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Pharmacology Unit 2 > Drugs of Abuse and Toxicity > Flashcards

Drugs of Abuse and Toxicity Flashcards

1
Q

Compulsive drug using behavior in which the person uses the drug for personal satisfaction, often in the face of known risks to health.

A

Addiction

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2
Q

Signs and symptoms that occur on withdrawal of drug in a dependent person

A

Abstinence Syndrome

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3
Q

A drug deemed to have abuse liability that is listed on governmental Schedules of Controlled Substances. Presumed to reflect current attitudes towards substance abuse, and which drugs are regulated depends on social judgement.

A

Controlled Substance

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4
Q

State characterized by signs and symptoms, frequently the opposite of those caused by a drug, when it is withdrawn from chronic use or when the dose is abruptly lowered.

A

Dependence

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5
Q

Synthetic derivative of a drug with a slightly modified structure, but no major change in pharmacodynamic action. Circumvention of the Schedules of Controlled Drugs is a motivation for the illicit synthesis.

A

Designer Drug

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6
Q

Decreased response to a drug necessitating larger doses to achieve the same effect.

A

Tolerance

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7
Q

Non-medical use of a variety of drugs that are prohibited by law.

A

Illicit Drug Use

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8
Q

Excessive dopaminergic stimulation may lead to reinforcement of rewarded behavior any may become compulsive.

A

Dopamine Hypothesis of Addiction

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9
Q

Drugs with no medical use and a high addiction potential.

A

Schedule I

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10
Q

Examples of Schedule I drugs

A

Heroin
LSD
PCP
MDMA
Marijuana

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11
Q

Drugs with medical use and a high addiction potential

A

Schedule II

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12
Q

Examples of Schedule II drugs

A

Amphetamines
Cocaine
Strong Opioids
Methylphenidate
Short Acting Barbiturates

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13
Q

Drugs with medical use and a moderate addiction potential

A

Schedule III

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14
Q

Examples of Schedule III drugs

A

Anabolic Steroids
Barbiturates
Ketamine
Dronabinol
Sodium Oxybate

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15
Q

Drugs with medical use and low abuse potentials

A

Schedule IV

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16
Q

Examples of Schedule IV drugs

A

Benzodiazepines
Mild Stimulants
Hypnotics
Weak Opioids
Chloral Hydrate

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17
Q

Benzodiazepines

A

Sedative Hypnotics
-pams and -lams
alprazolam (Xanax)
midazolam (Versed)
lorazepam (Ativan)

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18
Q

Barbiturates

A

Sedative Hypnotics
-barbitals

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19
Q

Sodium Oxybate

A

Sedative Hypnotic
(GHB)
“Party Drug”

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20
Q

Sedative Hypnotics Effect

A

Reduce inhibitions
Suppress anxiety
Relaxation
CNS Depressants

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21
Q

How do sedative hypnotics work

A

Facilitation of GABA
Antagonism at cholinergic nicotinic receptors.

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22
Q

Sedative Hypnotic Overdose

A

Depression of medullary respiratory and cardiovascular centers
(Dilated Pupils, Shallow Breathing, Weak and Rapid Pulse)

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23
Q

Sedative Hypnotic Overdose Management

A

Maintain airway and support ventilations

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24
Q

What is the antidote for benzodiazepine overdose?

A

Flumazenil

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25
Q

Sedative Hypnotics Withdrawal

A

Signs and Symptoms most pronounced in drugs that have a half-life of < 24 hours
SHORTER HALF-LIFE = BIGGER PROBLEM
Seizures

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26
Q

Ethanol

A

Sedative Hypnotic
Acetaldehyde = Toxic Component

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27
Q

Sedative Hypnotics Withdrawal Treatment

A

DO NOT ABRUPTLY STOP THESE DRUGS
Long acting-sedative hypnotics used to treat acute withdrawal followed by gradual dose reduction
Clonidine or Propranolol may be used to suppress sympathetic overactivity
Naltrexone may be used to prevent alcohol consumption (not antidote)

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28
Q

Opioids

A

Target opioid receptors
Heroin
Morphine
Codeine
Oxycodone

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29
Q

Opioid Overdose Treatment

A

Naloxone and ventilatory support

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30
Q

Opioids Withdrawal

A

Lacrimation
Rhinorrhea
Sweating
Weakness
“Gooseflesh”
Nausea and Vomiting
Tremors and Muscle Jerks
Hyperpnea

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31
Q

Opioid Withdrawal Treatment

A

Methadone
Buprenorphine (Suboxone)

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32
Q

Amphetamine

A

Stimulant
Increase release of CNS amines:
dopamine, norepinephrine, and serotonin
Euphoria and Self-confidence

33
Q

Amphetamine Overdose Symptoms

A

Agitation
Restlessness
Tachycardia
Hyperthermia
Hyperreflexia
Seizures

34
Q

Amphetamine Overdose Treatment

A

No specific antidote
Control body temperature
Protect against cardiac arrhythmia and seizures

35
Q

Cocaine

A

Inhibitor of CNS transporters of:
Dopamine, Norepinephrine, and Serotonin
Euphoria and Self-Confidence (short-lasting)

36
Q

Cocaine Overdose

A

Commonly cause death from:
Arrhythmias (blockade of norepinephrine uptake)
Seizures
Respiratory Depression
MI and CVA

37
Q

Cocaine Overdose Treatment

A

No Specific Antidote

38
Q

Stimulants Withdrawal

A

Increased Appetite
Sleepiness
Exhaustion
Mental Depression (antidepressants may be indicated)

39
Q

Three procedures to reduce absorption of poisons from the GI tract

A

Inducing Emesis (must be done in 1hr best if done in 5 minutes)
Gastric Lavage (stomach pumping done within 1 hour)
Activated Charcoal

40
Q

Only what treatment can remove poison once it has left the stomach and entered the small intestine?

