Drugs of abuse DSA (Kruse)

Question 1

__=compulsive drug-using behavior in which person uses the drug for personal satisfaction, often in face of known risks to health

Answer 1

addiction

Question 2

addiction was formerly referred to as __

dependence was formerly referred to as __

Answer 2

psychological dependence

physical or physiologic dependence

Question 3

__=a state characterized by signs and symptoms, frequently the opposite of those caused by a drug, when it is withdrawn from chronic use or when dose is abruptly lowered

Answer 3

Dependence

Question 4

__=decreased response to a drug, necessitating larger doses to achieve the same effect. This can result from increased disposition of the drug, an ability to compensate for the effects of a drug, or changes in receptor or effector systems involved in drug actions

Answer 4

Tolerance

Question 5

__=an increase in response with repetition of the same dose of the drug

Answer 5

Sensitization

Question 6

Tolerance shifts the dose-response curve __

Sensitization shifts the dose-response curve __

Answer 6

right

left

Question 7

__=adaptive changes that become fully apparent once drug exposure is terminated; generally d/t readaptation of CNS to absence of drug of dependence. This term is evidence of physical dependence

Answer 7

withdrawal

Question 8

dependence-producing drugs activate the __ DA system, releasing DA

Answer 8

mesolimbic

Question 9

which drugs activate GPCRs? Name their receptors and risk of addiction

Answer 9

Opioids –> mu opioid receptor, addictive (4/5)

Cannabinoids –> CB1R, slightly addictive (2/5)

Also has LSD, Mescaline, and psilocybin which are nonaddictive

Question 10

which drugs bind ionotropic receptors and ion channels? Name their receptors and risk of addiction

Answer 10

Nicotine –> nAChR, addictive (4/5)

Alcohol –> GABA-A, 5-HT3, nAChR, NMDA, Kir, medium addictive (3/5)

also have benzos (3/5) and phencyclidine and ketamine (1/5)

Question 11

which drugs bind to transporters of biogenic amines? Name their receptors and risk of addiction

Answer 11

Cocaine –> DAT, SERT, NET, Highly addictive (5/5)

Amphetamine –> DAT, SERT, NET, VMAT, Highly addictive (5/5)

Question 12

nonaddictive drugs of abuse primarily target what?

Answer 12

cortical and thalamic circuits

rather than mesolimbic DA system

Question 13

__ may lead to irreversible schizophrenia-like psychosis

__ can cause flashbacks of altered perception yrs after consumption

Answer 13

PCP

LSD

Question 14

Naloxone MOA and clinical use?

Answer 14

pure opioid antagonist that reverses effects of a dose of opiates within mins; can provoke acute w/drawal syndrome if dependenet person has opiates in system

Tx opioid OD

Question 15

Methadone and buprenorphine MOA and clinical use?

Answer 15

Long-acting opioids used for substitution tx (t1/2=25-52 hrs); given w/ supervised intake for opioid addiction

Question 16

__ is an FDA-approved THC analog for anorexia and weight loss in AIDS pts and cancer-chemo induced n/v

Answer 16

Dronabinol

Question 17

__ is a THC analog used for tx of refractory n/v assoc with cancer chemo and as an adjunct in chronic pain mgmt

Answer 17

Nabilone

Question 18

__ is AKA the date rape drug. At higher dose it hyperpolarizes DA neurons and inhibits DA release. Targets GABA-B receptors on both GABA and DA neurons

Answer 18

GHB (gamma-hydroxybutyric acid)

Question 19

Tx options for Nicotine addiction?

Answer 19

Nicotine: gum, lozenge, inhalers, transdermal patch

Bupropion: antidepressant w/unknown MOA

Varenicline: partial neuronal nAChR agonist

Question 20

what is blocked by cocaine that produces rewarding effects? what is blocked by cocaine that activates the sympathetic NS?

Answer 20

DAT

NET

Question 21

how to tx cocaine OD?

Answer 21

No antidote; Supportive, control rate/rhythm w/Propanolol and seizures w/Diazepam

Question 22

MOA of amphetamines?

Answer 22

cause release of endogenous biogenic amines by reversing action of biogenic amine transporters at plasma membranes. Interferes with VMAT in the cell

DAT, SERT, and NET work in reverse and release amines into the synapse

Question 23

MOA of ecstasy (MDMA)?

Answer 23

Similar to amphetamines but preferential affinity for SERT –> increased EC [5HT]

Question 24

Schedule of heroid, LSD, mescaline, PCP, MDA, MDMA?

Schedule of Benzos, mild stimulants, most hypnotics and weak opioids?

Answer 24

I

IV

Question 25

Schedule of Anabolic steroids, barbiturates, ketamine, moderate opioid agonists?

Schedule of Amphetamines, cocaine, methylphenidate, short acting barbiturates, strong opioids?

Answer 25

III

II