Lecture 15- Stimulants Flashcards
Exam 2
1
Q
Cocaine and Alcohol
A
- taking the edge off
- Liver enzymes that metabolize both produce cocaethylene (just as activite in bloocking transporters)
- Paradoxically, potentiates the euphoric effects
- Increases risk of dual dependency
- With chronic use, increases withdrawal
- Longer half-life, more toxic than cocaine
2
Q
How long are cocaine metabolites detectable for?
A
- 2 days- 2 weeks depending on length of chronic use
3
Q
Cocaine and heroin
A
- Combination (other opiates too) called speedball
- More common among heroin addicts
- enhance pleasurable effects of cocaine
- common cause of over-doses resulting from synergistic effects on blood pressure and heart rate
4
Q
What factors must be considered in the treatment of stimulant misuse?
A
- The drugs’ powerful reinforcing effects
- High tendency toward relapse
- Additional drug dependencies and/or psychiatric disorders (affective disorders, BPD)
5
Q
What must you have in the treatment of stimulant misuse?
A
- Immediate abstinence
- Diagnosis of coexisting disorders
- Determine if addiction is primary or secondary
- maintenance of abstinence
6
Q
Types of Treatment
A
- 12 step recovery programs (similar to AA)
- Psychopharmacolody: drugs that reduce the negative effects of dependence (ex. the craving of cocaine)
7
Q
Stimulant treatment
desipramine
A
antidepressant
8
Q
Stimulant treatment
Bromocriptine
A
DA receptor blocker
9
Q
Stimulant treatment
Tyrosine
A
increase in serotonin
10
Q
Lithium
A
mood stabilizer
11
Q
Topiramate
A
anti-seizure med also known to have anti-craving effects
12
Q
ADHD Core symptoms
A
Inattention, impulsivity, hyperactivity
13
Q
Why do stimulants work on ADHD?
A
Dopamine levels in reward pathways are low in people with ADHD
14
Q
Common ADHD drugs
A
- Concerta (slow-release) and Ritalin-methylphenidate
- Adderall- amphetamine
- Strattera- Atomoxetine (non-stimulant/norepinephrine reuptake inhibitor)
15
Q
Problems with ADHD treatment
A
- Side effects create compliance issues (insomnia, tics, anger/irritability, loss of appetite)
- Effects are somewhat short lasting- slow-release or patch (Daytrana) can help with this
- Strattera- teen suicide
- Increased rates of prescriptions- increased misuse potential
- A gateway drug?
