Drugs Use and Abuse 1-4 Study Guide

Question 1

psychoactive drugs

Answer 1

term more percise than just drugs, how drugs affect the body

Question 2

licit drugs

Answer 2

legal (ex: tobacco, alcohol, coffee)

Question 3

drugs

Answer 3

any substance that modifies mind/body functions

Question 4

anabolic steroids

Answer 4

synthetic male hormone testosterone increase body tissue and treat allergies

Androgens are the hormones most likely to be abused in US
Compounds chemically like the steroids that stimulate production of tissue mass

Schedule III systems

Question 5

OTC drugs

Answer 5

over-the-counter drugs

legal without prescription

use of legal more common than illegal drugs and way more deaths sickness illness crime (ex: tobacco alcohol)

Question 6

medicine

Answer 6

a compound or preparation used for the treatment or prevention of disease, esp. a drug or drugs taken by mouth.

Question 7

prescriptions

Answer 7

can be received through a doctor or medical professional

Question 8

narcotics

Answer 8

depress CNS

highly addictive

ex: heroine, codeine, opium

Question 9

equal-opportunity afflictions

Answer 9

no one immune to it

Question 10

dynamic affliction

Answer 10

always changing

Question 11

common tests for drug use

Answer 11

urine, blood, hair

Question 12

addiction

Answer 12

o Defined as a complex disease
o Compulsive, at times uncontrollable, drug craving, seeking, use that persist even in the face of extremely negative consequences
o Comes from Latin word addicere
• Process of binding things
o Largely refers for chronic adherence to drugs
o Physical and psychological dependence

o Considered a brain-disease by NIDA

Question 13

tolerance

Answer 13

need for increased amounts or diminished effect of the same amount

Question 14

withdrawal

Answer 14

experience of a characteristic withdrawal syndrome for the specific substance, which can be avoided by taking closely related substances; unsuccessful attempts to cut down

Question 15

abuse

Answer 15

the improper use of something.

Question 16

moral model

Answer 16

belief that people abuse alcohol because they choose to do so, traditional

Question 17

disease model

Answer 17

model of addiction in the US; belief that people abuse alcohol because of some biologically cause condition

Question 18

deviant model

Answer 18

theory emphasizing that other people’s perceptions directly influence one’s self-image
o Does not fully explain why initial drug use occurs but details processes by which many people come to view themselves as socially deviant from others
o Labeling theory says that other people whose opinions we value have a determining influence over our self-image
o Implied that we apply only a small amount of control over the image we portray
o Labels we use to describe people have a profound influence on their self-perceptions

Question 19

primary deviance

Answer 19

any type of initial deviant behavior in which the perpetrator does not identify with the deviance

Question 20

secondary deviance

Answer 20

any type of deviant behavior in which the perpetrator identifies with the deviance; perceives self as deviant

Question 21

social learning model

Answer 21

a theory that places emphasis on how an individual learns patterns of behavior from the attitudes of others, society, and peers

conditioning

o Drug use is a learned behavior
o Focuses on how drug use and abuse are learned through interaction with other drug users
o Emphasizes pervasive influence of primary groups

primary group - groups that share a high amount of intimacy and spontaneity and whose members are emotionally bonded (ex: families and long-term friends)

o Once drug use has begun, continuing the behavior involves learning the following sequence:
• 1) Identifying where and from whom the drug can be purchased
• 2) Maintaining steady contact with drug dealers
• 3) Preoccupation with maintaining secrecy of use from authority figures
• 4) Reassuring yourself that the drug is pleasurable
• 5) Using with more frequency
• 6) Replacing non-drug using friends with drug-using friends

Question 22

Form of psychiatric disorder

Answer 22

o Ex: bipolar, schizophrenia, depression

Sometimes difficult to distinguish between the two problems of substance-related mental disorders and primary psychiatric disorders
o For proper treatment, the cause of psychological symptoms must be determined
o DSM-IV-TR criteria says that substance abuse disorders can be identified by:
• Occurrence and consequence of dependence
• Abuse
• Intoxication
• Withdrawal
o DSM-IV-TR criteria to help distinguish between substance induced and primary mental disorders
• Personal and family medical psychiatric, and drug history
• Physical exams
• Laboratory tests to assess physiological functions and determine the presence or absence of drugs
o Coexistence of underlying psychiatric problems in a drug user is suggested by:
• Psychiatric problems do not match the usual drug effects
• Psychiatric disorder present before patient began abusing substance
• Mental disorder persists for more than 4 weeks after substance use ends
o DSM-IV-TR that knowing the difference between the mental disorders and substances of abuse is important for proper diagnosis, treatment, and understanding

Question 23

Phase I

Answer 23

Initial Clinical Stage
o 20-100 volunteers
o Formerly drug inmates not anymore
o Usually healthy people some patients

Question 24

Phase II

Answer 24

Clinical Pharmacological Evaluation Stage
o Effects of drug tested
o 100-300 volunteers a with medical problem

Question 25

Phase III

Answer 25

Extended Clinical Evaluation Stage
o By this time company has a good idea of both drug effectiveness and dangers
o Can be offered safely to a wider group of participants
o Safety checks made for side effects
o After testing program ends, careful analysis is made of the effectiveness, side effects, and recommended dosage
o Then company submits new drug application (NDA) as a formal request that the FDA consider approving drug for marketing
• Usually 1,000s of pages
• FDA usually calls for additional tests before the drug is determined safe and effective and marketing

