Exam 9: Psychomotor Stimulants

Question 1

Methamphetamine

Answer 1

Amphetamine with an added methyl group that helps resist metabolism by MAO and makes it more lipid soluble (better at entering the CNS)

Question 2

Methylphenidate

Answer 2

Ritalin
Used to treat ADD
Acts on the Locus Ceruleus (area with the most NE producing neurons)
Can also affect dopamine areas (abuse potential)

Question 3

Cathinone

Answer 3

Amphetamine-like molecule found in leaves of a plant in Africa and the Middle East
Analogs are found in “Bath Salts” which are snorted to produce amphetamine-like high

Question 4

Ephedrine

Answer 4

Natural product found in herbal preps
Sympathomimetic agent
Can be used to cook meth

Question 5

Modafanil and Armodafanil

Answer 5

Non-amphetamine stimulants
Used to treat narcolepsy and shift work disorder
Abused by students for their amphetamine-like effects

Question 6

CNS effects of stimulants

Answer 6

1. Arousal, make fullness (reticular activating system)
2. Euphoria (WOO!!!) (some people get dysphoria)
3. Delay fatigue-induced decline in performance (intellectual and motor)

Question 7

Adverse effects of stimulants

Answer 7

1. crashing
2. tolerance, dependence (psychological and physical)
3. Tactile Hallucinations (formication).
4. Symptoms that mimimc paranoid schizophrenia (usually reversible)
5. Appetite suppression

Question 8

Peripheral effects of stimulants

Answer 8

Hypertension, tachycardia, arrhythmias, mydriasis
Decreased food intake, wasting
Dental/skin problems

Question 9

Potential toxic neurological effect of stimulants

Answer 9

1. Degeneration of the dopaminergic and serotonergic pathways in the brain
2. Decreased levels of stored levels of DA in the reward centers (dependence)

Question 10

Amphetamine mechanism

Answer 10

Enhance release of NE and DA

Question 11

Cocaine mechanism

Answer 11

Inhibition of the uptake of NE and DA

Question 12

General mechanisms of stimulants

Answer 12

1. Enhance release or decrease uptake of NE and DA

2. Direct stimulation of alpha receptors in reward centers of the brain

Question 13

How can you increase excretion of amphetamines?

Answer 13

Acidify the urine

Question 14

Medical uses of amphetamines

Answer 14

Narcolepsy
ADD
Weight loss

Question 15

What is different about crack compared to powdered cocaine?

Answer 15

It is fat soluble and taken by smoking

Question 16

Positive effects of cocaine

Answer 16

Euphoria
Reinforcing effects on reward centers (causes seeking behavior)
Suppresses appetite

Question 17

Negative Effects of Cocaine in the CNS

Answer 17

Paranoia, hallucinations, psychosis
Craving
Lethargy, fatigue
Depression, anhedonia
Irritability, hostility, anxiety

Question 18

Peripheral effects of cocaine

Answer 18

Increased HR and BP
Arrhythmias
Stroke
Sudden death
Birth defects

Question 19

Mechanisms of cocaine

Answer 19

CNS- Inhibition of reuptake of NE and DA resulting in stimulant and reinforcing effects respectively
Periphery- Inhibits NE reuptake resulting in sympathomimetic effects

Question 20

What are drugs that could antagonize the effects of cocaine?

Answer 20

Antipsychotics tha tblock dopamine receptors

Question 21

Effect of chronic cocaine use?

Answer 21

Inhibition of DA reuptake eventually results in depletion of DA in the presynaptic neuron

Question 22

What are some treatments for cocaine dependence?

Answer 22

1. Nutritional supplements that help rejuvenate DA stores
2. L-DOPA
3. Bromocryptine (DA agonist)
4. Antidepressants (Bupropion) are less powerful DA reuptake inhibitors
5. Certain opioids

Question 23

Name 3 Methylxanthines

Answer 23

1. Caffeine
2. Theophylline
3. Aminophylline

Question 24

What are Theophylline and aminophylline used for?

Answer 24

Asthma (they relax the bronchioles)

Question 25

What could you use to stimulate respiration in preterm infants?

Answer 25

Caffeine or theophylline

Question 26

What are peripheral effects of methylxanthines?

Answer 26

Relax bronchioles
Stimulate gastric secretion (careful in patients with peptic ulcer disease)
Carcinogenic/teratogenic???-Controversial

Question 27

3 mechanisms of methylxanthines?

Answer 27

1. Phosphodiesterase inhibition
2. Adenosine receptor blockage
3. Calcium release

Question 28

Uses of methylxanthines?

Answer 28

Asthma
Headache
Diuretics
Respiratory stimulation in preterm infants

Question 29

Methyxanthine OD

Answer 29

Can lead to life threatening seizures or cardiovascular collapse

Question 30

Name 2 spinal cord stimulants

Answer 30

Strychnine and Tetanus toxin

Question 31

Strychnine

Answer 31

Glycine antagonist in the spinal cord and other CNS areas
Removes post synaptic inhibition and can cause severe seizures
Treat with diazepam

Question 32

Tetanus toxin

Answer 32

Inhibits glycine release from Renshaw cells

Causes convulsions, tetany