Exam 2 Flashcards
1
Q
What happens when GABA is suppressed by alcohol?
A
the flow of chloride increases
2
Q
What pathways are changed by alcohol?
A
AMP pathways
3
Q
What specific neurotransmitters are more likely to be disturbed by alcohol?
A
GABA and Glutamate
4
Q
What is a stimulant drug?
A
increases activity in your brain and nervous system. It also increases the circulation of chemicals such as cortisol and adrenaline in the body.
5
Q
What does niacinamide adenine determine?
A
how much alcohol one can metabolize
6
Q
_ to _ grams of alcohol can be metabolized per hour.
A
6 to 8 g
7
Q
In what percent range would you likely have alcohol poisoning?
A
about 0.3% to 0.4%
8
Q
Can the rate at which alcohol is metabolized be sped up?
A
no
9
Q
Define “off label use”.
A
a drug that is not FDA approved
10
Q
What are the 5 steps for treating alcohol dependency (pharmacotherapies)?
A
- reverse pharmacological effects
- prevent withdrawal
- maintenance of abstinence
- treat coexisting psych disorders and other related issues (depression, bipolar disorder, etc.)
- limit any neural-induced damage
11
Q
What do reverse pharmacological effects mean?
A
detox
12
Q
True or False: The use of caffeine is treated using various forms of therapy and drugs.
A
False, the use of caffeine is not treated.
13
Q
What is the treatment of choice for treating alcohol dependency?
A
mixed approach
14
Q
How is alcohol intervention handled (4)?
A
- prevent/treat some withdrawal symptoms
- use drugs to reduce relapse (combined with supportive therapy)
- treat complications
- reduce glutamate release and glutamate receptor regulation
15
Q
What kind of treatment complications can come from treating alcohol dependency?
A
sleep issues and depression
16
Q
How can glutamate receptors be regulated?
A
mood stabilizers and anticonvulsant
17
Q
Toluene activates
A
the central reward systems in the brain
18
Q
What did the rat study show about inhalants?
A
The rats showed an increase in stimulation in the hypothalamus as well as an increase in concentration levels. It also showed that there was an increase in depression after there was a crash in energy.
19
Q
What are the different categories of inhalants?
A
anesthetics, solvents, office supplies (ex. white put, sharpies, etc.), gases (ex. butane lighters), household aerosol repellents (ex. hairspray, paints, cooking spray, cleaning products, etc.)
20
Q
What age range is more likely to use and become addicted to inhalants?
A
mid-adolescents (13 to 15 million Americans)
21
Q
Vapor is inhaled rapidly and as intoxication increases, the person becomes _.
A
disoriented
22
Q
Why do some people die from inhalants?
A
the inhalants suppress O2
23
Q
What is it called when a person dies from the usage of inhalants?
A
Sudden Sniffing Death Syndrome (SSDS)
24
Q
True or False: It is not known exactly how inhalants work in the body.
A
True
25
What type of inhalant produces only light effects?
anesthetics
26
What is known about inhalant solvents?
they may slow brain activity
27
What are the effects of chronic use of inhalants?
damage to the liver, kidneys, parietal part of the brain, etc. chronic use can also cause dementia.
28
How is inhalant addiction treated?
through supportive/talk therapy
29
What are the "top two drugs of all time" according to Dr. Newell?
caffeine and nicotine
30
About how many Americans consume caffeine?
~80%
31
what are some pros to caffeine consumption?
mental alertness, dopaminergic effects, improvement in cognitive (when consumes in moderation) function, attention to detail, and reinforcement
32
How long does it take caffeine to reach its target?
~40 minutes
33
How long does the complete absorption of caffeine take?
~2 hours
34
Does caffeine get to the brain quickly or does it take a long time?
It gets to the brain fairly quickly
35
What percent of caffeine is left unchanged after it is metabolized?
about 10% is unchanged
36
What is the range of half-life for caffeine?
2 to 5 hours
37
What would cause caffeine half-life to be shortened?
smoking
38
What enzyme metabolizes caffeine?
