Lecture 15: Drugs of abuse Flashcards

1
Q

Do you use the term addict or drug abuse?

A

Best term is “Substance dependence syndrome”

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What systems do drugs work on?

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the autonomic dysfunction in opoid withdrawal syndrome:

A
Sweating
tachycardia
hypertension
vomiting
diarrhoea
fever
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the most physically dangerous and dependent drug?

NB upload pic

A

Fentanyl

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What drugs are stimulants?

A
Amphetamines
Cocaine
LSD
Caffiene
Ritalin
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What drugs have mixed effects?

A

Ketamine

Synthetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drugs are depressants?

A
Alcohol
Benzodiazepines
Barbiturates
GHB
Cannabis
Opoids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What does alcoholism potentially lead to?

A

Increased risk of depression, suicide, cognitive deficits and dementia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Describe the elimination of alcohol

A

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

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
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
What is methadone used for?
Methadone = Long action, slower onset for treatment in weaning programs
26
What is the analgesic ladder?
An approach to prescribing pain relief such that you avoid opioids and reduce the risk of substance dependence syndrome
27
Describe the analgesic ladder:
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
Write some notes on cocaine:
Potent inhibitor of catecholamines re-uptake, massive rush of adrenalin Local anesthetic and vasoconstrictor
29
What is crack?
Cocaine and baking soda + water
30
Describe the psychological effects of cocaine:
Euphoria, increased libido, energy, self esteem Highly addictive
31
What are the risks of cocaine?
Seizures | Cardiotoxicity (arrhythmogenic)
32
How does meth/amphetamine, benzadrine, dexedrine act?
Increased CNS catecholamines - dopamine, noradrenaline and serotonin
33
What do amphetamines do?
Anorexia Restlessness Euphoria Wakefulness
34
Why are new psychoactive substances dangerous?
``` Cheap Available Synthetic Potent Easily made Trendy Profitable Smokable ``` Very very dangerous, not regulated