exam 2 Flashcards

1
Q

what are stimulants

A

substances that increase activity of sympathetic nervous system

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2
Q

most common stimulants (6)

A

cocaine, crack, amphetamine, methamphetamine, caffeine, nicotine

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3
Q

cocaine prevalence in U.S.

A

one of world’s largest consumers of cocaine

black people are less likely than white to use powder and equally likely to use crack

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4
Q

coca leaves

A

cocaine, oral administration

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5
Q

powder cocaine

A

snorted, crosses BBB more easily

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6
Q

cocaine source

A

shrub native to Andes mountains

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7
Q

crack cocaine

A

smoked for quick and intense high

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8
Q

cocaine route of administration affects ____

A

amount of cocaine absorbed into bloodstream

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9
Q

cocaine speed of entry into brain (fastest to slowest route of administration)

A

smoked, injected, snorted, orally

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10
Q

cocaine metabolism system

A

cytochrome P450 system

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11
Q

cocaine mechanism of action

A

blocks pain pathways
blocks reuptake of dopamine, norepinephrine, and serotonin (these increase)

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12
Q

schedule of cocaine

A

II, approved for local anesthetic

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13
Q

adverse effects of cocaine

A

irritability, hostility, fear, restlessness, paranoia, heart attack

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14
Q

acute effects of cocaine

A

euphoria and increased energy
increased confidence
sweating/chills
increased heart rate
decreased appetite and need for sleep

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15
Q

chronic use of cocaine

A

tolerance or reverse tolerance, short-lived withdrawal, irritability

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16
Q

cocaine dependence

A

weak physical dependence but strong psychological dependence, no FDA approved treatments

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17
Q

amphetamine

A

more popular than cocaine, more potent effects, stimulates CNS by increasing same neurotransmitters

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18
Q

brand names of amphetamine

A

adderall, ritalin, concerta

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19
Q

methamphetamine

A

more lipid soluble form of amphetamine, enters brain faster, more addictive

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20
Q

amphetamine route of administration

A

oral, injection, intranasal, smoked

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21
Q

amphetamine effect duration

A

12 hours

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22
Q

methamphetamine effect duration

A

8 hours

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23
Q

amphetamine mechanism of action

A

increased postsynaptic levels of dopamine, norepinephrine, and serotonin to larger degree than cocaine

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24
Q

small doses effects of amphetamine

A

increase energy and alertness, reduced appetite

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25
Q

high doses effects of amphetamine

A

rush, intoxication, psychosis

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26
Q

meth specific effects

A

disinhibition, hypersexuality (but can decrease function)

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27
Q

difference between effects of cocaine and amphetamine

A

amphetamine has slower onset and longer duration but closely resemble one another

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28
Q

chronic use of stimulants

A

loss of neural tissue in prefrontal cortex

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29
Q

other stimulants

A

cathinone (khat) and bath salts

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30
Q

brain structures involved in effects of cocaine

A

increased dopamine in basal ganglia, prefrontal cortex, ventral tegmental area, nucleus acumbens

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31
Q

how have drugs laws for cocaine and crack contributed to racial disparities?

A

disproportionate incarceration rates and higher penalties for crack possession which was more common among blacks than powder cocaine

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32
Q

hallucinogen

A

drugs that distort perceptions of reality at relatively low doses

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33
Q

hallucinogen schedule

A

I

but most are physiologically safe and non-addictive

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34
Q

hallucination

A

experience involving perception of something that may not actually be there

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35
Q

illusion

A

altered and distorted perceptions, thoughts, feelings, awareness, insights

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36
Q

hallucinogen plants

A

peyote, salvia, atropa belladonna

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37
Q

fungi hallucinogen

A

psilocybin and amanita mushrooms

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38
Q

synthetic hallucinogen

A

LSD, MDMA, PCP, ketamine

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39
Q

psychedelics

A

alter perceptions while still allowing person to communicate with the present world

