Exam 5 - Stimulant Misuse Svensson

Question 1

what is the significance that nicotine is not metabolized by acetylcholinesterase like ACh?

Answer 1

nicotine will be in synapse longer, longer half life; more addiction potential

Question 2

T or F: unlike opioids, overdose deaths to psychostimulants have been decreasing in recent years

Answer 2

F (increasing)

Question 3

Cocaine primarily acts as

a. An inhibitor of monoamine oxidase
b. An inhibitor of dopamine receptors
c. An inhibitor of the dopamine transporter
d. An activator of acetylcholine receptors
e. A mimetic of serotonin

Answer 3

c. An inhibitor of the dopamine transporter

Question 4

T or F: The mesolimbic system is the pathway by which projections from the nucleus accumbens transports dopamine to the ventral tegmental area.

Answer 4

F (VTA transports DA to the NA)

Question 5

Which of the following is readily converted to methamphetamine?

a. Cocaine
b. Methylphenidate
c. Mephedrone
d. Methylone
e. Pseudoephedrine

Answer 5

e. Pseudoephedrine

Question 6

the nicotine ACh receptor has at least ___ different subunits

Answer 6

12

Question 7

Similarities between nicotine and ACh are charged _______ groups and hydrogen bond acceptor groups

Answer 7

amino

Question 8

T or F: nicotine is membrane penetrable at physiological pH (weak base)

Answer 8

T

Question 9

T or F: nicotine is degraded by acetylcholinesterase

Answer 9

F (not degraded by acetylcholinesterase)

Question 10

the Mesolimbic Dopamine System: The key dopaminergic pathway that transports dopamine from the _______ to the _______ and
amygdala

Answer 10

VTA; nucleus accumbens

Question 11

put these drugs in order of addiction liability: cocaine, cannabis, tobacco, heroin, alcohol

Answer 11

tobacco > heroin > cocaine > alcohol > cannabis

Question 12

nicotine activates nicotinic ACh receptors, while other psychostimulants directly enhance _______ release and/or inhibit reuptake

a. serotonin
b. dopamine
c. norepinephrine
d. ACh

Answer 12

b. dopamine

Question 13

T or F: chronic psychostimulant use results in downregulation of DA receptors

Answer 13

T

Question 14

what is the sympathomimetic toxidrome?

Answer 14

a constellation of signs/sx indicative of ingestion of a psychostimulant

Question 15

how does varenicline work as a partial agonist?

Answer 15

effect of a drug is proportional to the fraction of receptors occupied; varenicline is a partial agonist which will cause release of dopamine to prevent withdrawal, but not enough to reward abuse

Question 16

why is phenylephrine OTC and Sudafed behind the counter?

Answer 16

Sudafed has one OH group that can be reduced to hydrogen, leading to methamphetamine. Phenylephrine has two OH groups, one of which cannot be reduced to hydrogen, so it can’t make methamphetamine

Question 17

fenethylline is a combination of what two molecules connected by a linker?

Answer 17

amphetamine + 7-(2-chloroethyl)theophylline

Question 18

T or F: cocaine selectively blocks NERT > SERT > DAT

Answer 18

F (DAT > SERT > NERT)

Question 19

Methamphetamine, ecstasy, and bath salts are psychostimulants that primarily release endogenous _______

Answer 19

dopamine

Question 20

MOA of methamphetamine, ecstasy, and bath salts (3 things)

Answer 20

-causes more DA to be released from vesicles
-decrease reuptake
-activates Trace amine-associated receptor (TAAR1)

Question 21

2 outcomes of activating TAAR1

Answer 21

-phosphorylates DAT
-induces reverse transport function (efflux)

Question 22

what are cathinones?

Answer 22

Derivatives of the Khat plant (commonly known as bath salts) that display similar activity to methamphetamine

Question 23

T or F: delirium and tremors are neurological effects of methamphetamine

Answer 23

T

Question 24

T or F: anxiety, paranoia, hallucinations, delusions, and repetitive behaviors are psychological effects of methamphetamine

Answer 24

T

Question 25

poor oral hygiene can lead to what SE of methamphetamine?

Answer 25

profuse dental decay (“meth mouth”)

Question 26

T or F: methamphetamine use causes bradycardia and hypotension

Answer 26

F (tachycardia; hypertension/vasospasm)

Question 27

T or F: one common SE of methamphetamine use is diaphoresis

Answer 27

T (this is inc sweating)

Question 28

adderall misuse is highest in which population?

a. college males
b. college females
c. non-college males
d. non-college females

Answer 28

a. college males (14.6%)

Question 29

T or F: according to research, stimulants have been associated with cognitive enhancement

Answer 29

F (not well supported and can progress to stimulant use disorder)

Question 30

what is the mnemonic for sympathomimetic toxidrome?

Answer 30

MATHS

Mydriasis
Agitation, arrhythmia, angina
Tachycardia
HTN, hyperthermia
Seizure, sweating

Question 31

we can treat agitation, HTN, and seizures from sympathomimetic toxidrome with what drug class?

Answer 31

benzodiazepines

Question 32

when treating sympathomimetic toxidrome, we should avoid pure _____ _____ due to unopposed alpha agonism

Answer 32

beta blockers