Lecture 15 - Drugs of Abuse

Question 1

Physical dependence definition?

Answer 1

state that develops as a result of tolerance produced by resetting homeostatic mechanisms in response to repeated drug abuse - characterised by withdrawal syndrome

Question 2

Substance dependence syndrome?

Answer 2

continued use of a substance despite subtance-related problems, tolerance, withdrawal symptoms

Question 3

Origins of substance dependance - agent?

Answer 3

wanting to use (reinforcement), rapidity of onset

Question 4

Origins of substance abuse - host?

Answer 4

pharmacokinetic response, pharmacodynamic response, learned/behavioural response

Question 5

Origins of substance abuse - environment?

Answer 5

societal norms, peer pressure, low employment/education

Question 6

Dosage changes in alcoholism?

Answer 6

lethal dose never changes, effective dose rises in alcoholism, 1st to zero order kinetics after ~6 drinks

Question 7

Drug deaths & opioids?

Answer 7

2010 total 38,000 all drugs, 2017 opioid alone 64,000

Question 8

Opioid epidemiology

Answer 8

prescriptions gradual growth, heroin and fentanyl exponential from 2010

Question 9

Abuse potential pharmacokinetics?

Answer 9

related to lipid solubility i.e. potency;desire for relief of chronic pain adds to opioids abuse potential

Question 10

Analgesic ladder?

Answer 10

let pain increase to moderate before initiating opioids, hospitalise and monitor for severe

Question 11

Cocaine MoA and clinical relevance?

Answer 11

blocks catecholamine transporters; anaesthetic and vasoconstrictor

Question 12

Methamphetamine effects?

Answer 12

wakefulness, euphoria, anorexia, restlessness , hyperthermia, insomnia; dependence more psychological than physical

Question 13

Synthetic cannabanoids?

Answer 13

addictive w withdrawal, psychosis, seizures, renal & heart failure; more potent effect at cannabanoid receptors