CYP (1A2) enzyme
39
What is caffeine metabolized to?
paraxanthine (84%), theobromine (12%), and theophylline (4%)
40
After the __ metabolizes caffeine, the __ excrete what's remaining into urine.
liver; kidneys
41
Which metabolites behave like caffeine?
theophylline and paraxanthine
42
Which metabolite of caffeine is inactive and can also be used to treat asthma?
theophylline
43
What may cause toxicity or intolerance to caffeine?
cross metabolism with SSRI's
44
Caffeine stimulates the _ system.
nervous
45
What is a diuretic (also known as "water pills")?
a drug that increases your frequency of urination to help rid your body of salt (sodium) and water
46
Caffeine is what type of drug?
a stimulant
47
Caffeine can be used to treat what?
migraines and narcolepsy
48
What are some behavioral effects of caffeine?
reduces fatigue, keeps you awake, alertness
49
How many cups of coffee per day is considered a heavy consumption of caffeine?
about 12 cups or more per day
50
How many cups of coffee per day is considered lethal? What is it called when you consume this amount or near this amount per day?
100 cups per day; caffeine intoxication
51
Caffeine adversely affects __ at how many milligrams?
muscle control; about 100 milligrams
52
What are the primary symptoms for caffeine withdraw?
headaches, increased agitation, and a crash
53
Caffeine exasperates _ disorder.
anxiety
54
Caffeinism
a complaint encompassing a variety of unpleasant mental and physical symptoms associated with the consumption of excessive amounts of caffeine; produces CNS and PNS stimulation
55
What are the symptoms of caffeinism?
restlessness, nervousness, insomnia, increased anxiety, gastrointestinal issues
56
What issues can caffeinism cause in the PNS?
tachycardia, hypertension, arrhythmias, GI issues
57
How does caffeine effect panic disorders?
symptoms are exaggerated
58
Caffeine can increase chances of getting _ disease.
heart
59
Caffeine can decrease flow as well as pressure in the _.
brain
60
Caffeine blocks which two adenosine receptors?
A1 and A2A
61
What happens when caffeine blocks A2A receptors?
the is an increase in dopamine (D2) in the frontal cortex which is where the reward effects of caffeine come from
62
Adenosine Receptors
neuromodulators; influence the release of neurotransmitters; exerts a depressant effect
63
What happens when adenosine receptors are blocked?
there will be an increase in the release of neurotransmitters in the brain; the activity of dopamine, acetylcholine, glutamate, and norepinephrine increases
64
What effects are seen when A1 is blocked by caffeine?
the release of dopamine and glutamate are inhibited, and sometimes acetylcholine is blocked
65
__ and __ are responsible for reward (pleasurable feeling) and the increase in alertness from caffeine.
dopamine and glutamate
66
__ accounts for the behavioral affects of caffeine.
acetylcholine
67
What is the addictive aspect of cigarettes?
nicotine
68
True or False: There is no medical use for nicotine.
True
69
In the U.S., when do most people begin smoking/become addicted to cigarettes.
teen years (15 to 16)
70
Most early cigarette use is related to what?
other drug use and psychoactive issues
71
Cigarette use in the U.S. has decreased by __ in the last 20 to 30 years.
half
72
What is the difference between smoking cigarettes, cigars, and pipes.
Cigar and pipe smoke is not inhaled like cigarette smoke
73
What is the most common way nicotine is consumed?
inhalation via cigarettes
74
In what way is nicotine used via patches? Why is this used?
Nicotine is used via patches as a slow drip. This is typically used for those who are trying to discontinue the use of cigarettes.
75
Nicotine is easily absorbed through __.
the lungs and skin
76
Nicotine smoke= ?
tar
77
Nicotine rapidly saturates the __.
blood
78
When nicotine leaves the lungs...
there isn't as much nicotine in the blood as you'd think.
79
Cigarettes have different nicotine levels ranging from _ to _.
0.5 mg to 2 mg
80
~__ % of nicotine is inhaled and absorbed, the rest being absorbed by __.
