Drugs Of Dependence

Question 1

Drug Dependence

Answer 1

Altered state in a person which necessitates continued use of a drug
Caused by prior exposure to drug and conditions associated with use
Psychological state
Physical state
Often cross-dependence on similar drugs

Question 2

Psychological Dependence

Answer 2

Continuum: mild desire cravind compulsion
Withdrawal-> emotional distress
Self-induced changes in mood
Usually precedes physical dependence

Question 3

Vicious Cycle

Answer 3

Bingeing: Loss of control
Withdrawal: Amotivation and anhedonia
Craving: Drug expectation and attention bias
Intoxication: Impaired Self awareness
Cycles back

Question 4

Physical Dependence

Answer 4

Present even though no over signs
Withdrawal syndrome
May not be associated with increased desire for agent
Usually associated with development of cross- tolerance to similar drugs

Question 5

General CNS depressants

Answer 5

Ethanol
Barbiturates
Benzodiazepines
Solvents- inhalation

Question 6

Physical withdrawal syndrome

Answer 6

Purpose behaviour
Weak, N&V, anxiety, tremor, orthostatic hypotension
Insomnia, delirium tremens
Sleep

Question 7

Chronic Ethanol Consumption

Answer 7

Neurodegeneration: Dementia, Cerebellar degeneration, peripheral neuropathy
Fatal alcohol spectrum disorder: behavioural problems
Liver damage: Fat accumulation, fatty lover, hepatitis
Heart, BP, Cancer

Question 8

Ethanol Withdrawal

Answer 8

Detox: long acting benzo

Reduce intake/prevent relapse: CBT, opioid antagonists, acomparosate

Question 9

Opioids

Answer 9

Acute: onset of kick and high
Oral: 20-30 min
IV: 15-30 sec
Inhalation: 7-10 sec

Question 10

Opioid Withdrawal- first week

Answer 10

Dysphoria
N&V
Muscle aches, cramps, tremors
Watery eyes, runny nose, sweating
Dilated pupils, goosebumps, fever
Insomnia

Question 11

Opioid Withdrawal- Months

Answer 11

Craving
Feeling abnormal
Abnormal respiration and temperature
Depression, anxiety
Confounded by high co-morbidity with other disorders

Question 12

Opioids -detox

Answer 12

Methadone
Buprenorphine (Naloxone- becomes active if injected)

Psycho-social rehabilitation

Question 13

Nicotine abuse

Answer 13

Receptor: Nicotinic Ach (alpha4/beta2)
Detox: psychosocial therapy
Reduce cravings: bupropion
Partial agonist: vernicline
Antagonist: mecamylamine

Question 14

Psychomimetics- Halluciongenic Agents

Answer 14

Amphetamines- DA/NA/5-HT
LSD- 5-HT2A receptor
Atropine- Muscarinic Ach
Cannabis- CB1
Phencyclidine- NMDA

Question 15

Amphetamine- Cocaine

Answer 15

Acute: Mood elevation, anorexia, sympathomimetic, stereotypy, hallucinations, dellusions

Chronic: weight loss, self-mutilation, paranoia, exhaustion
Psychological dependence
Withdrawal

Question 16

LSD

Answer 16

Somatic phase
Perceptual phase
Psychic phase

Question 17

MDMA

Answer 17

Amphetamine-like & LSD-like
5-HT> DA,NA
Chronic destruction of serotonergic neurons
Recreational use: reduced SERT, incrased 5-HT2A, increased excitability in neocortex

Question 18

Atropine

Answer 18

Delirium: Disorientation, confusion, amnesia
Hallucinations
Somnolence, restlesness, incoordination

Question 19

Cannabis

Answer 19

Tetra hydro cannabinol
Acute: impaired cognition/perception, labile emotions, muscle relaxant, slowed reaction time, inc appetite, antiemetic, analgesic?, anticonvulsant, anti-glaucoma
Chronic: risk of schizophrenia, cognitive/emotional problems?, bronchitis