Drugs of Dependence

Question 1

What are commonly abused opioids?

Answer 1

morphine, heroin - cause eupohira

Question 2

What are commonly abused CNS depressants?

Answer 2

alcohol, diazepam (valium) - reduce anxiety

Question 3

What are commonly abused CNS stimulants?

Answer 3

cocaine, amphetamines, MDMA - increase energy

Question 4

What are commonly abused cannabinoids and hallucinogens?

Answer 4

delta-9-THC and LSD - alter perception

Question 5

What general areas of the brain are associated with drug abuse and addiction?

Answer 5

reward and salience, memory and learning, motivation and drive, inhibitory control

Question 6

What areas of the brain are associated with reward and salience?

Answer 6

nucleus acumbens and ventral pallidum

Question 7

What areas of the brain are associated with memory and learning?

Answer 7

Hippocampus and amygdala

Question 8

What areas of the brain are associated with motivation and drive?

Answer 8

orbitofrontal cortex, subcallosal cortex

Question 9

What areas of the brain are associated with inhibitory control?

Answer 9

prefrontal cortex, anterior cingulate gyrus

Question 10

How do drugs of dependence generally affect the brain?

Answer 10

increase dopamine levels in the nucleus acumbens (reward/salience area)

Question 11

What are key modulating transmitters of dopaminergic transmission?

Answer 11

acetylcholine, serotonin, noreadrenaline, GABA, glutamate, opiods

Question 12

CNS effects of amphetamine

Answer 12

releases noreadrenaline in the periphery; much more efficient at releasing dopamine and serotonin in CNS

Question 13

General effects of amphetamines (and cocaine)

Answer 13

vary with mood, dose, personality, environment: mood elevation, euphoria, increased locomotor activity, reinforcement of stereotypic behaviours; fatigue postponed, confidence, speedy performance, decreased accuracy

Question 14

Overdose effects of amphetamines (and cocaine)

Answer 14

anxiety, nervous and physical tension, tremors, confusion, dizziness, time passes quickly, hyperthermia, tachycardia, hypertension, vascular collapse and death, psychosis and hallucinations

Question 15

Dependence of amphetamines is related to

Answer 15

dopaminergic actions in nuclear accumbens; baseline (depression, lonely); withdrawal symptoms (lethargy, sleep, increased appetite, depression)

Question 16

CNS effects of MDMA (methylenedioxymetamphetamine/ecstasy)

Answer 16

release of dopamine and serotonin

Question 17

General effects of MDMA

Answer 17

stimulant and hallucinogenic, feelings of closeness, empathy, love, and heightened self-awareness; increased HR and BP, disrupted thermoregulation; potential degeneration of 5-HT and DA neurons by ROS metabolites

Question 18

General effects of LSD

Answer 18

visual, auditory, and tactile hallucinations (sensory modalities confused); disruption of thought process; dependence and tolerance (applies to other psychotomimetics as well ie need more of other drugs for an effect too); 5-HT2 receptor agonist activating autoreceptors on neurones in Raphe

Question 19

General effects of caffeine

Answer 19

increase alertness, well being, delays onset of sleep, stimulates mental activity (postpones boredom, fatigue, inattentiveness), enhanced intellectual and motor performance

Question 20

General effects of delta-9-THC

Answer 20

sharpened sensory awareness, increased intensity of sounds and lights, relaxation and well being,

Question 21

General effects of ethanol

Answer 21

increased confidence, euphoria; at higher doses aggression and mood swings; loss of motor coordination, slurred speech; liver damage, neurodegeneration, foetal impairment

Question 22

CNS effects of ethanol

Answer 22

inhibit Ca2+ channel opening (inhibits neurotransmission), enhance GABA-A action, inhibit glutamate receptors (NMDA channels), tolerance and dependence

Question 23

Pharmacokinetic dependence involves

Answer 23

how quickly the drug is metabolised

Question 24

Pharmacodynamic dependence involves

Answer 24

how the receptors interact at a mechanistic level

Question 25

What are the effects of tricyclic antidepressants?

Answer 25

inhibit neuronal uptake of noradrenaline and serotonin; antagonise a-aRs, muscarinic receptors, histamine receptors, and serotonin receptors

Question 26

What are the negatives of tricyclic antidepressants?

Answer 26

poor selectivity; takes weeks to develop effects; side effects; narrow therapeutic window

Question 27

Effects of monoamine oxidase inhibitors

Answer 27

increase levels of serotonin and noreadrenaline (moreso than dopamine)

Question 28

Side effects of monoamine oxidase inhibitors

Answer 28

reversible: postural hypotension, dizziness, nausea, insomnia; irreversible - ‘cheese reaction’ foods containing tyramine (cheese, red wine, chocolate, bananas) precipitate hypertensive crisis

Question 29

Side effects of SSRIs

Answer 29

nausea, insomnia, agitation, weight change, loss of libido; in conjunction with MAOI and TCA caused serotonin syndrome: hyperthermia, muscle rigidity, and cardiovascular collapse

Question 30

Where is the focus of new antidepressant drugs?

Answer 30

anti-depressant activity (MAOI, TCs), anxiolytic activity (SSRI, SSNRI) and pro-cognitive activity to elevate mood (new drugs)