20; CYP2A6
81
At what rate is nicotine metabolized?
quickly
82
What percent of nicotine is metabolized by the liver?
80 to 90%
83
What is the metabolite of nicotine?
cotinine
84
A higher level of cotinine is found in what demographic, making them more susceptible to addiction.
Black people
85
What is the half-life for chronic smokers?
~2 hours
86
What are the early symptoms of cigarette use?
nausea and feelings of sickness
87
Nicotine stimulates the __.
thalamus
88
ADH causes __.
fluid retention
89
The antidepressant effect of nicotine makes researchers believe what?
smoking is self medication
90
Teens are more likely to become addicted to/use cigarettes when they have a history of __.
ADHD and conduct disorder (rebellion of authority)
91
Nicotine reduces __ and __.
muscle tone and weight gain
92
What are the pros of nicotine?
-releases multiple actions in CNS which increases motor activity
-increases cognitive function
-increase in sensory motor function
-increase in attention/focus
-increase in ability to rapidly process information
93
Nicotine use can lead to the increase likelihood of __.
panic attacks
94
locus coeruleus
involved with physiological responses to stress and panic; behavioral arousal
95
What is the result of frontal lobe activation?
working memory function and mood
96
There is a strong connection between smoking and __.
adverse childhood abuse
97
Nicotine activates _ which responsible for _.
ACH; benefits of smoking cigarettes
98
Nicotinic receptors in the PNS:
cause an increase in blood pressure and heart rate
99
Why does nicotine cause an increase in blood pressure and heart rate?
because epinephrine is released
100
Nicotinic receptors in CNS:
are widely distributed throughout the brain; facilitate the release of neurotransmitters (excitatory effect)
101
Mesolimbic pathway =
addiction pathway
102
Glutamate and GABA are activated by nicotine. This has led to the debate that it may or may not produce __.
tolerance effects
103
What are the withdrawal symptoms when smoking/nicotine use is stopped?
-craving for nicotine
-decrease in mood (irritation, anger, aggravation, restlessness)
104
How long can nicotine/smoking withdrawal symptoms last?
up to a month
105
Research shows that there is a(n) __ in caffeine use when people decrease or stop the use of cigarettes and/or nicotine.
increase
106
What is the most toxic/harmful part of cigarettes?
tar
107
There is an estimate of about __ minutes taken off of lifespan for every __ cigarette that a person smokes.
14; 1
108
Cigarette use can lead to what type of disease (most often)?
cardiovascular (could also say cancer)
109
Why does cigarette/nicotine use lead to cardiovascular disease?
Because smoking deprives the heart of less O2 and nicotine increases the amount of work that the cardiovascular system has to do
110
Nicotine combined with tar can lead to...
heart disease, cardiovascular disease, and cancer
111
Benzopyrene (Benzo[a]pyrene) (BPD)
major carcinogen in cigarettes
112
What makes cancer more likely when smoking?
We all have cancer that our bodies fight off so that we do not get sick, but with the combination of nicotine and tar, the cancer suppressor gene is more suppressed. This makes cancer more likely to occur.
113
What are the various treatments for nicotine addiction?
-"cold turkey" (doesn't usually last long)
-psychological (relapse prevention, hasn't worked a lot)
-acupuncture (more common in the 80s)
-replacement therapy
-pharmacotherapy approach
-replace one form of nicotine with another (cigarettes --> patches)
-a fairly successful approach
-drugs
-bupropion (antidepressant) (Zyban in cigarette treating form)
-time release capsules
-A-typical: dopamine involved
-partial nicotine receptors (agonistic)
-vaccine approach (currently in its early stages)
114
Partial nicotine receptors:
-antagonist
-varenicline (chantics)
-increases chances of stopping smoking (up to 3x more likely)
-more successful than bupropion
115
What are the side effects of partial nicotine receptors for nicotine addiction treatment?
nausea, GI issues, neuro-psych disturbances, increase in violence and aggression
116
What form of nicotine addiction treatment is more successful than bupropion?
partial nicotine receptors
117
What does the vaccine treatments for nicotine addiction treatment target?