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40
Q

indoleamines

A

similar to serotonin

LSD, psilocybin, DMT, morning glory

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41
Q

phenylethylamines

A

similar to dopamine and norepinephrine

peyote, MDMA

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42
Q

deliriants

A

block acetylcholine

atropa belladonna, henbane, mandrake

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43
Q

dissociatives

A

cause amnesia, sense of detachment from environment

salvia, PCP, ketamine, amanita mushrooms

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44
Q

most psychoactive hallucinogen

A

LSD, 25 micrograms

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45
Q

orally administered hallucinogens

A

psilocybin, LSD, MDMA

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46
Q

route of administration of PCP and ketamine

A

ingested, snorted, smoked, injected

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47
Q

DMT duration

A

30 mins

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48
Q

ketamine duration

A

1 hour

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49
Q

peyote duration

A

5 hours

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50
Q

PCP and psilocybin duration

A

6 hours

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51
Q

MDMA duration

A

7 hours

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52
Q

LSD duration

A

11 hours

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53
Q

psychedelic hallucinogens affect ___

A

serotonin, brain areas related to sensory processing, emotions, and higher executive processing

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54
Q

MDMA effects

A

increased serotonin, dopamine, oxytocin

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55
Q

deliriants effects

A

prevent binding of acetylcholine

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56
Q

acute effects of hallucinogens

A

hallucinations, altered perceptions of time and reality, euphoria, increased heart rate

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57
Q

3 stages of LSD and psilocybin

A

sympathetic nervous system is activated – alterations in perceptions and sensations – self-perception change leading to distortions of reality and emotions

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58
Q

MDMA acute effects

A

sense of empathy and closeness to others, inner peace

more prone to toxic effects on heart, serotonin syndrome, hyperthermia

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59
Q

deliriants acute effects

A

hallucinations over illusions
affects temp, vision, hydration, bladder

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60
Q

PCP and ketamine acute effects

A

depend on dose and environment, high doses can be toxic

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61
Q

schedule I hallucinogens

A

psilocybin, LSD, mescaline, MDMA

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62
Q

medical uses of schedule I hallucinogens

A

depression, PTSD, drug and alcohol dependence, psychological trauma

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63
Q

tolerance of hallucinogens

A

develops quickly and dissipates quickly

64
Q

tolerance of MDMA

A

depression and cognitive deficits

65
Q

chronic use of PCP and ketamine

A

memory loss, speech problems, delusional thinking

66
Q

addictive hallucinogens

A

PCP, ketamine, MDMA (slight potential)

67
Q

nonaddictive hallucinogens

A

psilocybin, LSD, mescaline

68
Q

opiates

A

occur naturally in opium poppy

69
Q

example opiates

A

opium, morphine, codeine

70
Q

opioids

A

natural/synthetic/semi-synthetic/endogenous substances that bind to opioid receptor

71
Q

recent changes in opioid use

A

increase due to overprescription and nonmedical usage, as guidelines became stricter, people turned to heroin

72
Q

most common methods of obtaining painkillers for nonmedical purposes

A
  1. given to by friend or relative
    and being prescribed by more than one doctor
73
Q

naturally occurring opioids

A

coming from opium poppy
morphine, codeine, thebaine

74
Q

semi-synthetic opioids

A

chemically modified natural opiates

heroin, Vicodin, oxycontin, Percocet

75
Q

synthetic opioids

A

methadone, fentanyl

76
Q

opioids route of administration

A

ingested, rectally, sublingually, transdermally, snorted, smoked, injected

77
Q

mechanism of action opioids

A

opioid receptors and endogenous opioids

78
Q

acute effects of opioids

A

diminish pain, suppress respiration, increase sleep, euphoria, impaired cognitive function

79
Q

opioid triad

A

three key signs of opioid overdose
coma, depressed respiration, pinpoint pupils

80
Q

medical uses of opioids

A

cough suppressant, alleviate diarrhea

81
Q

opioid tolerance

A

metabolic, cellular, behavioral (increased tolerance if its in a location that has repeatedly been used prior), cross-tolerance to other opioids

