashcards

Drugs of Abuse Flashcards

1
Q

What is recreational drug use?

A

use of a pharmacologically active agent for purposes other than its intended medicinal or other purpose

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2
Q

what is tolerance?

A

a state at which there is no longer the desired response to the drug; to achieve the desired response, more drug is required

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3
Q

how long does it take before tolerance is typically lost?

A

10-14 days

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4
Q

what is reverse tolerance?

A

sensitization; requires less drug to achieve the desired response

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5
Q

what is functional tolerance?

A

aka pharmacodynamic tolerance
change in the post synapses of the CNS
desensitization of receptors is short; down regulation of receptors/signalling pathways is long

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6
Q

what is metabolic tolerance?

A

aka pharmacokinetic tolerance

adaptation of the metabolic machinery to repeated exposure to a drug (similar to drug resistance mechs)

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7
Q

what is withdrawal?

A

a maladaptive behavioural change, with physiological and cognitive concomitants, that occurs when blood or tissue concentrations of a substance decline in an individual who had maintained prolonged heavy use of the substance

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8
Q

what are some drug classes that are known to cause withdrawal?

A 
alcohol
opioids
hypnotics
anxiolytics
sedatives
amphetamines
nicotine
cocaine
cannabis
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9
Q

what is dependence?

A

the state at which the user functions normally only when taking the medication
reinforced by withdrawal symptoms

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10
Q

what is an example of physiological dependence?

A

withdrawal of alcohol from an alcoholic can be life threatening

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11
Q

what is an example of psychological dependence?

A

repeated crack cocaine use; drug seeking habits in spite of risks; repeated dosing related need to keep the high
implies addiction

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12
Q

what are 5 characteristics of addiction?

A

1) Inability to consistently abstain
2) Impaired in behavioural control
3) craving: or increased “hunger” for drugs or rewarding experiences
4) diminished recognition of significant problems with one’s behaviours and interpersonal relationships
5) a dysfunctional emotional response

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13
Q

what is the difference between opioids and opiates?

A

opioids - fully synthetic; umbrella term

opiates - synthetic derivatives from opium poppy

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14
Q

what are some other effects opioids have on the body besides euphoria?

A

respiratory depression
dependence
prominent effect on GI tract
miosis (excessive constriction of eye pupil)

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15
Q

which receptor are opioids selective for? what is the one exception?

A

mu receptor

pentaocine (kappa receptor)

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16
Q

what are some desirable effects of opioid use?

A 
analgesia
euphoria
sedation
relief of anxiety
depress cough reflex
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17
Q

what are some undesirable effects of opioid use?

A 
dysphoria (dizziness, nausea)
vomiting
constipation
biliary tract spasm
urinary retention
withdrawal
respiratory depression
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18
Q

what are the available routes of administration for opioids

A 
oral
IV
IM
smoked
intranasal
transdermal
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19
Q

briefly describe the PK of opioids

A 
readily absorbed orally
lipid solubility affects distribution and CNS levels
First pass metabolism: glucoronidation
renal elimination
enterohepatic recycling
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20
Q

what are some effects of opioid toxicity?

A

CNS: convulsions
Resp: rate/volume/exchange depression, decreased resp responsiveness
CV: orthostatic hypotension, stroke, ECG abnormalities
GI: decreased motility, intestinal obstruction, increased biliary tract pressure

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21
Q

what symptoms will be experienced in the first 8-12h of opioid abstinence syndrome? (4pts)

A

lacrimation
perspiration
yawning
rhinorrhea

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22
Q

what symptoms will be experienced in the first 12-14h of opioid abstinence syndrome? (7pts)

A 
irritability
piloerection
restlessness
weaknesses
mydriasis
tremor
anorexia
23
Q

what symptoms will be experienced in the first 48-72h of opioid abstinence syndrome? (13 pts)

A 
increased irritability
increased HR
insomnia
marked anorexia
hypertension
sneezing
hyperthermia
hyperpnea 
aching muscles
hot and cold flashes
nausea/vomiting
piloerection
abdominal cramps
24
Q

how long does opioid abstinence syndrome typically last?

A

7-10 days

25
Q

what is acetyl fentanyl?

A

designer drug that is 5-15x more potent than heroin

26
Q

what is some effects of acetyl fentanyl?

A

euphoria
altered mood
drowsiness
resp depression

27
Q

what is the problem with acetyl fentanyl?

A

responsible for multiple deaths

28
Q

what are some effects of cannabis that cause it to be used recreationally

A

dysphoria and hallucinations

29
Q

what is the major psychoactive constituent in cannabis?

