Elicit drugs and Anti-depressants Flashcards
How does MDMA work?
Blocks the uptake of Serotonin and promotes its release from Vesicles
How does Cocaine work? and what can be an affect of this?
It blocks mono-amine re-uptake. namely dopamine.
it also blocks noradrenaline and adrenaline.
- symapthetic response
How do amphetamines work?
Block dopamine up-take and promote its release from vesicles
How do beznodiazepines work?
GABA agonists - cause sedation
How do opioids work?
Activate Mu receptors = Modulate pain and cause sedation
Mu receptors also activate the mesolimbic pathway causing reward feedback
Kappa Receptors = Dysphoria
What kind of a drug is LSD and how does it work?
Hallucinogen/ psychedelic
Release of 5HT
What kind of a drug is mephedrone and how does it work?
A so called “legal high”.
promotes release of noradrenaline and blocks monoamine - uptake including 5HT and dopamine
Give examples of Serotonin Noradrenaline re-uptake inhibitors/ SNRI’s
Venlafaxine
Duloxetine
Give an example of an Mono-oxidase inhibitor:
Pheneizine
Name a drug that promotes the release of dopamine and is used for ADHD treatment
Dexamphetamine
What is the second line of treatment for ADHD and what is the drug type?
Atomoxetine
Noradreanline Re-uptake inhibitor
What is 3rd line for ADHD and what type of drugs are these?
Clonidine
Gaunfacine
Alpha -2 agonists
What drugs may be given for Dementia with lewy bodies, Parkinson’s and Alzheimer’s?
Cholinesterase inhibitors
Give three examples of cholinesterase inhibitors:
Donepizil
Rivastigamine
Galantamine
What may be given for Alzheimer’s dementia other than cholinesterase inhibitors?
NMDA receptor antagonists
Name a NMDA receptor antagonist
Memantine
What type of dementia must anti-pychotics not be given too?
Dementia with Lewy bodies - it can make it worse.
What drug can be given for alcoholics to discourage drinking? and how does it work?
Disulfiram
Blocks Acetaldehyde dehydrogenase
How many candidates fail the first clinical trial?
70-80%
What is a serious toxic effect of carbamazepine?
Steven - Johnson syndrome - toxic epidermal necrolysis
Name two pro-drugs commonly used
Codeine
Aspirin
What is the pyramid of analgesics? from the bottom
Step 1: NSAIDs/ Paracetamol
Step 2: Codeine, Dihydrocodeine
Step 3: Tramadol
Step 4: Morphine/ Oxycodone/ Pethidine
What are the routes of entry into for drugs into the brain?
Blood - IV
Intrathecal - via sub arachnoid
Enteral - drug must be lipophilic to cross
What drug can be used to disrupt the blood brain barrier?
mannitol
How do Diazepams work?
Allosteric GABA agonists
How does opioids cause euphoria?
reduce the disinhibition to the mesolimbic pathway - increasing dopamine firing from the VTA to the nucleus accumbens
Give an example of a NSRI:
Venlafaxine
What bicarbonate is on the lumen of the PCT and which is inside?
IV on lumen side
II is inside
What drugs will not cause a change in pupils?
Sedatives
What receptors does ketamine work on?
NMDA receptor antagonists
What receptor activation will cause anxiolysis and ataxia?
GABA receptor stimulation
At what blood alcohol level would euphoria and impaired of balance become notable?
0.08-9
At what blood level is coma and death most likely?
0.4 - 0.5
What is seen in stimulant toxidrome? and what is a serious effect?
Dilated pupils
Elevated body temperature
What is seen in serotonin syndrome?
Triad of:
- altered mental status - confusion / seizures
- autonomic changes - sympathetic drive
- neuromuscular effects - clonus, hypereflexia
Onset of coacaine? main action and half life?
30 mins onset
Blocking uptake of dopamine, NA and 5HT
half life 30-90mins
Half life of amphetamines
12 hours
What are long term side effects of stimulants?
Anxiety sleep depreviation Aggression Paranoia cognition effects
What does cocaine do to platelets?
Increases aggregation
What are some major concerns with cocaine?
Strokes
Through which neurotransmitter do drugs cause dysphoria? and what receptor is often associated?
Dopamine
Kappa receptors
What is the features of opioid toxidrome?
parasympathetic action
- pulmonary oedema
- seizures
What are the common causes of neurological damage in sedatives?
Usually caused by indirect things such as falling.
compressive palsies
axonal damage
What neurotransmitters does angel dust affect?
ACh and dopamine
What does Atropa Belladona cause changes in?
ACh
Whats long term effects of solvent abuse?
Ataxia
diploia
Nstagmus
coma