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Pharmacology - Exam 3 > Drugs of Abuse > Flashcards

Drugs of Abuse Flashcards

1
Q

DEA Schedule I

A

High Potential for Abuse
No acceptable use as a therapeutic in the US
Examples: LSD, Heroin, Marijuana

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2
Q

DEA Schedule II

A

High Potential for Abuse
Abuse may lead to sever psychological (addiction) or physical dependence
These drugs have accepted medical uses in the US
Examples: morphine, codeine, amphetamine, cocaine, barbituates

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3
Q

DEA Schedule III

A

Potential for abuse less than drugs in Schedules I and II
Abuse may lead to moderate or low physical dependence or high psychological dependence
Examples: codeine+acetaminophen, anabolic steroids

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4
Q

DEA Schedule IV

A

Low potential for abuse compared to the drugs in Schedule III
Abuse may lead to limited physical or psychological dependence relative to the drugs in Schedule III
Examples: benzodiazepines, tramadol

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5
Q

DEA Schedule V

A

Low potential for abuse relative to the drugs in Schedule IV

Examples: OTC cough medicines w/codeine

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6
Q

Cellular Tolerance

A

Adaptive response of cells to drug exposure
Major Mechanism: Occurs within seconds, hours, or days
Changes in receptors or cell signaling proteins
Receptors can be removed from the cell surface or trafficked to the cell surface
Synthesis of new receptors can be inhibited

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7
Q

Metabolic Tolerance

A

Enhanced elimination rate of drug
Minor mechanism
Induction of drug metabolizing enzymes

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8
Q

Biological Theory of Addiction

A

Stimulation of the brain’s reward system

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9
Q

Main Component of the Reward System

A

Mesocorticolimbic pathway: dopaminergic neurons from midbrain (ventral tegmental area) to the forebrain (nucleus accumbens and prefrontal cortex)

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10
Q

Physiological Dependence

A

Appearance of withdrawal symptoms when drug intake is stopped
Occurs with repeated/chronic use of the drug

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11
Q

Impaired Control Over Substance Use Criteria

A
  1. Individual uses a substance in larger amounts or for longer period of time than intended
  2. Wants to cut down or quit but not able to
  3. Spends a lot of time obtaining and using a substance
  4. Craving: intense desire or urge to obtain the substance
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12
Q

Social Impairment Criteria

A
  1. Failure to fulfill obligations at work, school, or home due to substance use
  2. Continues substance use despite negative social or interpersonal consequences
  3. Important social, occupational, or recreational activities are given up or reduced due to substance abuse
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13
Q

Risk Use Criteria

A
  1. Recurrent substance use in situations that are physically hazardous
  2. Continues substance use despite known negative physical/psychological effects
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14
Q

Pharmacological Criteria

A
  1. Appearance of tolerance: use requires markedly increased doses of substance to achieve the desired effect
  2. Appearance of withdrawal symptoms: Individual is likely to consume the substance to relieve the symptoms
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15
Q

Opioids: Drug Effect

A

Activation of mu opioid receptors in medullary respiratory center, spinal and supraspinal sites mediating analgesia, enteric nerves

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16
Q

Opioids: Acute Effects

A

Histamine release resulting in vasodilation, bronchoconstriction, hypotension
Potentially life-threatening respiratory depression

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17
Q

Opioids: Tolerance/Withdrawal

A

Uncomfortable but not life-threatening symptoms: hyperalgesia, diarrhea, dilated pupils, hypertension, sweating, dysphoria, craving

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18
Q

Opioids: Mechanism of Reward Pathway Activation

A

Activation of mu opioid receptors in reward pathway

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19
Q

CNS Depressants: Drug Effects

A

Ethanol: enhances GABA binding to GABA-A receptors, inhibits glutamate binding to NMDA receptor
Benzodiazepines: enhance GABA binding to GABA-A receptor
Barbituates: enhance GABA binding and directly activate GABA-A receptor

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20
Q

CNS Depressants: Mechanism of Reward Pathway

A

Ethanol: inhibits glutamate binding to NMDA receptor, facilitates release of endogenous opioids in VTA

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21
Q

CNS Depressants: Acute Effects/Toxicity

A

Potentially life-threatening respiratory depression with ethanol and barbiturates

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22
Q

CNS Depressants: Tolerance/Withdrawal

A

Sympathetically driven tremors, tachycardia, hypertension, sweating

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23
Q

Stimulants: Drug Effect

A

Amphetamine and methamphetamine enhance synaptic release of DA
Cocaine blocks reuptake of DA

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24
Q

Stimulants: Acute Effects

A

Acute Effects: arousal, alertness, euphoria, increased HR and BP
Chronic Use can lead to hallucinations, violent behavior, psychosis

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25
Q

Stimulants: Tolerance/Withdrawal

A

Reverse tolerance can be seen in some patients

Withdrawal may be mild: dysphoria, sleepiness, bradycardia, craving and depression

