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Fall P2 > IDT - Drugs of Abuse, Ishmael > Flashcards

IDT - Drugs of Abuse, Ishmael Flashcards

1
Q

The Continued, compulsive obsession with obtaining, consuming and experiencing the effects of self-administered drugs

A

Substance Dependence (addiction)

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2
Q

Drugs that have psychoactive properties have a ____________ which makes it __________ to be abused.

A

Positive reinforcing action

More Likely

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3
Q

The return to a drug use after abstinence

A

Relapse

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4
Q

What changes must be made in order to achieve continued recovery?

A

behavioral, social, psychological and physiologic changes

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5
Q

What area of the brain is responsible for the pathway in addiction?

A

Nucleus accumbens, projections from the Ventral Tegmental area.

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6
Q

Why are drugs that block dopamine receptors less likely to be self-administered?

A

They may have dysphoric effects that people would rather avoid.

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7
Q

What are the natural rewards that may be devalued and overriden in addictive pathways?

A

Food
Water
Sex
Nurturing

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8
Q

What is tolerance?

A

The decrease in pharmacologic response on repeated administration of the drug

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9
Q

What is sensitization?

A

Responses/side effects become stronger than previously anticipated.

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10
Q

Classification when administration of the drug is required to maintain normal function and avoid withdrawal syndrome.

A

Physiologic dependence

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11
Q

When a drug dependence is removed from a physically dependent person, this unwanted side effects might occur

A

Withdrawal syndrome

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12
Q

The process of by which an individual that is physically dependent on a drug is withdrawn from it

A

Detoxification

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13
Q

The 7 classes of drugs that have been recognized as obsessively self-administered by humans

A 
Methylxanthines
Nicotine
Alcohol
Marijuana
Stimulants
Opiates
Hallucinogenic/Dissociative drugs
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14
Q

Nicotine

  • Mechanism
  • Effect
  • likelihood of dependence
A
  • Binds to Nicotinic Acetylcholine receptors
  • Excitatory/Stimulant effect
  • Dependence has a genetic component
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15
Q

Pharmacologic treatment strategies for smoking cessation

A 
NRT 
- patches, gum, e-cig etc 
- Reduces withdrawal by changing behavior 
Anti Depressants (no SSRIs)
- Bupropion
- Nortriptyline
Varenicline
 - Chantix, selective partial agonist
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16
Q

Varenicline (Chantix)

  • Target
  • Efficacy
A

Selective alpha4beta2 nicotinic receptor partial agonist

Causes sufficient dopamine release to reduce cravings/withdrawal but prevents full activation of receptor.

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17
Q

Why can Nicotine be so addicting?

A

Nicotinic receptors within the VTA and impact dopamine release in the nucleus accumbens

(mixes behavioral, cognitive and psychological signals)

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18
Q

How do Buproprion and Nortrtiptyline differ in their mechanism of action for smoking cessation

A

Buproprion targets NET and DAT

Nortriptyline (NET < SERT ««< DAT)

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19
Q

The observed phenomenon where the pharmacologic effect of alcohol having greater effect while rising than falling, even though blood ethanol concentration is the same.

A

The Acute Tolerance
or
Mellanby Effect

20
Q

Effects of Alcohol on CNS

A 
slurred speech
motor incoordination
impaired judgement
uninhibited behavior
increased self-confidence
sedation
relief of anxiety
increased pain threshold
21
Q

What is the first thing you lose during consumption of alcohol?

A

Cognitive functions, as the neuronal populations are more sensitive

22
Q

Describe the Asian Glow

A

Asian populations lack aldehyde dehydrogenase or have a mutation which allows the alcohol’s aldehyde intermediate to build up and cause dysphoric effects.

23
Q

Disulfiram

A

An inhibitor of aldehyde dehdryogenase, supposed to make people sick when they drink in order to ween bad drinking behaviors

24
Q

Alcohol withdrawal symptoms

A 
Tremors (Shakes)
Increased BP
Rapid Breathing
Sweating/Nausea
Alcohol Hallucinations
Seizures
Delirium Tremens
25
Q

What class of medications can be used to lessen alcohol withdrawal symptoms

A

Benzodiazepenes

OTC - vitamins (thiamine, magnesium)

26
Q

What is the main psychoactive ingredient in marijuana?

A

delta9-tetrahydrocanabinol

27
Q

Why is marijuana not associated with severe withdrawal?

A

Not high enough dose to overload reward pathway and cause dependency

28
Q

When did the Oregon Medical Marijuana Act get passed

A

Dec 1998; Approved for recreational use in Oregon in 2015

29
Q

What debilitating medical conditions may be prescribed marijuana?

A 
Agitation related to Alzheimer
Cachexia
Cancer
Glaucoma
HIV/Aids
Nausea
PTSD
Severe Pain
Seizures
Persistent muscle spasms
30
Q

How do endogenous cannabinoids modulate NT release

A

They decrease calcium ions by binding at CB receptors on the presynpatic neuron

31
Q

Medicinal marijuana use vs

Recreational marijuana use

A

Medicinal - Symptom relief

Recreational - Pleasure

32
Q

What routes of administration are often used for consumption of marijuana

A

Smoking
Oral (edibles)
Vaporizing

33
Q

What route of marijuana consumption allows allows rapid and predictable bioavailabiity and allows for self-titration?

A

Smoking the Ganj

34
Q

What is CUD?

A

Cannabis Use disorder

  • pattern of substance abuse that leads to clinically significant impairment
  • Social, occupational and recreational activities reduced in favor of drug
  • tolerance, withdrawal may develop, causing behavioral and physical effects, persistence in spite of negative consequences just like other drugs
35
Q

What medication was used to treat morphine addiction in 1884?

A

Cocaine

36
Q

What legitimate medical use can cocaine be used for?

A

Local anesthetic and vasoconstriction (use dependent Na+ channel blocker)

  • Upper respiratory tract
  • ear
  • nose
  • throat
37
Q

Cocaine’s mechanism of action

A

Binds to and blocks the Dopamine, SR and NE transporters, enhancing DA levels especially in the nucleus accumbens

38
Q

What conditions can amphetamines be used to treat?

A

ADHD
Narcolepsy
Obesity

39
Q

What is the primary effects of CNS stimulants?

A

Increased Alertness
Increased locomotor activity
Stereotype behavior, Euphoria, excitement, overconfidence and anorexia

40
Q

What are the chances of developing dependence with amphetamine meds?

A

High, rapid, as it creates euphoria and is needed to avoid the unpleasant ftigue and depression that follows

41
Q

What is the affect on dopamine transport by amphetamines?

A

Creates a “Reverse Transport”, because amphetamines act as substrates of NET, SERT, DAt and VMAT, they may deplete the pH gradient in vesicles and cause efflux of endogenous neurotransmitters.

42
Q

What do Cocaine and SSRI’s/SNRI’s have in common?

A

They are both non-transported inhibitors, binding to the receptor but not being actively transported themselves.

43
Q

What are the 3 types of ADHD?

A

Inattentive
Hyperactive-impulsive
Combined

44
Q

In individuals that have been diagnosed with ADHD, what is the likelihood of dependence or abuse?

A

Much lower, and is considered safe, with no convincing evidence it may lead to this.

45
Q

What is the effect of stimulants in treatment of ADHD?

A

Tends to reduce the hyperactivity, impulsiveness and works to improve the ability to focus.

46
Q

How is Atomoxetine unique from other CNS stimulants?

A

It targets the NE transporter and inhibits its function rather than acting as a stimulant, so it has low abuse liability

Fall P2 (13 decks)

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