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HPRO 2255 > Midterm #1 > Flashcards

Midterm #1 Flashcards

1
Q

4 General principles of psychoactive drugs use

A

1 - drugs aren’t bad or good
2 - every drug has multiple effects
3 - size and quality of the effect depend on the amount taken.
4 - effects depend on individual history and expectations

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2
Q

Drug misuse

A

use of drugs in a greater amount than suggested or for a purpose other than suggested.

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3
Q

Drug abuse

A

drug use in a manner, amount, or in a situation that causes social, occupational, psychological, or physical problems.

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4
Q

dependence

A

when a drug is used so frequently that it would be difficult to stop.

  • psychological/behavioural
  • physiological/physical
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5
Q

tolerance

A

reaction to a drug decreases so that larger doses are required to achieve the same effect

  • lower effect after repeated use
  • body learns to compensate for chemical imbalances.
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6
Q

withdrawal

A

abnormal physical or psychological effects of stopping drug use.

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7
Q

examples of withdrawal symptoms

A
  • sweating
  • tremors
  • vomiting
  • anxiety
  • insomnia
  • aches and pains.
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8
Q

Correlate vs. antecedent

A

correlate - a variable that is statistically related to another

antecedent - a factor that occurs before an event

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9
Q

Correlates to drug use

A 
race/ethnicity/culture
gender
education
personality
genetics

NOT SOCIOECONOMIC STATUS or personality problems

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10
Q

Antecedents to drug use

A 
aggressiveness
conduct problems
poor academic performance
attachment to drug-using peers
parental and community norms
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11
Q

Risk factors for drug use

A
  • community/peer/parental attitudes toward drugs
  • antisocial behaviour
  • poor academic performance
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12
Q

Protective factors against drug use

A
  • involved with religion

- perceived harm of drug

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13
Q

Motives fr Drug use

A
  • characteristics of the drug
    Motives for TRYING - family/community/societal factors
    Motives for CONTINUING - drug properties/charcteristics
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14
Q

drug

A

any substance, natural or artificial, other than food, that by its chemical nature alters structure or function in a living organism

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15
Q

psychoactive drug

A

a drug that specifically affects thoughts, emotions, or behaviours

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16
Q

illicit drug

A

a drug that is unlawful to possess or use.

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17
Q

harm reduction

A

initiatives of Canada’s Drug Strategy to use public education programs to significant;y reduce the damage associated drug use.

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18
Q

Federal approach to drug regulation in early 1900s?

A
  • relaxed
  • laissez-faire
  • no regulations
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19
Q

acute behavioural toxicity

A

intoxication that disrupts to actions of the user and increases danger to others. eg. drunk driving.

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20
Q

acute physiological toxicity

A

overdose

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21
Q

chronic behavioural toxicity

A

personality/lifestyle changes and effects on relationships

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22
Q

chronic physiological toxicity

A

heart disease, lung cancer, cirrhosis, etc.

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23
Q

Examples of Drug Monitoring Systems

A
  • Drug Abuse Warning Network (DAWN)
  • Canadian Institute of Health information (CIHI)
  • Canadian Vital Statistics (CVS)
  • Canadian Centre of Substance Abuse (CCSA)
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24
Q

Drug Abuse Warning Network (DAWN)

A
  • US system
  • doesn’t include all hospitals
  • doesn’t consider # of users vs. # of reported problems
  • doesn’t consider relative danger vs. total impact.
  • does NOT tell use how dangerous a drug is, but can give us a picture of the deaths and ER visits due to different drugs.
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25
Q

Canadian Vital Statistics (CVS)

A

causes of drug related emergency room visits and deaths

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26
Q

Canadian Centre on Substance Abuse (CCSA)

A

information on mortality due to alcohol, illicit drugs and tobacco.

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27
Q

physical dependence

A

The body has adapted to the drug’s presence

- tolerance precedes physical dependence

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28
Q

behavioural / Psychological dependence

A
  • emotional desires
  • cravings
  • behaviour is reinforces by consequences.
  • biggest reason for relapse and continued use.
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29
Q

Perspectives on Substance Dependence

A
  • Early Medical model
  • Positive Reinforcement Model
  • Psychological Dependence
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30
Q

Early Medical Model of Substance Dependence

A
  • a true addiction is defined by physical dependence

- solution = treat withdrawal symptoms.

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31
Q

Positive reinforcement model of Substance Ause

A

drugs can reinforce behaviour WITHOUT physical dependence.