26
Q

Nicotine: Drug Effects

A

Activation of central and peripheral acetylcholine receptors in reward pathway

27
Q

Nicotine: Acute Effects/Toxicity

A

Stimulant effects: increased arousal, concentration

Depressant effects: decreased anxiety

28
Q

Nicotine: Tolerance/Withdrawal

A

Irritability, anxiety, dysphoria, difficulty concentrating, restlessness, increased appetite/weight gain

29
Q

Cannabinoids: Drug Effect

A

Activation of cannabinoid receptors in brain and spinal cord

30
Q

Cannabinoids: Acute Effects/Toxicity

A

Relaxation, increased appetite, psychedelic-like effects, sympathomimetic effects

31
Q

Cannabinoids: Tolerance Withdrawal

A

Tolerance to acute effects develops quickly

Withdrawal: restlessness, irritability, depression, insomnia

32
Q

Psychedelics: Drug Effect

A

Related to serotonin: agonists at 5HT, DA and adrenergic receptors

Related to dopamine and amphetamines: induce 5HT and DA release; agonist 5HT, DA, and adrenergic receptors

33
Q

Psychedelics: Acute Effects/Toxicity

A

Altered perception, hallucinations (mostly visual), altered mood

34
Q

Psychedelics: Tolerance/Withdrawal

A

Minimal tolerance

Withdrawal: craving, confusion, anxiety, depression

35
Q

Dissociatives: Drug Effects

A

Inhibits NMDA receptors

36
Q

Dissociatives: Acute Effects/Toxicities

A

Analgesia, anesthesia, feelings of detachment, increased HR and BP

Toxicities: hallucinations, delusions, psychosis, violent behavior

High doses: seizures, coma, death

37
Q

Disulfram: Clinical App and Mechanism

A

Alcohol aversion therapy

Inhibits ALDH, leading to accumulation of acetaldehyde upon consumption

38
Q

Disulfram: Adverse Reactions

A

Hepatotoxic

Can lead to respiratory depression, cardiovascular collapse, convulsions

39
Q

Acamprosate, Topiramate: Clinical App and Mechanism

A

Alcohol addiction

known to increase the activity of GABA-A receptors and inhibit glutamatergic NMDA receptor activity

40
Q

Naloxone: Clinical App and Mechanism

A

Used in opioid overdose

Inhibits mu opioid receptors in VTA of brain; SHORT ACTING

41
Q

Naloxone: Side Effects

A

Cardiac arrhythmias, hepatotoxic, pulmonary edema, opioid withdrawal

42
Q

Naltrexone: Clinical App

A

Anti-craving therapy for alcohol addiction

Limited success in treating opioid dependency

43
Q

Naltrexone: Mechanism of Action

A

Inhibits mu opioid receptors in VTA; LONG ACTING

44
Q

Methadone: Clinical App

A

Used for detoxification and maintenance of opioid addiction

45
Q

Methadone: Mechanism of Action

A

Agonist at mu opioid receptor; suppresses symptoms of craving and withdrawal

46
Q

Methadone: Adverse Effects

A

Cardiac arrest due to long QT syndrome, respiratory arrest, constipation, nausea

47
Q

LAAM: Clinical App

A

Maintenance therapy and detox for opioid addiction

48
Q

LAAM: Mechanism of Action

A

Same as methadone but longer lasting so delivered 2-3/week

49
Q

LAAM: Adverse Effects

A

Same as methadone

50
Q

Buprenorphine: Clinical App

A

Maintenance and detox for opioid addiction

51
Q

Buprenorphine: Mechanism of Action

A

Partial agonist at mu opioid receptor and antagonist at kappa opioid receptor; LONG ACTING

52
Q

Buprenorphine: Adverse Effects

A

Respiratory depression, hypotension, dizziness, sedation, bradyarrythmias, tachyarrhytmias

53
Q

Nicotine Replacement Therapy (NRT): Clinical App

A

Smoking cessation aid; multiple forms available

54
Q

NRT: Mechanism of Action

A

Slower absorption and longer nicotine plasma levels, less rewarding and alleviating cravings

55
Q

Bupropion: Clinical App

A

Smoking cessation aid

56
Q

Buproprion: Mechanism of Action

A

Non-competitive antagonist of nicotinic acetylcholine receptors in reward pathway

57
Q

Buproprion: Adverse Effects

A

Suicidal thoughts, erratic behavior, exacerbation of underlying psych illness

58
Q

Varenicline: Clinical App

A

Smoking cessation aid, reduces cravings, prevents withdrawal

59
Q

Varenicline: Mechanism of Action

A

Partial agonist at nicotinic acetylcholine receptors in VTA and nucleus accumbens

60
Q

Varenicline: Adverse Effects

A

Suicidal thoughts, erratic/aggressive behavior, exacerbation of underlying psych illness

Pharmacology - Exam 3 (12 decks)

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