82
Q

withdrawal of opioids

A

symptoms are opposite of direct effects of drugs

pain, irritability, insomnia, diarrhea, dilated pupils

83
Q

organ impact from opioids

A

organs are not damaged from long term use but addict lifestyle is most dangerous effect

84
Q

opioid dependence

A

addiction due to physical, environmental, and psychosocial factors

85
Q

substitution opioids

A

methadone and buprenorphine

harm reduction to allow addicts to function normally and lessen craves and withdrawals

86
Q

other opioid treatment methods

A

needle exchange, detoxification under anesthesia

87
Q

medications to aid opioid dependence

A

naltrexone, clonidine

88
Q

most potent opioids

A

fentanyl, heroin, oxycodone

89
Q

least potent opioids

A

morphine (baseline), codeine

90
Q

sedatives

A

relieve anxiety, cause relaxation, mild CNS depressants

91
Q

hypnotics

A

cause drowsiness and sleep

92
Q

BZD prevalence

A

more popular than barbiturates, females to males = 2 to 1 ratio

93
Q

barbiturates and BZDs more likely to be abused

A

short acting, lipid soluble

94
Q

short acting sedatives used for

A

preanesthetic sedatives or for insomnia

95
Q

longer acting sedatives used for

A

anticonvulsants, muscle relaxants, anxiolytics

96
Q

anxiolytic

A

kind of medication that eases anxiety

97
Q

sedative routes of administration

A

oral, rectal, injection

98
Q

BZD absorption

A

less lipid soluble than barbiturates, absorbed more slowly, slower onset of action

99
Q

BZD trade names

A

xanax, valium, klonopin, Ativan

100
Q

metabolism of sedatives

A

liver with cyp450 system

101
Q

sedative metabolism decreased in ____

A

infants, pregnant women, liver disease, elderly

102
Q

BZD mechanism of action

A

binds to GABA A receptor in limbic system, reticular activating system, cortex, (not respiration)

103
Q

barbiturate mechanism of action

A

more general effect on GABA than BZD

104
Q

acute effects of sedatives

A

reduce muscle tone, impair coordination, reduce anxiety, learning, memory, cause bizarre uninhibited behavior

105
Q

effect of sedatives on sleep

A

total sleep time is increased by REM sleep and restorative deep sleep are reduced

106
Q

effects of sedatives on fetus

A

cleft palate, floppy infant syndrome

107
Q

sedative drug interactions

A

other drugs metabolized by cyp450 system

108
Q

safety of barbiturates

A

low TI, risk of overdose increased when used with other opioids or depressants

109
Q

Therapeutic use of barbiturates and BZDs

A

insomnia, anxiety, seizures, alcohol withdrawal, anesthesia

110
Q

why have BZDs largely replaced barbiturates?

A

more specific effects
fewer side effects
wider margin of safety
lower potential for abuse/tolerance
less effect on REM sleep, longer lasting effects have less potential for abuse

111
Q

z drugs

A

ambien, Lunesta, sonata

produce sleep rhythm more like natural sleep

increased risk of car accidents, sleep walking/eating/sex/driving

112
Q

chronic use of sedatives

A

daytime fatigue, accidents, mortality

113
Q

sedative tolerance

A

develops for sedative/hypnotic effects but not for anticonvulsant effects

more common in barbiturates (cellular and metabolic) than BZDs

114
Q

sedative addiction

A

barbiturates > BZDs

115
Q

sedative withdrawal

A

should be medically supervised

insomnia, confusion, difficulty concentrating

116
Q

inhalants

A

substances that have effects similar to sedatives/hypnotics

117
Q

prevalence of inhalants

A

younger adolescents

118
Q

volatile inhalants

A

glues, aerosols, cleaning agents, fuels

119
Q

anesthetic inhalants

A

ether, nitrous oxide

120
Q

nitrite inhalants

A

amyl/butyl nitrite

121
Q

acute effects of inhalants

A

similar to alcohol intoxication, huffing, sudden sniffing death syndrome, incoordination and recklessness

