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MD1 Neuroscience > Drugs of Dependence and Antidepressants > Flashcards

Drugs of Dependence and Antidepressants Flashcards

1
Q

What is drug dependence?

A

Drug taking becomes compulsive

Takes precedence over other needs

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2
Q

What is drug abuse?

A

Use of illicit substances or illicit use of legal substances

Recurrent and clinically significant adverse consequences

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3
Q

What contributes to psychological dependence?

A

Rewarding effect of psychoactive drug

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4
Q

What is the rewarding effect of the psychoactive drug?

A

Positive reinforcement > desire to continue experience

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5
Q

Does the rewarding effect only happen with drugs?

A

No, it can happen with any activity

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6
Q

What contributes to physical dependence?

A

Habituation/adaptation

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7
Q

What is habituation/adaptation?

A

Feeling normal/aversion of negative symptoms

Don’t take drug to feel good but not to feel bad

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8
Q

What are the reward and salience circuits involved in drug abuse and addiction?

A

Nucleus accumbens

Ventral pallidum

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9
Q

What are the memory and learning circuits involved in drug abuse and addiction?

A

Hippocampusw

Amygdala

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10
Q

What are the motivational drive circuits involved in drug abuse and addiction?

A

Orbitofrontal cortex

Subcallosal cortex

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11
Q

What are the inhibitory control circuits involved in drug abuse and addiction?

A

Prefrontal cortex

Anterior cingulate gyrus

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12
Q

What happens to the inhibitory control circuits in drug abuse and addiction?

A

Removed to elicit excitation

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13
Q

Which circuits have interplay between them in drug abuse and addiction?

A

Those for reward and salience, and memory and learning

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14
Q

Which neurotransmitter is implicated in reward pathways, and how?

A

Increased dopamine in nucleus accumbens

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15
Q

What are the key transmitters modulating dopaminergic transmission?

A 
Atch
Serotonin
NA
GABA
Glutamate
Opioids
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16
Q

Which neurotransmitters are targeted by most of the drugs that are used and abused?

A

Those that modulate dopaminergic transmission

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17
Q

Describe the dose-response curve in the CNS

A

Bell-shaped rather than sigmoid

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18
Q

What effects did cocaine have on people with high dopamine receptor levels?

A

Aversive effects

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19
Q

What effects did cocaine have on people with low dopamine receptor levels?

A

Pleasant effects

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20
Q

Do receptor levels change, and if so, what do they change in response to?

A

Yes, change in response to

  • Time
  • Disease
  • Drug taking
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21
Q

How do some tolerance mechanisms work when receptors are involved?

A

Receptor levels are too high, so with extended drug use, they’ve been downregulated

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22
Q

What are two examples of opioids?

A

Morphine

Heroin

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23
Q

What are the CNS effects of opioids?

A

Euphoria

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24
Q

What are two examples of CNS depressants?

A

Alcohol

Diazepam

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25
Q

What are the CNS effects of CNS depressants?

A

Reduced anxiety

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26
Q

What are three examples of CNS stimulants?

A

Cocaine
Amphetamine
MDMA

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27
Q

What are the CNS effects of CNS stimulants?

A

Excitement
Euphoria
Reduce fatigue

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28
Q

What is an example of an hallucinogen?

A

LSD

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29
Q

What are the CNS effects of hallucinogens?

A

Altered perception

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30
Q

What is an example of a cannabinoid?

A

D-9-THC

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31
Q

What are the CNS effects of cannabinoids?

A

Altered perception

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32
Q

What is non-therapeutic drug use?

A

Consumption by choice not medical advice

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33
Q

What are the specific effects of CNS stimulants on CNS transmission>

A

NA, dopamine, and serotonin to various degrees

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34
Q

What does cocaine do at the synapse?

A

Block neuronal uptake of NA

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35
Q

What does amphetamine do at the synapse?