A

THC

30
Q

what is the MoA of cannabis?

A

bind to cannabinoid receptors CB1 and CB2

CB1 associated with MAP kinase/adenylyl cyclase/K-channel

31
Q

what is the approx % of THC in leaves, hashish, and oil extract?

A

leaves: 2-5%
hashish: 5-25%
oil extract: >20%

32
Q

what are some CNS effects of cannabis?

A

euphoria
lack of concentration
motor function impairment (reaction time)
impaired attention, memory, learning
users at heightened anxious state (CB1 in amygdala)
paranoia

33
Q

what are some CV effects of cannabis?

A 
increased HR
decreased BP (vasodilation)
34
Q

what are some resp effects of cannabis?

A

deceased resp rate
bronchodilation
lung damage (smoking)

35
Q

What are two drug interactions that can occur with cannabis?

A

cocaine/amphetamines - increased hypertension, tachycardia, possible cardiotoxicity
CNS depressants - additive effect

36
Q

briefly describe the PK of cannabis

A

smoking: rapid onset and 18-50% bioavailability
oral: slower onset, 6-18% bioavailability, first pass effect

THC is lipophilic; enterohepatic circulation; t1/2 = 3 days in chronic users

37
Q

what are the desirable effects of cocaine?

A 
locomotor stimulation
euphoria
elevation of mood
increased energy
alertness, sociability
confidence
sexual arousal
decreased need for food
38
Q

what are some undesirable effects of cocaine?

A 
dysphoria (state of unease/dissatisfaction)
irritability
drug craving
paranoia
assaultive behaviour
hallucinations
hyperthermia
psychosis
death
39
Q

what is cocaine?

A

a stimulant that inhibits the reuptake of NE, DA, and 5-HT

40
Q

how do DA, NE, and 5-HT contribute to the side effects of cocaine?

A

DA - localized in the striatum; reward and control of motivation; hyperthermia
NE - adrenergic (tachycardia)
5-HT - dysphoria, depression and craving

41
Q

what is the difference between crack cocaine and cocaine?

A

cocaine - hydrochloride salt

crack cocaine - free base

42
Q

when is the peak effect of cocaine seen in the following forms: IV, smoking, intranasal

A 
IV = 5min
smoking = 7min
intranasal = 20min
43
Q

what is the time to decrease effect to 1/2 max of cocaine in the following forms: IV, smoking, intranasal

A 
IV = 15min
Smoking = 17min
Intranasal = 27min
44
Q

what is the duration of action for cocaine?

A

10-30min

45
Q

what are some of the withdrawal symptoms for cocaine?

A

fatigue
irritability
loss of sexual desire
muscle pain

46
Q

what are some symptoms of cocaine toxicity? (9pts)

A

1) increased muscular activity and vasoconstriction (hyperthermia)
2) psychosis
3) grand-mal convulsions
4) coma
5) vasoconstriction
6) ventricular arrhythmia
7) MI
8) chenyn-stoke breathing
9) respiratory paralysis

47
Q

what are some of the combination drugs that include cocaine?

A

speedball: cocaine and heroin and alcohol
tick: cocaine and phencyclidine
turbo: cocaine and marijuana

48
Q

what are some of the symptoms that can occur with chronic cocaine use? (9pts)

A

1) malnutrition
2) violent protective behaviour
3) hyperkinetic behaviour
4) distorted perception
5) rhinitis (nasal septum performation)
6) SoB
7) cold sweats
8) tachycardia
9) MI; stroke (vessel rupture)

49
Q

how does ecstasy cause its effects on the body?

A

increases 5-HT, DA, and NE release and inhibits serotonin receptors

50
Q

what are the positive effects of ecstasy?

A

empathy
well-being
reduced anxiety

51
Q

what are the adverse effects of ecstasy?

A 
hyperthermia
dehydration
increased BP
depression
risk of serotonin syndrome
52
Q

what is the difference between the S and R enantiomers of ecstasy in regards to effects on the body?

A

S is far more neurotoxic than R

53
Q

what are the effects of bath salts on the body? (15pts)

A

1) paranoia, violent behaviour
2) hallucinations
3) delusions
4) suicidal thoughts
5) seizures
6) panic attacks
7) chest pain
8) N/V
9) Increased HR
10) increased BP
11) increased body temp
12) rhabdomyolysis
13) multiple organ failure
14) coma
15) death

54
Q

give an example of a bath salt

A

mephedrone

Pharmacology (9 decks)

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