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32
Q

Psychological Dependence Model of Substance Abuse

A
  • Current understanding
  • psychological dependence is the driving force for repeated use.
  • evidence against the argument that less addictive drugs are less dangerous.
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33
Q

DSM-V criteria for a substance related and addictive disorder

A

6/11 symptoms
Impaired Control
- taken in large quantities for longer periods of time
- persistent desire & unable to cut down
- lots of time spent getting, using, and recovering from drug use.
- cravings
Social Impairment
- failure to fulfill major obligations
- continued use despite social and interpersonal problems
- withdrawal from family, friends, and hobbies.
Risky Use
- use of the drug in physically unsafe situations
- failure to stop, despite know it is physically or psychologically damaging.
Pharmacokinetics
- withdrawal
- tolerance

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34
Q

10 categories of drugs in DSM-V

A
  • cannabis
  • alcohol
  • hallucinogens
  • inhalants
  • opioids
  • sedatives
  • hypnotics & anxiolytics
  • stimulants
  • tobacco
  • caffeine
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35
Q

List the Theories of the Cause of Dependence

A
  • the subatcne
  • biological
  • personality
  • family
  • biopsychosocial
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36
Q

The Substance - Theory of Dependence

A
  • some drugs are more likely to cause dependence
  • nature of the drug
  • perpetuates the “war on drugs”
  • perpetuates the idea that drugs themselves are bad.
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37
Q

Biological - Theory of Dependence

A
  • biochemical and physiological processes of the brain cause dependence.
  • we can’t know if this is the cause because we are unable to test it.
  • genetics have been implicated but none have solid evidence
  • even if there is some biological relationship to dependence, environmental factors are still required to induce the effect.
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38
Q

Personality - Theory of Dependence

A
  • we see relationships between certain personality types and drug dependence
    eg. sensation-seeking and impulsive personality types.
  • unsure if the personality causes the drug problem or if the drug problem causes the personality to change.
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39
Q

Family - Theory of Dependence

A
  • dysfunctional family relationships play a role in dependence.
  • comes from families with a history of alcohol abuse.
  • even if there is some familial relationship, other factors are required.
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40
Q

Biopsychosocial - Theory of Dependence

A

Currently agreed upon

  • biological
  • personality
  • social interactions/environment.
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41
Q

4 ways drug use might cause increased crime

A
  • drug use changes people’s personalities
  • people under the influence are more likely to commit crimes. (lowered inhibitions, more aggressive, etc.)
  • crimes are often carried out to obtain money for drugs
  • drug use itself is a crime.
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42
Q

Timeline of important historic events in Drug Policy

A 
1908 - Opium Act
1909 - Patent Medicine Act
1911 - Opium & Drug Act
1950's - decline in drug use
1961 - Narcotic Control Act
1969 - Le Dain Commission
1960's/1970's - incline in drug use
1987 - Canada Drug Strategy
1996 - Bill C8 (the controlled Drugs and Subatnces Act)
2003 - Canada's Drug Strategy Renewal
2007 - National Anti-Drug Strategy
2013 - Bil S-10 (Safe streets and communities act)
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43
Q

The Opium Act

A
  • 1908
  • beginning of drug regulation in Canada
  • public fear of East Asian Immigrants
  • couldn’t sell, but could still possess and use.
44
Q

Conclusions of the Opium Act

A

1 - opium smoking was growing in popularity among whites
2 - Chinese merchants were profiting from the opium trade
3 - the opium trade was in violation of current provincial pharmacy legislation
4 - Canada has a moral responsibility to serve as a leader in the campaign against opium use.

45
Q

Patent Medicine Act

A
  • 1909
  • much stricter on prescription drugs
  • created the federal department of health (replaced in 1920)
  • minister of health could cancel drug licenses
46
Q

Patent Medicine Act requirement of prescription drugs

A
  • documentation and approval
  • No cocaine
  • list all ingredients
  • other specific requirements - licensing, etc.
47
Q

The Opium and Drug Act

A
  • 1911
  • beginning of the enforcement era
  • response to failure of the opium act.
  • favored imprisonment
  • targeted Chinese immigrants, excluded Canadians.
48
Q

The Narcotic Control Act

A
  • 1961
  • highly punitive
  • criminalization of drugs
  • challenged by emerging public health movement.
49
Q

The Le Dain Commission (1969) recommendations

A
  • gradual decriminalization
  • possession of cannabis - not an offense
  • more lenient for possession of other illicit drugs
  • no imprisonment
  • government research required.
50
Q

Canada Drug Strategy

A
  • 1987
  • new era of drug prohibition
  • Canada follows suit w/ Ronald Reagan - “The War on Drugs”
  • substance abuse disorders viewed as a health issue.