A

Activated Charcoal

41
Q

What is a major cause of hepatic failure in the United States?

A

Acetaminophen Toxicity

42
Q

What causes the toxicity of acetaminophen?

A

Formation of the metabolite
(N-acetyl-p-benoquinone imine) NAPQI

43
Q

How is acetaminophen metabolized in normal doses?

A

Phase II Conjugation to form glucuronide or sulfate

44
Q

What peptide prevents NAPQI from ultimately producing cell death?

A

Glutathione

45
Q

What is the antidote for severe acetaminophen toxicity?

A

N-Acetylcysteine (NAC)
(precursor of Glutathione)
Brand Name: Mucomyst

46
Q

Where is methanol commonly found?

A

Windshield Washer Fluid
Antifreeze
Paint Thinner
Printing Solutions
Adhesives

47
Q

How quickly does methanol absorb?

A

Rapid PO absorption (about 5 minutes)
Peaks in 30-60 minutes

48
Q

What part of methanol is toxic?

A

Methanol is not very toxic
Metabolites are the cause of toxicity

49
Q

Methanol Metabolization

A

Metabolized by alcohol dehydrogenase to form formaldehyde
Oxidation of formaldehyde to formic acid by aldehyde dehydrogenase
Very Rapid (1-2 minutes)

50
Q

Where is ethylene glycol found?

A

Antifreeze and Coolant

51
Q

How quickly does ethylene glycol absorb?

A

20 - 30 minutes
80% is metabolized
20% excreted through urine

52
Q

How is ethylene glycol metabolized?

A

Liver metabolizes it via alcohol dehydrogenase to form glycoaldehyde
Glycoaldehyde is then metabolized by aldehyde dehydrogenase to form glycol acid, glyoxylic acid, and oxalic acid

53
Q

Toxic portion of Ethylene Glycol is what?

A

Glycolic acid leading to metabolic acidosis
Oxailic acid binds to calcium to form crystals and cause renal injury

54
Q

Methanol and Ethylene Glycol Treatment

A

Ethanol and Fomepizole
(both block metabolization of alcohol dehydrogenase)
Fomepizole has a 500-1000x greater affinity for alcohol dehydrogenase than ethanol and has become the standard treatment
Also: Hemodialysis

55
Q

Cyanide Poisoning Exposure

A

Metal Extraction
Metal Hardening
Photography
Printing

56
Q

Cyanide Poisoning Mechanism

A

complete blockade of oxidative phosphorylation
(occurs in moments)

57
Q

What critical enzyme is affected by cyanide poisoning?

A

Cytochrome a3
becomes nonfunctional = loss of ATP synthesis

58
Q

What is the antidote for cyanide poisoning?

A

Hydroxycobalamin (Vitamin B12)
high affinity for cyanide
nontoxic cyancobalamin is formed

59
Q

Supportive treatment for cyanide poisoning?

A

Monitor SpO2 and give high-flow O2 ASAP
Methemoglobin decreases O2 carrying capacity

60
Q

Digoxin mechanism of action

A

Interacts with Na/K transporters and has a narrow therapeutic index
decreased cardiac conduction
increased automaticity

61
Q

What are the symptoms of digoxin overdose?

A

Unusual blind sports
Color mismatch
Irregular pulse
Tachycardia
Deadly SVT

62
Q

What is the antidote for digoxin overdose?

A

Digibind
Digoxin Specific Antibody Fragment (Fab fragment)
(binds digoxin on a molecule to molecule basis)

63
Q

A binding agent that suppresses chemical actvity by forming chelates

A

Chelator

64
Q

What is the chelating agent for arsenic?

A

Dimercaprol

65
Q

What is the chelating agent for iron?

A

Deferoxamine

66
Q

What is the chelating agent for lead?

A

Succimer, EDTA

67
Q

What is the chelating agent for mercury?

A

Succimer, Dimercaprol

68
Q

What is the mechanism of action of Warfarin?

A

inhibits the vitamin K cycle reducing the activity of coagulation factor-dependent clotting functions.

69
Q

Antidote for Warfarin

A

Phytonadione (Vitamin K)
5-10mg orally
Fresh Frozen Plasma for life threat

70
Q

Acetaminophen Overdose

A

Acetylcysteine
replenishes depleted glutathione stores

71
Q

Cholinesterase Inhibitors Overdose (Organophosphates)

A

Atropine

72
Q

Drug Induced Movement Disorders

A

Benzatropine

73
Q

Beta Adrenoreceptor Antagonists
Calcium Channel Blockers

A

Glucagon

74
Q

Anti-muscarinic Overdose

A

Neostigmine

75
Q

Hypertension due to alpha adrenoreceptor agonists
(MAO-inhibitors, clonidine, ergotamine)

A

Phentolamine

76
Q

Cholinesterase Inhibitors Overdose

A

Pralidoxime

77
Q

Heparin Reversal Agent

A

Protamine

78
Q

Salicylate Toxicity Antidote

A

Sodium Bicarb

Pharmacology Unit 2 (3 decks)

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