Drugs of abuse

Question 1

What is the definition of drug abuse?

Answer 1

Substance dependence syndrome.
Requires continued use despite substance-related problems, tolerance and withdrawal symptoms
1-2 is abuse
3 is dependence

Question 2

Where in the brain does drug dependence occur?

Answer 2

The mesolimbic dopamine system.

The nucleus accumbens (the pleasure center) connects the mesolimbic system to the ventral tegmentum area).

Question 3

What are the symptoms of withdrawal?

Answer 3

Opposite to the drug.
Craving, restlessness, irritability, increased sensitivity to pain, nausea, muscle aches, dysphoria, insomnia, anxiety, hallucinations

Autonomic dysfunction: sweating, tacchycardia, hypertension, vomiting, diarrhoea

Question 4

Dependence vs. risk of harm.

Answer 4

Direct correlation

Question 5

Alcohol elimination at different numbers of drinks?

Answer 5

1-4 drinks is first order

any more and it becomes zero order.

Question 6

What is a symptom of alcohol withdrawal?

Answer 6

Delerium tremors. Only 5% will experience.
This consists of severe agitation, confusion, visual hallucinations, fever, sweating, nausea, diarrhea, dilated pupils. Treatment is giving alcohol.

Question 7

What are the pathologies associated with chronic alcohol abuse?

Answer 7

Liver cirrhosis, fulminant hepatic failure. Cardiac failure (dilated cardiomyopathy), malnutrition, pancreatitis, aspiration pneumonitis, Peripheral neuropathy dementia, fetal alcohol syndrome.

Question 8

What are theeffects of opioids?

Answer 8

Analgesia, sedation, cough suppression,
respiratory depression
Constipation, nausea, vomiting, itching,
Hypotension, bradycardia, pupillary constriction

Question 9

What causes the potency of an opioid?

Answer 9

Its lipid solubility.
Diamorphine&raquo_space; fentanyl&raquo_space; pethidine&raquo_space; morphine&raquo_space; codeine

Methadone is long action with a slow onset

Question 10

What order are pain killers given in?

Answer 10

Stage 1) Nonopioid (paracetamol) +/- an adjuvant (iprophen).
Stage 2) Opioid for mild to moderate pain (codine or tramadol). +/- nonopioid +/- adjuvant
Stage 3: opioid for moderae to severe pain (morphine) +/- nonopioid +/- adjuvant

Question 11

How does methamphetamines work?

Answer 11

Increases the relase and decreases the reuptake of CNS catecholamines (dopamine, noradrenalin and serotonin).

Question 12

How does cocaine work?

Answer 12

its the reuptake of catecholamines (Serotonin, dopamine and noradrenalin)

Question 13

What kills people when they take cocaine>

Answer 13

Seizures and cardiotoxicity.

Question 14

What are the features of propofol?

Answer 14

Safe, effective, reliable, rapid induction of anaesthesia, rapid offset with minimal side effects.

Easially abused, euphoric.

Apnoea, loss of airway tone and reflexes, hypotension, bradycardia, death.

Has a very narrow window of therapeutic effect.. Can easily take too much and loose control of airway tone.