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MBCHB3: Nervous system module. > Lecture 15: Drugs of abuse > Flashcards

Lecture 15: Drugs of abuse Flashcards

1
Q

Do you use the term addict or drug abuse?

A

Best term is “Substance dependence syndrome”

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2
Q

What diagnoses substance dependence syndrome?

A

Factors: A cluster of symptoms including;

  • Continued use despite substance related problems
  • Tolerance
  • Withdrawal syndromes

1 or 2 factors = abuse
3 or more = dependence

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3
Q

What can repeated doses of the same drug lead to?

A
  • Sensitization (rare)

- Tolerance (i.e because metabolism enhanced or decreased receptor expression)

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4
Q

What systems do drugs work on?

A

Increased activity of the mesolimbic system in response to pleasure/rewarding drugs

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5
Q

What are some factors that indicate withdrawal and why?

A
  • Evidence of physical dependence
  • Autonomic syndrome due to removal of drug i.e GI reflux, sweating, GI disturbance, etc
  • Specific to drug class
  • Body works overtime to tell you that you need more of the drug
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6
Q

Describe the symptoms of opioid withdrawal syndrome?

Extra

A 
Craving
Restlessness
irritability
increased sensitivity to pain
nausea
muscle aches
dysphoria
insomnia
anxiety
hallucinations
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7
Q

What are the autonomic dysfunction in opoid withdrawal syndrome:

A 
Sweating
tachycardia
hypertension
vomiting
diarrhoea
fever
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8
Q

What potentially makes a drug more dangerous?

A
  • Associated with increased central neurotransmitters
  • Rapidity of onset
  • Presence of withdrawal syndrome
  • Convenient and effective method of administration
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9
Q

What can make the user more likely to have dependence?

A

Personality: Genetics, development, upbringing
Anxiety, depression or psychiatric disorders
Stress, Insomnia
Environment - Peer pressure, societal norms, socioeconomic factors, education

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10
Q

What is the most physically dangerous and dependent drug?

NB upload pic

A

Fentanyl

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11
Q

What drugs are stimulants?

A 
Amphetamines
Cocaine
LSD
Caffiene
Ritalin
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12
Q

What drugs have mixed effects?

A

Ketamine

Synthetics

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13
Q

What drugs are depressants?

A 
Alcohol
Benzodiazepines
Barbiturates
GHB
Cannabis
Opoids
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14
Q

What does alcoholism potentially lead to?

A

Increased risk of depression, suicide, cognitive deficits and dementia

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15
Q

Describe the elimination of alcohol

A

Michaelis-menten kinetics at low concentrations and apparent zero order kinetics once concentrations rise above moderate

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16
Q

Write some notes on the effects of alcohol on the body

A

Mild intoxication: Motor inco-cordination sleepiness stimulation disinhibition

Increasing dose = sedation /anesthesia -> Coma and death

17
Q

What happens with alcohol tolerance and dose?

A

Tolerance leads to decreased sedation but lethal dose remains unchanged

18
Q

What happens to withdrawal symptoms and alcoholism?

A

50% experience withdrawal symptoms following cessation

Only 5% will progress to delirium tremens

19
Q

Write some notes on chronic alcohol abuse

A

-Liver cirrhosis
Dilated Cardiomyopathy
Pancreatitis

20
Q

If you come across a drug overdose what are the first steps?

A
  • Safety first for yourself
  • Airway
  • Breathing
  • Circulation
  • Disability
  • Exposure

For alcohol, gastric lavage or charcoal is controversial

21
Q

What do opiods do?

A

Analgesia

Respiratory depression

22
Q

Another name for heroin?

A

Dimorphine

23
Q

What does opioid abuse lead to?

A

Abuse potentially related to lipid solubility and euphoric high

24
Q

List the order of opioids in severity:

A

Fentanyl > Diamoprhine > Oxycodone > Morphine

25
Q

What is methadone used for?

A

Methadone = Long action, slower onset for treatment in weaning programs

26
Q

What is the analgesic ladder?

A

An approach to prescribing pain relief such that you avoid opioids and reduce the risk of substance dependence syndrome

27
Q

Describe the analgesic ladder:

A

1) Non-opioid +/- adjuvant i.e NSAID
2) Opioid for mild to moderate pain +/- nonopioid +/- adjuvant
3) Opioid for moderate to severe pain +/- Nonopioid +/- adjuvant

28
Q

Write some notes on cocaine:

A

Potent inhibitor of catecholamines re-uptake, massive rush of adrenalin

Local anesthetic and vasoconstrictor

29
Q

What is crack?

A

Cocaine and baking soda + water

30
Q

Describe the psychological effects of cocaine:

A

Euphoria, increased libido, energy, self esteem

Highly addictive

31
Q

What are the risks of cocaine?

A

Seizures

Cardiotoxicity (arrhythmogenic)

32
Q

How does meth/amphetamine, benzadrine, dexedrine act?

A

Increased CNS catecholamines - dopamine, noradrenaline and serotonin

33
Q

What do amphetamines do?

A

Anorexia
Restlessness
Euphoria
Wakefulness

34
Q

Why are new psychoactive substances dangerous?

A 
Cheap
Available
Synthetic
Potent
Easily made
Trendy
Profitable
Smokable

Very very dangerous, not regulated

MBCHB3: Nervous system module. (39 decks)

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