Exam 1 Flashcards
pharmacology
uses, effects, and modes of actions of drugs
psychopharmacology
Influence of drugs on behavior and psychological function
neuropharmacology
Influence of drugs on brain function
neuropsychopharmacology
Influence of drugs on brain, behavior and psychological function
psychoactive drug
chemical substance that alters perception, mood, or consciousness
purposes of psychoactive drugs
recreational, ritual/spiritual, therapeutic
classification by source
natural, synthetic, semisynthetic
classification by behavioral/psychological effects (5)
stimulants, depressants, analgesics, hallucinogens, psychotherapeutics
classification by pharmacological action
often drugs have multiple pharmacological actions, so it’s difficult to classify
other ways to classify drugs
chemical structure, legal status
what terms have been synonymous with addiction?
dependence and drug abuse
physical dependence
body relies on drug to prevent withdrawal
addiction
- uncontrollable cravings
- inability to control drug use
- compulsive drug use
- use despite doing harm to oneself or others
- classified as a disease
in the last month, __% of the U.S. population has used illicit drugs
13
most common illicit drug used in the U.S.
marijuana
age group in which drug use is most common
young adults (18-20)
percentage of people with substance use disorder
14.5% (40.3 million people)
most common substance abused & diagnosed
alcohol
binge drinking
at least 5 drinks in one session for men; at least 4 drinks in one session for women
heavy drinking
at least 5 binge days out of last 30 days
daily marijuana use has ___ among college students
increased
binge alcohol use is ___ in college students than in non-college peers
greater
marijuana and nicotine vaping are ___ among college students
increasing
illicit drug use in high school students
- steady in 12th graders over the years
- decreased alcohol use across all grades over the last decade
cigarette use in high-school students has ___ over the last 10 years
decreased
nicotine and THC vaping have ____ in high-school students
increased
psychoactive substances used throughout history (5)
nicotine, caffeine, morphine, cocaine, and THC
alcohol temperance movement’s effects on attitudes towards drugs/alcohol
did not outlaw alcohol, but drug use in general was socially unacceptable
prohibition
alcohol is outlawed and seen as criminal behavior
scientific advancements that led to greater drug use
increased addictive potential of drugs and development of hypodermic syringes
approach to drug control that led to increased drug use
increased drug availability and lack of drug control laws
changes in treatment of addiction
medicalization led to categorizing addiction as a disease
effects of Nixon’s War on Drugs in 1971
expanded incarceration, drug crimes more severely punished and policed
targets of the War on Drugs
Black population, anti-war left
effects of the War on Drugs in the 80s
mandatory minimum prison sentences, increased penalties for posession
Anti Drug-Abuse Act of 1986
created a big sentencing disparity between crack and powder cocaine, which further fueled racial disparities in incarceration
top consumer of illicit drugs in the world
USA
race typically subjected to higher rates of arrests and incarceration
Black population
past approach to the war on drugs
- viewed drugs as a criminal justice problem
- law enforcement
- penalization
science’s influence on drug policy
little to none
what method is effective when tackling a drug problem
treatment programs
future of war on drugs
- drugs are a public health problem
- increased treatment availability
- focus on education, prevention
- reduced drug sentences
- legalization of marijuana
- harm reduction (syringe programs)
DSM-5 definition of substance use disorder
significant impairment in at least 2 categories in a 12-month period: impaired control, social impairment, risky use, pharmacological properties
changes from DSM-I to DSM-V when discussing addiction
gradual transition from stigmatizing to biological basis
addiction is NOT
physical dependence and withdrawals
addiction IS
craving and relapse
definition of addiction
chronic, relapsing brain disease characterized by compulsive drug seeking/use, despite harmful consequences, major impairment to self-control
bioavailability
amount of drug available to bind to target sites and elicit drug action
absorption
movement from site of administration to blood circulation
oral route of administration
- aka preoral, PO
- absorption in the GI tract
- slow, variable
- undergoes first-pass metabolism in the liver before entering the bloodstream
first-pass metabolism
aids in drug degradation and sometimes drug design
routes of administration that typically avoid first-pass metabolism
intranasal (bypasses BBB), inhalation, sublingual, rectal, transdermal
