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Pharm II Test 2 > Drugs of Abuse > Flashcards

Drugs of Abuse Flashcards

1
Q

Cocaine- Mech of Action

A

inhibit dopamine transporters in presynaptic terminals = dopamine reuptake prevented

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2
Q

Cocaine- Elimination

A

1/2 life 40-80 min.

metabolized by live into an inactive metabolite (Benzoylecgonine) measurable in body fluids for 8 days

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3
Q

Cocaine- Clinical Use

A

Freud used for depression
appetite suppressant
topical anesthetic- eye and nasal surgery

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4
Q

Cocaine- Notes

A

derived from Coca plant
ingredient of original Coca Cola

treat withdrawals with Bromocriptine (dopamine agonist) or benzodiazapines

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5
Q

Cocaine- Adverse Effects/Contraindications

A 
Tolerance
Increased autoimmune disease chance
Neurocognitive impairment
Increased risk of viral infections
Cocaine may cause arrhythmias
Overdose (arrhythmia, hyperactivity, dilated pupils, agitation, hypertension, seizures, coma, paranoia)
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6
Q

Cocaine- Drug Rxns

A

in presence of EtOH transforms into Cocaethylene and becomes more cardiotoxic

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7
Q

Amphetamines- Mech of Action

A

Inhibit VMAT2- prevent sequestration of dopamine–>increased intracellular dopamine–>spontaneously released into cleft

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8
Q

Amphetamines- Clinical Use

A

originally marketed for asthma, obesity

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9
Q

Amphetamines- Notes

A

Synthetic

Used by military in WWII

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10
Q

Amphetamines- Adverse Effects/Contraindications

A 
Tolerance
Increased autoimmune disease chance
Neurocognitive impairment
Increased risk of viral infections
Cocaine may cause arrhythmias
Overdose (arrhythmia, hyperactivity, dilated pupils, agitation, hypertension, seizures, coma, paranoia)
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11
Q

Opioids (opium, morphine, heroin)- Mech of Action

A

Act on Mew receptors.

Inhibit GABAergic interneurons in VTA–> increase firing of mesolimbic dopamine tract

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12
Q

Opioids (opium, morphine, heroin)- Absorption, Distribution

A

PO, IV, Snorting, Smoking, SubQ

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13
Q

Opioids (opium, morphine, heroin)- Clinical Use

A

Pain relief

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14
Q

Opioids (opium, morphine, heroin)- Notes

A

Derived from poppy.
Heroin is a prodrug that has an active metabolite.
Treat overdose with Naloxone (Mew antagonist).
Treat withdrawal with Methadone (Mew agonist) or Buprenorphine (partial mew agonist).

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15
Q

Opioids (opium, morphine, heroin)- Adverse Effects/Contraindications

A

Overdose (RESPIRATORY DEPRESSION, PULMONARY EDEMA, bradycardia, hypotension, miosis, unconsciousness)

Cross-tolerance among the opiods.

Non-life threatening withdrawals (LACRIMATION, RHINORRHEA, YAWNING, PILOERECTION, INVOLUNTARY MOVEMENT)

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16
Q

Cannabinoids- Mech of Action

A

act on cannabinoid receptors

inhibit GABAergic interneurons in VTA= increase firing of mesolimbic dopamine tract

  • derived from cannabis, active ingredient is delta-9-tetrahydrocannabinol
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17
Q

Cannabinoids- Adverse Effects/Contraindications

A

INCREASED APPETITE
INJECTION OF THE CONJUNCTIVA (RED EYES)

sedation, mood alteration, impaired judgment and memory

withdrawals are minor (fatigue, hypersomnia, psychomotor retardation)

tolerance, gateway to other drugs

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18
Q

EtOH- Mech of Action

A

indirectly increase dopamine levels in mesolimbic system;
increase effects of GABA,
decrease effects of glutamate

19
Q

EtOH- Notes

A

Withdrawals can be life threatening.
Treat withdrawals with benzodiazepines (Diazepam has less chance of recurrent withdrawal, Lorazepam for patients with cirrhosis)
Treat dependence with Disulfiram, Naltrexone, Acamprosate (most efficient))

20
Q

EtOH- Adverse Effects/Contraindications

A

Type A dependence: later onset >25, milder dependence, environmental
Type B dependence: early onset, more severe, genetic
Primary disease- alcohol poisoning, alcoholic heart disease, gastritis, cirrhosis, polyneuropathy, psychoses
Secondary disease- cancer, diabetes, liver disease, pancreatitis

21
Q

Disulfiram- Mech of Action

A

prevent degredation of acetylaldehyde to acetate

increased levels of acetylaldehyde cause unpleasant symptoms

22
Q

Disulfiram- Clinical Use

A

treat EtOH dependence

23
Q

Naltrexone- Mech of Action

A

opioid receptor antagonist–>blocks release of dopamine

24
Q

Naltrexone- Clinical Use

A

treat EtOH dependence and reduce cravings

28
Q

Naltrexone- Adverse Effects/Contraindications

A

CI in patient who is also dependent on Opioids

29
Q

Acamprosate- Mechanism of Action

A

Not fully understood

30
Q

Acamprosate- Clinical Use

A

EtOH Dependence

31
Q

Acamprosate- Adverse Effects/Contraindications

A

diarrhea, irregular heartbeat

Contraindicated in severe renal disease

32
Q

Benzodiazepines- Mech of Action

A

indirect agonists of GABA receptors

33
Q

Benzodiazepines- Clinical Use

A

sedation
EtOH withdrawal- treat withdrawals with diazepam
Cocaine withdrawal
epilepsy

34
Q

Benzodiazepines- Adverse Effects/Contraindications

A

Withdrawals

35
Q

Nicotine- Mech of Action

A

acts on cholinergic receptors

36
Q

Nicotine- Dependence

A

treat dependence with Varenicline

37
Q

Hallucinogens (LSD, Mescaline)- Mech of Action

A

target serotonin receptors- 5HT-2A

38
Q

Hallucinogens (LSD, Mescaline)- Notes

A

Do not cause addiction or dependence

treat with anti-anxiety or anti-psychotic drugs

39
Q

Abuse

A

1+ in 12 month period:

  • Use results in neglected responsibilities (work, home, school)
  • Use in dangerous situations (while driving)
  • Related to legal problems (DUI)
  • Continued use despite making problems worse
39
Q

Dependence

A

3+ in 12 month period:

  • TOLERANCE
  • WITHDRAWAL
  • use larger amounts than intended
  • persistant desire or inability to control use
  • excessive time spent on substance
  • normal activities given up or reduced
  • use continued despite knowledge of problems
39
Q

Withdrawal

A

Signs and symptoms occur when use of drug is stopped;

signs and symptoms reversed when drug is administered again

40
Q

Varenicline- Clinical Use

A

Nicotine dependence

41
Q

Bromocriptine- Clinical Use

A

Cocaine withdrawals

42
Q

Naloxone- Clinical Use

A

Opioid overdose

43
Q

Methadone- Clinical Use

A

Opioid withdrawals

44
Q

Buprenorphine- Clinical Use

A

Opioid withdrawals

Pharm II Test 2 (8 decks)

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