122
Q

chronic use of inhalants

A

nose bleeds, depression, hostility, cancer, damage to organs, cognitive impairments

123
Q

cannabis prevalence

A

most commonly used illicit drug in the US (18% in past year)

inverse relationship between use and perceived dangers

124
Q

cannabis sativa

A

tall and slender with lighter green leaves

125
Q

cannabis indica

A

shorter and bushier and darker leaves

126
Q

almost all strains of cannabis today are ____

127
Q

female and male cannabis plants

A

flower clusters with psychoactive resin that catches pollen from male seeds, separating male and female will increase psychoactivity of the plants

128
Q

phytocannabinoids

A

THC, CBD
bind to cannabinoid receptors in the body

129
Q

THC

A

psychoactive

130
Q

CBD

A

anti oxidant/convulsant/inflammatory/anxiety

131
Q

hemp

A

trace amounts of THC, not psychoactive

132
Q

cannabis routes of administration

A

smoked, vaporizers, ingested (slower onset and less predictability of action)

133
Q

cannabis absorption

A

THC is very fat soluble, easily crosses BBB

134
Q

cannabinoid receptors

A

CB1 and CB2
THC partial agonist, CBD negative allosteric modulator which blocks some of THC’s effects

135
Q

cannabinoids bind to other receptors in the body such as _________

A

GABA, serotonin, glutamate

136
Q

mechanism of action of cannabis

A

endocannabinoid system

137
Q

endocannabinoid system

A

widespread system that controls physiological effects and helps maintain homeostasis

138
Q

neurotransmitters of endocannabinoid system

A

anandamide, 2-AG

139
Q

function of enzymes of endocannabinoid system

A

synthesize and break down cannabinoids, endocannabinoids synthesized on demand, not stored

140
Q

receptors of endocannabinoid system

A

CB1 and CB2

141
Q

location of receptors of endocannabinoid system

A

basal ganglia, cerebellum, hippocampus, amygdala, eye, pancreas, testes, uterus

142
Q

acute effects of cannabis depend on ____

A

dose, ration of THC to CBD, previous experience and expectations, environment

143
Q

biphasic dose response curve

A

for cannabis, optimal dose receives highest benefits and low/high doses receive low benefits (looks like normal curve)

144
Q

acute effects of cannabis

A

euphoria, laughter, impaired memory, impaired coordination, enhanced sensory perception, drawn out sense of time, hunger/thirst, increase heart rate

145
Q

TI of cannabis

A

very high, over 1000

146
Q

negative effects of cannabis

A

impaired fertilization from high doses, drug interactions, collateral damage from use

147
Q

medical uses of cannabis

A

chronic pain, nausea/vomiting, increase hunger, MS symptoms, reduce use of addictive substances, other disorders/conditions

148
Q

tolerance of cannabis

A

regular use causes tolerance

149
Q

addiction of cannabis

A

less addictive than other drugs, treatment involves psychological approaches, less than 50% stay abstinent

150
Q

cannabis withdrawal

A

symptoms are not severe if they occur

151
Q

primary function of liver in drug use

A

metabolism

152
Q

primary function of kidneys in drug use

A

elimination

153
Q

reward pathway in the brain

A

network of structures involved in pleasure, motivation, and reinforcement

154
Q

two main structures of reward pathway

A

ventral tegmental area (midbrain, produces dopamine in reaction to rewarding stimuli) and nucleus accumbens (limbic system, receives dopamine and generates feelings of pleasure)

155
Q

primary neurotransmitter of reward pathway

156
Q

How does methamphetamine differ from other stimulants and other forms of amphetamine?

A

stronger, longer lasting effect
stronger impact on dopamine release which causes euphoria, much more potential for abuse and addiction