injection routes of administration
subcutaneous, intramuscular, intravenous (IV)
factors affected by route of administration
onset, peak concentration, and duration
slow route of administration
typically for medical use, longer duration
fast route of administration
typically associated with drug use/abuse, used to achieve highest peak concentration with rapid onset
oral and transdermal administration
slow absorption
intravenous injection or inhalation/smoking (route of administration)
rapid drug entry, fast onset
increased addictiveness is associated with…
fast onset and short duration
how route of administration affects absorption rate
- blood circulation and surface area
- amount of drug destroyed by digestive or metabolic processes
- transport across membranes
drug properties that affect absorption rate
solubility, ionization
most drugs easily diffuse across membranes when they are
lipid-soluble, non-ionized
lipid solubility of heroin vs morphine
heroin reaches the brain much faster than morphine because of increased lipid solubility
drug ionization
occurs when drugs are dissolved in water (neutral pH) due to them being a weak acid or base
lipid solubility of ionized drugs
not readily lipid soluble, making diffusion difficult
factors affecting drug ionization
different bodily fluids (different pH)
ion trapping
concentration of drug in one compartment
distribution (ADME)
movement from blood to target site
factors affecting distribution
depot binding and the blood-brain barrier (BBB)
blood-brain barrier
selectively permeable (lipophilic) to keep a stable brain environment
weak BBB areas
area postrema, median eminence
depot binding
can occur in albumin (plasma), fat, and muscle, where the drug remains in an inactive state in the system and is protected from metabolism
factors affected by depot binding
peak concentration and duration of drug concentration
example of depot binding
THC: depot binding in fat leads to slow release, making THC detectable in urine days after the initial dose
metabolism and excretion (ADME)
movement out of the system
drug inactivation (biotransformation)
usually by metabolism, occurs in the liver by microsomal enzymes
phase I metabolism
oxidation, reduction, or hydrolysis (non-synthetic)
phase II metabolism
- addition of small molecules (glucuronide, sulfate, methyl groups (synthetic)
- products ionized and less lipid soluble so they become inactive metabolites
active metabolites
- have biological activity of their own
- need further metabolism to become inactive metabolites
drug clearance: first order kinetics
- drugs cleared at exponential rate
- based on half-life
- most common
drug clearance: zero-order kinetics
- drugs cleared at constant rate (linear)
- example: alcohol
individual variation in drug metabolism
- sex differences
- individual adaptation (tolerance)
- age effects
- genetic differences
drug therapy for alcoholics (Disulfram/Antabuse)
blocks ALDH
pharmacokintetics
how drugs move throughout the body
pharmacodynamics
- how drugs affect the body
- actions of drugs at receptor sites
ligand
neurotransmitter or drug that fits a given receptor
receptor
protein a ligand interacts with to initiate biological effects
drug + receptor =
drug effects
agonists
ligands that bind to a receptor to initiate a cellular response
antagonists
- ligands that bind to a receptor to block the action of an agonist or endogenous ligand at the same receptor
- do NOT reverse the effects of an agonist or cause an opposite reaction
receptors are bound at the ___ of the cell
membrane
a drug can be ___ specific for the receptor than the endogenous neurotransmitter
more
T/F: drugs can show agonist or antagonist actions
T
drug-receptor interaction
modulate normal neuronal functioning by mimicking, increasing, or inhibiting normal physiological/biochemical processes
characteristics of drug-receptor binding
temporary and reversible
binding affinity
determines speed of dissociation
law of mass action
- more drug molecules = increased receptor occupancy
- maximum drug effect = all receptors occupied
- cellular response proportional to degree of receptor occupancy
dose-response curve
relationship between cellular response and receptor occupancy
reversibility of drug-receptor interactions
- most are reversible
- some form long lasting, irreversible bonds
ED100
- effective dose that gives maximum response
- all receptors occupied
- giving more of the drug does not increase observed drug effect
ED50
dose that produces half the maximum effect
dose-response curve shape
sigmoid
therapeutic index
evaluates all desirable and undesirable drug effects
TD50
dose that produces a given toxic effect in 50% of all subjects
LD50
dose that kills 50% of subjects (lethal dose)
therapeutic index (TI, margin of safety)
LD50 / ED50