Drugs of Abuse Flashcards
Schedule I
LSD
Heroin
marijuana
Schedule II
Opiates
Amphetamine
Cocaine
Barbituates
Schedule III
Codeine+acetaminophen
Anabolic steroids
Schedule IV
Benzos
Tramadol
Schedule V
OTC cough meds w/ codeine
Addiction pathway
Mesocorticolimbic pathway, DA
Types of tolerance
- Cellular (receptor regulation)
* Metabolic (elimination)
Physiological dependence = susbstance use disorder?
NO
Alcohol
Mech
Up Gaba, down glutamate
Alcohol withdrawal syndrome
Tx
Mild: clonidine/propranolol
Severe: Diazepam
Alcohol relapse
Tx
Aversion = Disulfiram
Anti-craving =
- Naltrexone
- acamprosate
- topiramate
- SSRI
Barbituate withdrawal
(seizures)
tx
Phenobarbitol
Benzo high-dose withdrawal (seizure)
Tx
- Phenobarbitol
* long-acting benzo
Methadone pharm advantages over Heroin
- no sharp peaks and valleys
* Methadone withdrawal less
Opioid use disorder
Tx
- Methadone
- LAAM (levo-alpha-acetyl methadyl)
- Buprenorphine
- Naltrexone
- Clonidine
Nicotine
Tx
- Nicotine Replacement Therapy
(pharmacokinetics slower than smoking)
*Bupropion (zyban) = reduce craving, decrease withdrawal
*Varenicline (chantix) = a4b2 partial ag (less reward, less addict/craving/withdrawal) (black box PSYC)
Cannabinoid receptor BLOCKER
Rimonabant
withdrawn in europe for PSYC toxic
Endogenous cannabinoids
- anandamide
* 2-arachidonoyl glycerol
Synthetic THC
Dronabinol (marinol Sched 3) = nausea/anorexia in AIDS/chemo
Amphetamine
Mech
DA + NE release
Cocaine
Mech + S.E.
DA re-uptake blocker
S.E. = premature labor, developmental abnormalities
Stimulant OD
Seizures
Stroke (vasoconstricton)
psychosis
Stimulant
Reverse tolerance
=senstization
UP stroke/arrythmia risk
Stimulant withdrawal
depression
usually no treatment
Stimulant Use disorder
tx
related to route (smoking worse)
VERY difficult to treat
Stimulant
Preventing relapse
Psychotherapy (AA)
Topiramate
Anti-depressants
Hallucinogens
Psychedelics : Serotonin-related
LSD
Psilocybin
DMT
*Ags = 5HT/DA/Adrenergic
Hallucinogens
Psychedellics : DA/Amphetamine-related
MDA
MDMA
Mescaline
*Ags= 5HT/DA/Adrergic/ 5HT reuptake inhibit
Hallucinogens
Psychedelics: Kappa opioid receptor
Salvinorin A
Dissociatives
PCP
Ketamine
Deliriants
Scopolamine
Atropine
Hallucinagens
Addiction- Tx
not addictive
*behavioral/social support
Dissociatives (PCP/Ket)
mech
general anesthetic
*inhibit NMDA receptors
PCP/ketamine
CNS effects
- Analgesia/anesthesia
- Feelings of detachment from self/environment
- Hallucinations
- Delusions
HIGH DOSE: seizure, coma, death
PCP/ketamine
Peripheral effects
- Sympathomimetic : UP HR/BP/sweating
* Parasympathomimetic: UP salivation
PCP/ketamine
Tx
none, counseling
addiction possible