Lecture 35 - Emerging treatments for drug dependence: preclinical evaluation Flashcards

1
Q

What was the 2010 cost of drug and alcohol abuse to austrlia?

A

$56 billion

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2
Q

What is a good working definition of addiction?

A

a chronic relapsing disorder which consists of a compulsive pattern of drug seeking and drug taking behaviour

takes lace at the expense of other activities

persists despite adverse consequence

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3
Q

What parts of the brain are important in stress induced relapse?

A

Extended amygdala - central amygdala nucleus

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4
Q

What parts of the brain are important in Que (seeing a picture of beer) induced relapse?

A

basolateral amygdala

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5
Q

What is the common pathway for que and stress induced relapse?

A

pre-frontal cortex -> nucleus accumbens core -> ventral pallidum

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6
Q

What kind of disorder is alcoholism and what are the factors ?

A

polymodal disorder - multiple causes

Gnenetic factors - still awaiting definitive marker gene

Environmental factors - peer pressure to self-medication of underlying psychological disturbance

Diagnosis is critical for selection of appropriate therapy

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7
Q

What are most alcoholism patientsbeing presscribed?

A

antidepressants - not to alleviate depression, but an attempt to reduce the abberant alcohol use

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8
Q

What are the problems with Disulfiram

A

ALDH inhibitor - needs high motivation and compliance - significant adverse side effects

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9
Q

what is Baclofen?

A

GABAb agonist - used in initial withdrawal period

ongoing trials

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10
Q

Are antidepressants, Benzodiazepines useful clinically?

A

no

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11
Q

what is the problem with Naltrexone?

A

non-selective opioid receptor antagonist - tolerance an issue

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12
Q

CRF1 receptor antagonists are…

A

under development

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13
Q

Explain naltrexone

A

may have a clinically meaningful effect for alcohol - dependent patients with a high chance of consistent drinking

trials have had abstinence as end points - not realistic

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14
Q

How can you model drug seeking behavior?

A
Self-administration
- continual access
-restricted access
operant responding
(does the drug stop people taking the drug when its available)

conditioned place preference

extinction (suddenly doesn’t get the drug) / reinstatement (make the drug available) - “relapse”

sensitisation

withdrawal syndrome

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15
Q

What does naltrexone do clinically?

A

reduces responding for ethanol in primates and rodents

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16
Q

The Orexin-containing neurons are activated during…

A

cue-induced reinstatement to alcohol-seeking

17
Q

What does CRF receptor antagonism stop?

A

the enhanced responding for alcohol observed in withdrawing dependent rats - ineffective in non-dependent rats3

18
Q

What are the emerging treatments for smoking addiction?

A

Nicotine replacement

Bupropion - amine uptake inhibitor

modafinil - amine uptake inhibitor

Mementine - partial NMDA R antagonist

Varenicline - partial agonist at nicotinic Rs

Vaccine

19
Q

What are the emerging treatments for smoking addiction and have any been approved?

A

none have been approved

selegeline - MAO inhibitor

Venlafaxine - SNRI

20
Q

What are the emerging treatments for cocaine addiction and have any been approved?

A

none have been approved

Modafinil

Topiramate

antidepressants are often used

21
Q

What are the emerging treatments for opiates addiction and have any been approved?

A

yes

methadone

heroin prescription

Buprenorphine

22
Q

What 3 things should effective therapeutic be?

A

safe, well-tolerated and efficacious

combination with Cognitive behavioral therapy and other behavioural strategies

23
Q

What are the major issues with addiction-medication?

A

non-compliance

co-morbidity

24
Q

Episodic Rx for ____ ______ may possibly provide wider windows of opportunity for Rx

A

.relapse prevention