Drugs of Abuse Flashcards
what is Reinforcement?
The tendency of a pleasure-producing drug to lead to repeated self-administration.
what is Pharmacodynamic Tolerance:
Lessened response at target to same drug concentration - via changes in receptor sensitivity or other adaptive changes
what is Behavioral tolerance?
skills developed due to repeated experiences in attempting to function despite mild-moderate intoxication
What is Conditioned tolerance ?
develops when environmental cues (sights, smells, situations) are consistently paired with drug administration
what is Reverse Tolerance?
Sensitization (increased response) to drug following repeated doses. Sensitization in nucleus accumbens may play a role in drug craving properties. Requires longer interval between doses (~ 1 day).
what is Psychological Dependence?
Perceived need for a drug (“craving”) in the absence of any physiological dependence or withdrawal phenomena
If a drug causes elevated seizure threshold, ________ are seen during withdrawal; if a drug relieves fatigue and causes mood elevation, withdrawal is characterized by _______
spontaneous seizures,
lethargy and depression
Name the 5 opioids that can be abused
Heroin Morphine Phentanyl oxycodone, hydrocodone
what are the reinforcing effects of opioids?
Euphoria
sedation
Describe acute toxicity in opiod overdose
respiratory depression,
miosis
coma -> death
arrythmias and convuslions are possible
what is the Tx for opiod acute toxicity
naloxone (IV / SC)
What is the Tx for opiod withdrawal
Clonidine ( decr. sns sx)
methadone (via cross dependence)
what are the Sx of opiod withdrawal
insomnia
tachycardia
diarrhea
what is the Tx of opioid relapse
buprenorphine +/- naloxone, naltrexone
what are the toxicty Sx’s seen in CNS Depressants
respiratory failure,
come -> death
(rare w/BDZs)
what is the Tx for withdrawel from CNS depressants
substitution with BDZ, and dose taper to prevent seizures
CNS Depressant withdrawel has a significant risk of mortality due to ________
Seizures
what is the Tx for Ethanol toxicity
supportive + Fluids, thiamine, electrolytes
what is the Tx for Alcohol relapse
acamprosate,
naltrexone disulfiram
What are the Sx’s of withdrawal from enthanol
seizures (6-48 hrs), visual hallucination (12-48 h), delirium tremens (48-96 hrs)
what is the Tx for acute toxicity from Bezodiazapines
flumazenil
what is the mechanism of action for cocaine
inhibits monoamine reuptake transporters
what are the reinforcing effects of cocaine
euphoria
decreased fatigue
Increased arousal and confidence
what are the Sx’s of acute toxicity from cocaine
SNS overactivity with Increased HR,BP, body temp. chest pain arrhythmia, MI, paranoid psychosis
what are the Sx’s of cocaine withdrawal?
sleepiness,
fatigue,
depression,
hyperphagia
what are the reinforcing effects of Nicotine
increased alertness
what are the Sx’s of nicotine withdrawal
irritability, hostility, anxiety, Increased appetite weight gain
what is the tx for nicotine acute toxicity?
CVP support,
emetics,
gastric lavage,
charcoal
what is the TX for cocaine acute toxicity
cardiovascular support,
vasodilators for BP,
BDZs for seizures
Opioid tolerance develops __________, but tolerance to _______ does not develop at all
Rapidly,
Constipation
________ to Hallucinogens ( LSD,Psilocybin,Bufotenine)
is not common since repeated use is unusual, and _____ does not develop
Tolerance,
Dependance
what is the Tx for withdrawal from CNS stimulants
largely behavioral
what are the reinforcing effects of CNS depressants
Anxiolysis,
sedation,
loss of inhibition
