Exam 5 lecture 7 Flashcards
describe current trends in stimulant overdose deaths
All increasing.
What parts of the brain are activated by stimulants
VTA and Nucc Acc (emotion, fear, reward, planning, memory, learning)
Nicotine MOA
Acts on acetylcholinergic receptor by causing inflow of Na and outflow of K, causing action potential.
What determines how many molecules of Ach bind to receptor
Heterogenity of subunits
why does nicotine bind to Ach receptor?
Nictotine is structurally similar to Ach
What are the structural similarities and differences of nicotine and acetylcholine
Both have charged amine groups and hydrogen bond acceptor groups
Nicotine is membrane penetrable at physiological PH (weak base)
Nicotine is also not degraded by by acetylcholinesterase
What effect does nicotine not being degraded by acetylcholinesterase have
longer duration of action of nicotine (more potent)
Rank addictive probability, cocaine, nicotinem heroine
Nicotine
heroin
cocain
Drug therapy used to treat nicotine dependence
partial agonist (varenicline)
What are things to know about partial agonist drugs used for quitting nicotine
Highly addictive. Partial agonists increase quit rate
Why is pseudoephedrine BTC
Can be converted to Meth fairly easily
What are some commonly abused psychostimulants
MDMA
Meth
Ritalin
cocaine
What is Fenethyline? Use?
Amphetamine + theophylline
Wide spread use in arabian peninsula
ADHD
MOA of cocaine
antagonist of amine transprters
DAT SERT NERT
Rank the receptors cocaine will have most effect on
Dat>SERT>NERT
MOA of methamphetamines/bathsalts
Competitive reuptake
Block DA reuptake
Push out DA from vesicle and induces reverse transport
What are the clinical effects of methamohetamine abuse
neurologic- delirium, tremor
psych-anxiety, panaroia, delusions, hallucinations
ENT- profuse dental decay
cardiovascular- tachycardia, hypertension, vasospasms
skin- diaphoresis
describe what is seen in brain scan of meth abuser
DA receptor in normal brain has high concentration.
Meth abusers will have a down regulation of dopamine receptors. Receptor downregulation believed to mediate withdrawal sx
is dopamine downregulation evidence of a broken brain
No, recovery of of DA receptors shows ability to return to homeostasis
Do addictive drugs increase brain dopamine
decrease in C-raclopride binding reflect increase synaptic ventral striatal dopamine levels.
Can low dose psychostimulants increase productivity?
This off label use is not well supported by research and can progress to stimulant use disorder
What is sympathomimetic toxidrome? symptoms? EXAM
MATHS
M-Mydriasis
A- agitation, arrhythmia, angina
T- tachycardia
H-Hypertension, Hyperthermia
S- Seizure, sweating
Management of sympathomimetic toxidrome
- treat agitation, HTN and seizures with BZDs
- Avoid pure BB due to unopposed alpha antagonism
What are things to know about sympathomimetic syndrome
HTN usually responds to sedation
hyperthermia denotes poor prognosis