Lectures 50 + 51 - Opioids Flashcards
In acute drug use, there are neuroplastic changes that last only a few hours or days, and these drug effects are based on the effects of _______. However, more long-term effects (days to weeks) with repeated drug use occur because more long-lasting proteins are involved, particularly Delta _______ (a transcriptional regulator that increases AMPA ______ receptor subunits –> so new circuits are based on _______, not Dopamine.)
Keep in mind these new circuits feed back into the _____ ______ from the ________ cortex.
Dopamine
Delta FosB
Glutamate receptor subunits
Glutamate
Nucleus Accumbens
Prefrontal Cortex (basically telling the nucleus accumbens to continue seeking pleasure with simultaneous increased signaling from the reward pathway –> double whammy)
Anterior ______ gyrus is part of the frontal cortex involved with Impulse control.
Anterior Cingulate gyrus
How do Set and Setting affect probability of overdose?
Increase the risk –> the same dose a person is used to BUT taken in a different setting can cause overdose.
There is a high concentration of opioid receptors in the Brain stem, particularly the ________, which is why Opioid overdose causes respiratory failure.
Keep in mind Endorphins bind the same receptors as Opioids.
Medulla
Opioids can alleviate both somatic and psychological ______. They can also cause nausea and vomiting (typically in the first few doses) bc they act on the Area _______ (responsible for nausea and vomiting).
Keep in mind ______ (pin-point pupils) are a tell-tale sign that someone is on Opioids, and this is fairly resistant to tolerance –> it will continue to happen with each use.
Pain
Area Postrema
Miosis
Opioid withdrawal symptoms peak at about ______ hrs after cessation. Acute withdrawal can last up to _____ days for Heroin and up to _____ days for Methadone. However, Post-acute Withdrawal Syndrome can last up to ______.
72 hrs
7 days
25 days
1 year
Methadone, Buprenorphine, and Naloxone are medications that can be prescribed for the treatment of Opioid addiction.
Which one is a Full Agonist, which is a Partial Agonist, and which is an Antagonist?
Methadone –> agonist
Buprenorphine –> partial agonist
Naloxone –> Antagonist
Keep in mind Heroin is short acting, creating a large initial spike in dopamine and then a precipitous drop leading to withdrawal across only _____ hrs.
8hrs
Buprenorphine is a partial agonist that only leads to ___% activation despite having extremely high receptor ______.
40%
High Affinity
Unlike with Buprenorphine, ______ can only be dispensed from a Federally Regulated clinic if it is for the treatment of Opioid use disorder. If it is for pain, it can be prescribed individually.
Methadone
________ is an implant that provides low dose of Buprenorphine (8mg instead of the normal 16). It is good for people who have been able to come way down with their use already.
Probuphine implant