Goals

  • control and enforce
  • prevention
  • treatment & rehab
  • harm reduction
51
Q

Canada Drug Strategy Renewal

A
  • 2003
    more focused on harm reduction and prevention
  • reduce harm
  • control substances, alcohol, and drugs.
  • promote education, prevention, and health promotion.
52
Q

National Anti-Drug Strategy

A
  • 2007

- aim to reduce supply and demand

53
Q

Bill C8

A
  • 1996
  • The Controlled Drugs and Substances Act
  • regulations for anything imported, exported, produced, sold, provided or possessed in Canada.
  • prescription drugs from a doctor only and no sharing
  • convictions for trafficking, possession, export, import, or trade.
  • responsible for sentencing, drug paraphernalia laws, regulations on sales of alcohol/tobacco, impaired driving, and diversion to treatment
54
Q

Bill S-10

A
  • Safe street and communities act
  • ended in 2013
  • Stephen Harper
  • mandatory prison time, jail sentences for marijuana, sentencing for aggravating factor
    Impacts
  • target marginalized groups
  • more punishment than protection.
55
Q

Pharmaceutical Regulation in Canada - Federal level

A
  • regulated by Health Canada
  • Health Products and Food Branch (HPFB)
    includes
  • human and animal drugs
  • medical devices
  • NHPs
  • other therapeutic products

New Drug Submission process

56
Q

New Drug Submission Process

A
  • Clinical trials and scientific evidence have to show results for safety, efficacy, and quality
  • File a New Drug Submission (NDS) with HPFB
  • releasing a generic brand? - must show comparable bioavailability
  • any changes to a drug must submit a new NDS
57
Q

Successful submission of a New Drug Submission?

A
  • Notice of Compliance (CIN)

- Eight digit drug identification Number (DIN)

58
Q

Pharmaceutical regulations in Canada - Provincial

A
  • drug benefits
  • assess drug or medical device eligibility for inclusion in drug formularies
  • manage drug formularies
  • assess whether a brand-name & it’s generic competitor are interchangeable.
59
Q

3 phases of clinical research for a new drug

A

1 - low dose. 20-80 health volunteers
2 - 200 patients who could benefit
3 - 1000-5000 patients.

60
Q

Marijuana Medical Access Regulations (MMAR)

A
  • 2001
  • Through health Canada (Federal)
  • allows possession and production of marijuana for individual use

Who could apply?

  • Compassionate end of life / symptoms associated with specified medical conditions
  • Debilitating symptoms.
61
Q

Marijuana for Medical Purpose Regulations (MMPR)

A
  • 2014
  • Through provincial health care - pharmacist, doctor, health care practitioner.
  • individuals aren’t licensed to produce marijuana anymore, only licensed producers.
62
Q

Complaints leading from MMAR -> MMPR?

A
  • application process
  • single strain
  • potential for diversion to illicit markets (feds can’t monitor it as closely)
  • risk of violence and home invasions
  • fire hazards
63
Q

Benefits of switching from MMAR -> MMPR

A
  • more efficient
  • more authorized practitioners that can allow access.
  • more straings and suppliers
  • quality-controlled
64
Q

NHP regulation in Canada

A

Natural Health Products Directorate (NHPD) - regulatory authority

65
Q

What is a NHP?

A
  • vitamins & minerals
  • herbal remedies
  • homeopathic medicines
  • tradition medicines (Chinese, Ayurvedic)
  • probiotics
  • amino aicds
  • essential fatty acids
66
Q

Why have NHPs become so popular?

A
  • interest in foods that can be used as prevention and treatment
  • growing belief that NHPs are better than chemical drugs
  • aggressive multi-level marketing organizations distributing NHPs
67
Q

Health Canada Concerns with NHPs

A
  • NHPs are classified as food, not drugs
  • evidence for safety, but not efficacy
  • exempt from providing contraindications, side effects, etc.
68
Q

Aggravating factor

A

anything involving youth

69
Q

drug

A

any substance “manufactured, sold, or represented for use in the diagnosis, treatment, mitigation or prevention of a disease, disorder or abnormal physical state, or its symptoms, in human beings or animals

70
Q

food

A

any article manufactured, sold, or represented for use as a food or drink for humans.

71
Q

NHP

A

a variety of substances that are formulated, packaged, and/or promoted in a manner similar to drugs but were classified and regulated as foods.