A

Utilises uptake carrier for NA to enter pre-synaptic terminal
Displaces NA from synaptic terminal

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36
Q

What effect do cocaine and amphetamine have on NA at the synapse?

A

Increase NA levels in synaptic cleft

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37
Q

Which neurotransmitters are predominantly affected in the CNS by cocaine and amphetamine?

A

Dopamine

Serotonin

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38
Q

Which neurotransmitters does amphetamine release in the CNS?

A

Predominantly NA and dopamine

Also serotonin

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39
Q

With what do the effects of amphetamine vary?

A

Mood
Personality
Environment

40
Q

What are the CNS effects of amphetamine?

A

Mood elevation and euphoria
Increase locomotor activity
Stereotypic behaviour

41
Q

What effects does amphetamine have on physical and mental performance?

A

Fatigue postponed

Confident and speedy performance, but less accurate

42
Q

What is the possible mechanism for the appetite suppressant activity of amphetamine?

A

Serotonin effect

43
Q

What is a medical application of amphetamine?

A

Analogues used for ADHD

44
Q

Does amphetamine induce tolerance?

A

Yes, need larger dose for same effect with long term use

45
Q

What is the mechanism by which amphetamine induces tolerance?

A

Downregulation of receptors over time

46
Q

Does amphetamine cause psychological dependence?

A

Yes, but not as marked as cocaine

47
Q

Which group of people are more susceptible to amphetamine dependence?

A

Depressives

Lonely people

48
Q

What are the physical withdrawal symptoms of amphetamine?

A

Lethargy
Sleep
Desire for food
Depression

49
Q

What does chronic use or an overdose with amphetamine cause?

A 
Anxiety
Nervousness
Physically tension
Tremors
Confusion
Dizziness
Time passes quickly
Hyperthermia
Tachycardia
Increased BP
Vascular collapse > death
Psychosis - hallucinations
50
Q

Compared to amphetamines, what neurotransmitters do cocaine and MDMA targeet?

A

Target same ones but cocaine and MDMA have relative selectivity for dopamine, serotonin and NA

51
Q

What are the cognitive effects of caffeine?

A

Increases alertness and well being
No euphoria
Delays onset of sleep

52
Q

In what ways does caffeine stimulate mental activity?

A

Postpones boredom, fatigue, and inattentiveness

Enhanced intellectual and motor performance

53
Q

What do high doses of caffeine cause?

A

Anxiety
Tension
Tremors

54
Q

What is the drug class of caffeine?

A

Methylxanthine

55
Q

What are the targets of caffeine?

A

Predominantly an adenosine antagonist
Phosphodiesterase inhibitor > cAMP not broken down
By targeting 2nd messengers, it affects transmission beyond NA, DA and 5-HT

56
Q

Does caffeine cause dependence?

A

Not strongly in animals or humans

Reinforcing behaviour linked with social aspect

57
Q

What is a withdrawal symptom of caffeine dependence?

A

Headache

58
Q

What sort of hallucinations does LSD cause?

A

Visual
Auditory
Tactile
- Sensory modalities get confused

59
Q

What happens to your thought processes whilst on LSD?

A

Disturbed but aware drug-induced

60
Q

Does LSD cause dependence?

A

Could be aversive rather than reinforcing some people - “bad trip”

61
Q

How is tolerance to LSD mediated?

A

Receptor mediated

62
Q

How fast does tolerance to LSD happen?

A

Quickly

63
Q

What happens when you take LSD with other psychotomimetics?

A

Effects impaired by cross tolerance

64
Q

What is the target of LSD?

A

In CNS agonist at 5-HT2 receptor

Causes inhibition of 5-HT neurons in Raphe

65
Q

What neurotransmitters does MDMA/ecstacy release?

A

Dopamine and serotonin

66
Q

What are the effects of MDMA?

A

Stimulant and hallucinogenic effects

67
Q

Is MDMA as effective as amphetamine or LSD?