NIC-002 and NIC-VAC
118
What are the features of vaccine therapies for the treatment of nicotine addiction?
-has to be repeated
-intermuscular injections
-if you smoke too much it won't work
119
What is the goal of vaccine therapies for the treatment of nicotine addiction?
reduce antibodies and prevent bonding so the drug cannot get through the blood-brain barrier
120
What will make the vaccine therapies for the treatment of nicotine addiction effective?
only works for smokers with high titer antibodies; only effective if you have enough antibodies
121
Cocaine is a _.
stimulant/amphetamine
122
Cocaine comes from __.
the leaves of the coca plant
123
What are the benefits of the substances from the leaves of the coca plant?
increases alertness, sense of being, and indurance
124
List the history of the coca plant briefly.
-1855: E.coca isolated
-1860: purified and used as medication
-used as an anesthetic until novocaine was discovered
-1885: no laws in the US against cocaine (was in coca-cola (18mg))
-end of 1800s: we started to recognize its issues
-1914: cocaine was made band (Harrison Act)
-for the next 15 years cocaine use decreased and was replaced with amphetamines
-1960s-1980s (more so the 80s): huge increase in the use of cocaine
125
What were some causes of the skyrocketed use of cocaine in the 80s?
-the price of amphetamines increased
-became easier to use drugs in general
-bad time for the US (financial issues and such)
-development of crack cocaine (easy, cheap, and very accessible) ("crack baby")
126
What are the different ways that cocaine can be used?
smoked, snorted, or injected
127
The use of cocaine was later replaced by __ in lower socioeconomic communities.
meth
128
What is used to make meth?
pseudoephedrine
129
Crack cocaine is insoluble in __ but highly soluble in __.
water; alcohol/ether
130
What percent of cocaine is made up of the coca plant leaves?
1/2 to 1%
131
How are the leaves of the coca plant prepared for cocaine?
they're soaked and mashed up to make a paste and then the paste is treated with an alkaloid
132
Cocaine paste contains __% of cocaine.
40-80% (75% likely answer for exam)
133
How long does cocaine show up on blood tests and urine tests?
12 hours; urine: 2 weeks
134
What is the most common way cocaine is administered?
snorting
135
When snorted, what percentage of cocaine reaches the blood?
20-30%
136
How long does it take for cocaine to reach its peak after being snorted?
~30 minutes
137
Snorting cocaine produces what kind of effect?
euphoric effect (organismic effect)
138
What is the time of onset for cocaine when smoked?
within seconds
139
What percent of cocaine reaches the plasma when smoked?
10-30%
140
When injected, cocaine __ in tissues.
accumulates
141
What is the half-life of cocaine?
60 minutes
142
What metabolizes cocaine?
Cytochrome P450 (CYP450)
143
What is the metabolite of cocaine?
Benzoylecgonine (BE)
144
What is the mechanism of action for cocaine? (3)
1. potent anesthetic
2. vasoconstrictor (constricts blood vessels)
3. powerful reenforcing stimulant
-this is how you become addicted
145
What are the neurotransmitters that are effected by cocaine?
-dopamine (addictive nature)
-serotine
-norepinephrine
146
What are the effects of frequent use of cocaine?
-increases dopamine supply in the brain leading to drug reduced psychosis (psychotic episodes, schizophrenia)
-happens quickly
-not permanent bc when stopped the person returns to normal (unless previous history of mental illness)
147
How does cocaine affect dopamine, serotonin, and norepinephrine?
Cocaine blocks the transporters of dopamine, serotonin, and norepinephrine, causing increases in extracellular levels of these neurotransmitters.
148
What is considered a low dose of cocaine?
25-100 mg
149
What are the effects of cocaine at a low dose?
-hyperactivity
-rapid heartbeat
-restriction of blood vessels
-euphoria
-uncontrollable happiness
-increase in self-awareness (can be a good thing but could also be very bad)
-boastfulness
-suppression of appetite
-delays sleep (insomnia)
-decrease in mental activity
150
Approximately how long do the effects of a low dose of cocaine last?