Question 26

Phase IV

Answer 26

– Post Market Surveillance
o Over $1 billion to develop a new drug

Question 27

1906 Pure Food and Drug Act

Answer 27

• Required manufacturers to say amounts of alcohol, morphine, opium, cocaine, heroin, and marijuana extract on label of each product
• Most government at the time focus on regulation of food not drug
• Made false-advertisement/misrepresentation illegal
• Amended by Sherley Amendment in 1912

Question 28

Sherley Amendment in 1912

Answer 28

• Cancer remedy claim false, decided in US Supreme Court
• No false claims
• Law required that government prove fraud which was difficult
• Didn’t improve drug products just encouraged pharmaceutical companies to be more vague in advertisements

Question 29

Food Drug and Cosmetic Act

Answer 29

• Defined drugs to include products that affected bodily structure or function even in absence of disease
• Companies had to file with the government for all new drugs to prove they were safe (not effective just safe)
• Had to list all ingredients and quantity of each and provide instructions regarding correct use of drug and warnings about its dangers
• Eliminated Sherley Amendment requirement to prove intent to defraud in drug misbranding
• Allowed drug companies to create a class of drugs that could not be sold legally without a prescription
• FDA motivated by misuse of barbiturates and sulfa antibiotics
• Allowed manufacturer to determine whether a drug was to be labeled prescription or nonprescription

Question 30

Durham-Humphrey Amendment

Answer 30

• After passed almost all new drugs placed in prescription-class
• Established criteria which are still used today for determining whether a drug should a prescription or nonprescription, if does not fall into 1 or following 3 categories it is nonprescription:
• 1) The drug is habit-forming
• 2) No safe for self-medication because of its toxicity
• 3) Drug is a new compound that has not shown to be completely safe

Question 31

Kefauver-Harris Amendments

Answer 31

• 1938 act did not give FDA authority to supervise clinical testing of drugs, the effectiveness of drugs being sold to public were not being determined
• Supposed to fix problem, but didn’t pass until thalidomide accident

• Required fro the first time that drug manufacturers demonstrate the efficacy as well as safety of their drugs

Question 32

Orphan Drug Law

Answer 32

Allows drug companies to receive tax advantages if they develop drugs that are not very profitable because they are useful in treating only small number of patients, such as those who suffer from rare diseases
• Rare disease is defined as effecting fewer than 200,000 people in US or one for which the cost of development is not likely to be recovered by marketing

Question 33

Prescription Drug User Fee Act 1992

Answer 33

• Require drug manufacturers to pay fees to FDA for evaluations of NDAs
• Congress required the FDA to use these fees to hire more revieweres so as to expedite the reviews

Question 34

Switching policy

Answer 34

Allows agency to review prescription drugs and evaluate their suitability as OTC products
o Following criteria must be satisfied to switch prescription to OTC:
• Drug must have been marketed by prescription for at least 3 years
• Use of drug must have been relatively high during the time it was available as a prescription
• Adverse drug reactions must not be alarming, and the frequency of side effects must have increased during the time the drug was a prescription
o Switching policy has been well received by the public
o But concern over increased misuses and abuse

Question 35

Harrison Act of 1914

Answer 35

first legitimate effort by the US government to regulated addicting substances

Question 36

Drug Abuse and Prevention Act of 1970

Answer 36

determines the ways in which law enforcement agencies deal with substance abuse, this act divided substances with abuse potential into categories based on the degree of their abuse potential and their clinical usefulness
• Schedule I – High abuse potential and no currently approved medicinal use, health professionals cannot prescribe them
• Schedule II – High abuse potential but are approved for medical purposes and can be prescribed with prescriptions
• Schedule V - Least addictive and least regulated of the substances of abuse

Question 37

neurons

Answer 37

specialized nerve cells that make the nervous system and release neurotransmitters
• Highly versatile
• Distinguished by types of chemical substances they release as neurotransmitters to send their messages
• Human brain 100 billion neurons

Question 38

neurotransmitters

Answer 38

a chemical substance that is released at the end of a nerve fiber by the arrival of a nerve impulse and, by diffusing across the synapse or junction, causes the transfer of the impulse to another nerve fiber, a muscle fiber, or some other structure.

Question 39

acetycholine

Answer 39

Large quantities of acetylcholine (ACh) are found in the brain
One of the major neurotransmitters in the autonomic portion of PNS
Depending on the region can have either excitatory or inhibitory effects
• Divided into muscarinic and nicolinic
• Muscarinic inhibitory
• Nicotine activate nicolinic (excitory)

Question 40

anticholinergic

Answer 40

agents that antagonize the effects of acetylcholine

Question 41

nerve structures

Answer 41

Glia – supporting cells that are critical for protecting and providing sustenance to the neurons
Axons – an extension of the neuronal cell body along which electrochemical signals travel

Receptors – special proteins in a membrane that are activated by natural substances or drugs to alter cell function

Acetycholine – excitatory-inhibitory, mild euphoria, excitation, insomnia, tobacco, nicotine
Synapse – site of communication between message-sending neuron and its message-receiving target cell
• Excitatory – increasing activity in target cell
• Inhibitory synapse – diminishes likelihood of an impulse in the receiving neuron or reduces activity to other target cells
Synaptic cleft – minute gap between the neuron and target cell, across which neurotransmitters travel
Dendrites – short branches of neurons that receive transmitter signals

Question 42

Effects of sympthomimetic drugs

Answer 42

agents that mimic the effects of norepinephrine or epinephrine
Classified into alpha and beta categories
Norepinephrine act predominantly on alpha receptors