A

No

68
Q

What cognitive effects does MDMA have?

A

Feeling of closeness
Empathy
Love
Heightened self-awareness

69
Q

Does MDMA cause dependence?

A

Yes because of rewarding reinforcing effect

70
Q

What are the effects of MDMA on the cardiovasular system?

A

Increases HR

Increases BP

71
Q

What effect does MDMA have on thermoregulation?

A

Disrupts it - causes chills and sweating

72
Q

What is the effect of the active metabolites of MDMA on the brain?

A 
Potential degeneration of 5-HT and DA neurons
Affects
- Mood
- Memory
- Sleep
- Appetite
73
Q

What effect do CNS depressants have?

A

Relaxation

Sense of well being

74
Q

What are two forms of cannabis that are often taken?

A 
Marijuana
- Dried leaves
-  Flower heads
Hashish
- Extracted resin
75
Q

What is the active component in cannabis?

A

D9-THC

76
Q

What are the cognitive effects of D9-THC?

A

Relaxation
Feeling of well being
Sharpened sensory awareness - increased intensity of sounds and sights

77
Q

What influences the effects of D9-THC?

A

Characteristics of drug

Individual

78
Q

What are the cannabinoid receptors to which D9-THC binds?

A

CNS - CB1

PNS - CB2

79
Q

What type of receptors are CB1 and CB2, and what effect do they have when they’re activated?

A

GPCRs

Inhibition of adenylate cyclase > inhibition of transmission

80
Q

Which other drug can possibly interact with D9-THC?

A

Caffeine

81
Q

What is anandamide?

A

Endogenous cannabinoid receptor agonist

Unknown physiological role

82
Q

What is nabilone?

A

Synthetic cannabinoid analogue

Being developed as anti-emetic

83
Q

What is the effect of cannabinoids on neurotransmitters?

A

Increase dopamine neuronal firing by decreasing GABAergic inhibition of dopamine neural activity

84
Q

What are the central effects of D9-THC?

A 
Impaired short term memory
Impaired motor coordination
Catalepsy
Analgesia
Anti-emetic
Increased appetite
85
Q

What are the peripheral effects of D9-THC?

A

Tachycardia
Vasodilation
Reduced intraocular pressure
Bronchodilation

86
Q

Does D9-THC cause dependence?

A

Some evidence of physical and psychological dependence in heavy users

87
Q

What are the effects of ethanol on the neuron?

A

Inhibit Ca channel opening > stop exocytosis
Enhance GABA action and glycine mediated inhibition
- GABA-A receptors
- Reversal by Flumazenil
Opens some K channels > cell hyperpolarises
Inhibits glutamate receptors
- NMDA channel

88
Q

How does ethanol bind to the GABA-A receptor?

A

Binds in lipid membrane
Changes shape of receptor
Increases GABA binding

89
Q

What are the behavioural effects of ethanol?

A

Subjective

  • Increased self confidence
  • Euphoria
    • Usually loud and outgoing
    • Less often morose and withdrawn
  • At higher doses aggression and mood swings
90
Q

What are the motor effects of ethanol?

A

Loss of motor coordination

Slurred speech

91
Q

What are the tissue effects of ethanol?

A

Liver damage
Neurodegeneration
Foetal impairment

92
Q

What is the mechanism of tolerance of ethanol?

A

Pharmacokinetic mechanism - enhanced clearance

93
Q

What are the behavioural signs of ethanol withdrawal?

A 
Anxiety
Insomnia
Nausea
Anorexia
Delusions
Hallucinations
94
Q

What are the neurological signs of ethanol withdrawal?

A 
Tremor
Hyperactive reflexes
Agitation
Delirium
Convulsions
Status epilepticus
95
Q

What are some physical signs of ethanol withdrawal?

A

Vomiting
Postural hypotension
Sweating
Hyperpyrexia

MD1 Neuroscience (55 decks)

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