~30 minutes but euphoria remains for longer
151
What happens after the low dose effects of cocaine wear down? what is typically done when this happens?
depression will set in, can lead to trimers and/or seizures (which can be deadly), sexual dysfunction, bad crash; the person will replenish and if they do not they typically have anxiety
152
What happens with symptoms from cocaine as the dosage increases?
the symptoms will increase as well
153
What can long-term use of cocaine lead to? Why?
increased chances of stroke, hemorrhage, and heart issues; bc it's a stimulant and makes the body work overtime
154
Increasing the dose of cocaine =
toxic symptoms
155
What are some other symptoms of long-term cocaine use?
-increase in paranoia
-increase in impulse control issues
-hyperactivity
156
Toxic paranoid psychosis
chronic paranoia and hyperactivity from cocaine use
157
What is considered toxic dose of cocaine?
1 to 2 mg/kg
158
At what point does cocaine become morbid?
when it is cross-linked with other drug use and/or previous psych issues
159
Cocaine being used during pregnancy leads to...
low birth weight
160
True or False: When cocaine is used during pregnancy, the baby receives more of the drug than the mother.
True
161
What is the best approach for treating cocaine addiction?
1. get the person through withdrawal
2. treat issues that may have led to use
162
True or False: There is no real consensus on how to treat cocaine use.
True
163
What is the best way to get someone off of cocaine use?
treating comorbidity
164
What drug can be used to help symptoms of cocaine withdrawal?
Ritalin
165
Ritalin can restore _.
dopamine malfunction
166
_ to _ "crack babies" are born each year.
50,000 to 100,000
167
Pathogenic Agents
-sympathetic neuron system
-"mimic" agents
-epinephrine
168
Amphetamines produce what kind of affects?
vasoconstriction
-tachycardia
-trimers
-hypertension
-increased restlessness
-increased agitation
-increased alertness
169
What are the more likely symptoms of amphetamine use?
-increased restlessness
-increased agitation
170
What was the original use of amphetamines?
treatment of medical issues (still used today)
171
iatrogenic
relating to drug/amphetamine addiction caused by medical treatment (drug prescription)
-how a lot of people initially become addicted to amphetamines
-benzodiazapean
-opiates
-pain medication
172
In what ways are amphetamines still used today in medicine?
to treat ADHD and sleep disorders (narcalepsy)
173
Mechanism of Action for Amphetamines: CNS affects are a result of __.
newly synthesized norepinephrine and dopamine
174
In the PNS, amphetamines have what effect on norepinephrine and dopamine levels?
Amphetamines increase norepinephrine and dopamine in the PNS
175
What is the result of dopamine being released from the recumbent?
reward/feel good system
176
What effect does amphetamine have on dopamine in the synapses? What other drug is this similar to, making it hard to tell the difference between the two?
dopamine is increased and reuptake is blocked; cocaine
177
What form are amphetamines usually in?
pills
178
What is considered a "low dose" of amphetamines?
5 to 50 mg but may differ depending on the drug
179
What are some effects of low dosages of amphetamines?
-increased bp
-increased heart rate
-bronchial muscle relaxes
-metabolites excreated in urine almost entirely
180
About how long are amphetamines detectable in urine?
48 hours or more
181
What is considered a "moderate" dosage of amphetamines?
20+ mg (depends on drug)
182
What are some effects of moderate dosages of amphetamines?
the same as low dosage effects but intensified:
-increased bp
-increased heart rate
-bronchial muscle relaxes
-metabolites excreated in urine almost entirely
183
What makes higher dosages of amphetamines different from low or moderate dosages (besides the obvious)?
low and moderate dosages are taken orally while higher dosages are more likely to be taken intravenously
184
What are some effects of moderate dosages of amphetamines?