72
Q

Homeostasis

A

a state of equilibrium - temperature, acidity, water, sodium, glucose, physical/chemical factors

73
Q

Properties of Glial cells

A
  • brain structure and support
  • bring nutrients and eliminate waste
  • form myelin
  • BBB
  • communication

Types

  • astrocytes
  • microglia
  • oligodendrocytes
74
Q

Properties of Neurons

A 
analyze and transmit information
regions
- dendrite
- body
- axon
- presynaptic terminal
75
Q

Steps of an Action Potential (AP)

A 
1 - resting period
- K open, Na closed
2 - threshold
- Na opens
- ion influx - depolarization
3 - overshoot
- voltage-gated Na channels open
- continued influx and depolarization 
4 - undershoot
- inactivation of Na, K open 
- ion eflux - repolarization & hyperpolarization
76
Q

Dopamine

A
  • ganglia
  • reward, pleasure, motor function, compulsions
  • nigrostriatal pathway - muscle rigidity
  • mesolimbic pathway - psychotic behaviour, potential reward pathway involvement.
77
Q

Acetylcholine

A
  • cerebral cortex and basal ganglia
  • learning and memory
  • Alzheimers
  • Rhodiola Rosea - inhibits Ach esterase & improves memory.
78
Q

Norepinephrine

A

arousal, attentiveness, wakefulness, food intake, body weight

79
Q

Serotonin

A
  • brain stem (raphe nuclei)

- mood, memory processing, sleep, cognition, impulsivity, aggression, depression, control of food & alcohol intake

80
Q

Drugs that target Serotonin Pathways

A
  • LSD/Hallucinogens
  • Sibutamine - diet drug - SNRi
  • SSRIs - depression drug
81
Q

GABA

A
  • inhibitory
  • found everywhere
  • sedative drugs target GABA pathways
82
Q

Glutamate

A
  • excitatory
  • found everywhere
  • euphoric effects of cocaine associated.
83
Q

Endorphins

A
  • opioid-like chemicals naturally occuring in the brain
  • pain relief
  • plays a role in drug abuse and dependence but it isn’t understood well.
84
Q

Life Cycle of an NT

A
  • NT precursor circulates in blood
  • uptake of precursor
  • synthesis of NT in cell
  • storage in a vesicle
  • AP = release of vesicle
  • NT binds to receptor on postsynaptic terminal (excitatory or inhibitory effect)
  • re-uptake or metabolism
85
Q

Brain imaging techniques

A
  • PET scan

- MRI

86
Q

Major Drug Categories

A
  • Stimulants
  • Depressants
  • Opioids/Narcotics/Analgesics
  • Hallucinogens
  • Psychotherapeutics
87
Q

dose-response relationship

A

determines how much of a drug causes a particular effect in the body.

88
Q

effective dose (ED)

A

the dose of a drug that produces a meaningful effect in some percentage of the test subjects

89
Q

ED50

A

the effective dose for half the subjects of a drug test

90
Q

Lethal Dose (LD)

A

the dose of a drug that has a lethal effect in some percentage of test subjects

91
Q

LD50

A

the lethal dose for half the subjects in a drug test.

92
Q

Therapeutic Index

A

LD50 / ED50
> 1
* always want LD50 to be higher than ED50.

93
Q

drug effects

A

behavioural, cognitive, and emotional changes produced following drug action

94
Q

nonspecific effects

A

derived from the user’s unique background, expectations, perceptions, adn environment.
- subjective

95
Q

specific effects

A

depend on the presence of a chemical at certain concentrations
- objective

96
Q

placebo effect

A

effects produced by an inactive chemical that the user believes to be a drug.
- used in addiction treatment

97
Q

therapeutic effects

A

the intended, desired effects of a drug

98
Q

side effects

A

the unintended effects that accompany therapeutic effects

99
Q

potency

A

measured by the amount of a drug required to produce a given effect.
- only refers to relative effective dose (ED)

100
Q

toxicity

A

capacity of a drug to do damage or cause adverse effects

101
Q

safety margin

A

lowest dose that produces the desired therapeutic effect.

102
Q

Pharmacokinetic factors of drug action

A

A - absorption
D - distribution
M - metabolism
E - excretion

103
Q

routes of arministration

A
  • oral
  • inhalation
  • intravenous injection
  • intramuscular injection
  • subcutaneous injection
  • topical application
104
Q

Blood Brain Barrier

A
  • only small lipophilic molecules can pass through
  • structural barrier by glial cells
  • active transport required
  • trauma and infection can disrupt the Blood Brain Barrier
105
Q

Types of tolerance

A
  • drug disposition/pharmacikinetic tolerance - increased metabolism reduces effect of the subsequent dose
  • behavioural tolerance - same biochemical effect with reduced behavioural effect as the individual learns to compensate for nervous system impairment
  • pharmacodynamic tolerance - sensitivity of neurons changes

HPRO 2255 (1 decks)

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