Misc Flashcards
Nicotine
- first stimulate adrenal glands (epinephrine)
- increase DA in reward circuits
- biphasic effect
Tx:
bupropion (Wellbutrin)- DNRI
varencline (Chantix)- partial agonist of nicotine receptor
Cannabinoids (delta 9 THC)
increase HR
2-4 hr but lipid soluble so can accumulate in fat
lungs to blood to brain to CB1 cannabinoid receptors (affect mood, appetite, memory), linked to opioid effects
GHB
CNS depressant
- acts rapidly
- removes inhibitions, date rape
death from respiratory depression (sleep, coma, death)
-acts on GABA-B receptor and GHB binding site
Cocaine
DA, 5HT, NE transporter inhibitor
OD: psychosis, seizures, stroke, MI, sudden cardiac death
tx: support, no beta blockers
withdrawal not life threatening like alcohol
- acute crash (depression)
- craving return
- “abstinence syndrome” chronic (sadness)
Alcohol
- holds GABA receptors open longer, more Cl- in brain
- sensitizes NMDA in nucleus accumbens (easier to induce pleasure signals)
BAC .03 euphoria, motor .05 coordination .08-.1 mood, judgement, ataxia .2-.3 nystagmus, slurred speech >.3 anesthesia >.4 coma
withdrawal: increase NMDA
uncomplicated- postural tremor, N/V, autonomic hyperactivity
complicated- seizures, psychosis, delirium tremens
Dependence tx:
Disulfiram-averse
Naltrexone- block reward
Acamprosate- Glu receptor modulator
Amphetamine
increase DA, 5HT, NE release, block reuptake
high doses- MAO inhibitor
-similar physiology and withdrawal to coke but lasts longer
increased wakefulness, mood disturbance, violence
OD: support, no beta blockers (no FDA approved meds exist)