-repetitious acts
-increase in violence
-increase in paranoia, anxiety, and anorexia
-psychosis (psychotic issues)
-relationship issues
185
Methamphetamine is known for producing what kind of effects?
psychosis
186
Brief history of amphetamines:
-1887: amphetamine first synthesized
-Early 1900s: active ingredient isolated
-1918: meth synthesized
-1920s: amphetamines used for meds
-1930s: amphetamines marked as med
-After WWII: used for fatigue and depression
-1960s: we start to see issues with addiction and abuse
-1970s: we realized the issue with amphetamines
-Today: not used as often but still used
-meth has taken over
-amphetamine abuse has increased among young people (college students)
187
Why have we seen an increase in amphetamine use among young adults (college students)?
more pressure, ppl using it to increase performance
188
Compare and contrast cocaine and amphetamines:
Cocaine:
-half life= 30 to 50 minutes
-snorted or smoked
-leaves system quicker which in turn makes it have faster effects
-more addictive
-metabolized more quickly
Amphetamines:
-long duration of effect (longer half-life)
Same:
-both are lipid soluble
-both have same risk for overdose
-both stored in the tissues (cross membrane readily)
189
What is the "drug of choice" in today's world?
methamphetamine
190
About what percent of methamphetamine is manufactured at home?
35% or more
191
Methamphetamine ingredients are readily available, what ingredient can you buy at the store? (Hint: The sale of this ingredient is banned in most states except Oklahoma)
pseudoephedrine
192
What are the different ways methamphetamine can be used?
vaporized, inhaled, and smoked
-usually crystalized
193
What is the half-life of methamphetamine?
11 hours
194
Methamphetamine is excreted through the __.
liver and kidneys
195
What percent of methamphetamine is excreted unchanged?
40%
196
When methamphetamine is mixed with __ and __, the risk is increased as well as neurotoxicity.
alcohol and marijuana
197
In the 1900s, methamphetamine was used to treat what?
ADHD
198
What percent of crime is related to substance abuse?
60 to 70%
199
Alcohol is a __ depressant.
CNS
200
What are the general side effects of methamphetamine use?
-hallucinations
-increase in violence
-decrease inhibition
-more prone to infection
-heart issues
201
The Thompson and Cohort study shows a link between chronic methamphetamine abuse and ___.
structural brain defects
202
Chronic methamphetamine abuse leads to:
-decrease in gray matter
-increase white matter (scar replacement)
-tissue of hippocampus becomes loose (loss of memory)
-early onset alzeheimers
203
The use of amphetamines during pregnancy:
-congenital issues
-preterm labor
-low birth rate
-increase risk of cerebral hemmoriage
-increase risk for anxiety early in age
-increase risk in ADHD
204
Amphetamine tolerance:
-big tolerance built because of euphoric effects
-compulsive abuse
-physical dependence
-cold turkey
205
What are the risks of going "cold turkey" from amphetamine?
severe depression and suicidal ideations
206
Ice:
-smokable form of meth
-crystalized form of meth
-absorption is very fast
207
What is the half-life for "ice"?
12+ hours
208
What effect does Ritalin have on serotonin (5HT) and dopamine?
increases it
209
Nonamphetamines are _ different from methamphetamine.
structurally
210
What are some different types of nonamphetamines?
-ephedrine
-bath salts
-bupropion
211
Flakka
-2nd generation synthesized
-smoked
-dopamine and norepinephrine blocker
-increases heart rate and bp
-not easily detected in urine
212
ADHD is believed to be an imbalance of __.
serotonin and dopamine
213
Ritalin is believed to balance out __.
dopamine and serotonin
214
Nonamphetamine effects are similar to the effects of __.
cocaine
215
Nonamphetamine balances
GABA and glutamate
216
How is stimulant abuse treated?
-there are no FDA drug treatments
1. reduce withdrawal symptoms
2. reduce craving
217
How is the craving for a stimulant reduced during stimulant abuse treatment?
-dopamine agonist is used which decreases anxiety and depression
-have to treat comorbid issues
218
THP
decreases cocaine self-administration and chances of cocaine relapse
