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PHAR 100 > Module 3 - section 3 + 4 > Flashcards

Module 3 - section 3 + 4 Flashcards

1
Q

what is cannabis

A

a drug containing forms of the hemp plant cannabis sativa

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2
Q

chemical compounds in cannabis

A

there are 60 chemicals compounds in it, called cannabinoids

THC is the most potent psychoactive agent in cannabis, accounting for most psychoactive effects

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3
Q

HISTORY - SEE IF NEEDED

A
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4
Q

classification of cannabis (list)

A

can be classified pharmacologically and legally

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5
Q

pharmacological classification of cannabis

A

its a CNS depressant, euphoriant and hallucinogen (hallucinogen only at high doses)

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6
Q

legalization of cannabis

A

October 17th 2018, in canada

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7
Q

administration of cannabis

A

dried flowering plant typically smoked or inhaled

extracts with concentrated amounts of cannabinoids typically in oil can be administered by vaping or through oral consumption

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8
Q

mechanisms of action of cannabis

A

THC binds to receptors in the brain and spinal cord called type 1 cannabinoid receptors

causes activation of receptors which inhibits the release of excitatory neurotransmitters (glutamte) into the synaptic cleft

leads to depression of the CNS and reduction of cognitive functions

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9
Q

what is anandamide

A

it is an endogenous cannabinoid that is a retrograde transmitter

released from post synaptic neuron and influences presynaptic neuron

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10
Q

anandamide mechanism of action process

A

released from post synaptic neuron

diffuses across synaptic cleft

bind to type 1 cannabinoid receptors

activates and inhibits the release of excitatory neurotransmitters into the synaptic clef

causes depression of the CNS

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11
Q

types of cannabinoid receptors (list + location)

A
  • CB1, brain - cerebral cortex and hippocampus
  • CB2, outside CNS - lymphocytes
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12
Q

CB1 receptors in the cerebral cortex

A

cerebral cortex ones mediate distortion of time, colour, sound and taste

decrease cognitive function and concentration

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13
Q

CB1 receptors in the hippocampus

A

account for changes in memory and learning

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14
Q

CB1 receptors in the brain stem

A

none are present in the brain stem so cannot depress respiration

explains relative non lethality of the drug

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15
Q

CB2 receptors

A

not involved in psychoactive effects but may be involved in inflammation

binding of receptors on lymphocytes responsible for immunosuppressive properties

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16
Q

absorption of THC

A

inhaled - rapid and actions almost immediate
- lasts 3-4 hours

ingested - slowly and incomplete, action is delayed 30-60 mins
- effect is less than smoking

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17
Q

distribution of THC

A

inhalation - rapidly distributed through body especially to tissues with high blood perfusion
- lungs, heart, brain, liver

rapidly crosses placenta

slower for oral administration

lipid soluble so stored in adipose tissues

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18
Q

metabolism of THC

A

slowly metabolized

can be measured in drug tests weeks after

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19
Q

excretion of TBH

A

half life of 30 hours

elimination of THC in adipose tissue takes longer

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20
Q

systems effected by short term cannabic use (list)

A
  • CNS
  • cardiovasular
  • GI track
  • reproductive
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21
Q

short term effects of cannabis on CNS

A

causes
- relaxation and drowsiness
- feeling of wellbeing and euphoria
- impaired motor coordination
- increase appetites

dose increased causes pseudo hallucinations, mixed senses, impaired judgement/coordination and in some cases toxic psychotic reaction

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22
Q

short term effects of cannabis on cardiovasular system

A

causes
- increased heart rate
- increase blood flor to extremities
- postural hypotension (may)

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23
Q

short term effects of cannabis on GI track

A

causes
- increase appetite
- dryness of mouth and throat

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24
Q

short term effects of cannabis on reproductive system

A

reduction of sex drive in males
- THC reduce testosterone levels

disruption of ovarian cycle in females

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25
other short term effects of cannabis
can cause hangover similar to alcohol when worn off
26
long term effect of cannabis use (list)
- psychological - cardiovascular - respirator - fertility
27
psychological effect of long term cannabis use
occasional low dose: not harmful high dose: (amotivational syndrome), disappear with cessation - loss of short term memory - lack of concentration - loss of ability in abstract thinking - loss of ambition - emotional flatness permanent effects: unknown, structural changes to brain associated with impairment of memory and learning
28
effect of long term cannabis use on the cardiovascular system
effects usually reversible changes in blood pressure are not serious, unless an individual has heart disease
29
effect of long term cannabis use on respiratory system
causes: (addictive with the simultaneous use of tobacco) - bronchitis - asthma - sore throat - chronic irritation of and damage to membrane of the respiratory track high concentration of tars and carcinogenic absorbed - increases lung cancer - increase chronic obstructive pulmonary disease
30
effect of long term cannabis use on the reproductive system
males - decrease sperm count females - cause follicle stimulating hormone luteinizing hormones reduces - cycles occur without ovulation during pregnancy, THC crosses placenta causing developmental delays - leads to cognitive defects, impulsiveness/inattention and hyperactivity difficult to distinguish effects of THC to, concurrent drug use, diet and poor prenatal care
31
medical use of cannabis
not an approved therapeutic product in canada used to relieve symptoms that have no responded to conventional medical treatment - prevention of nausea/vomiting associated with anticancer drugs THC derivative used more
32
potential misuse and SUD of cannabis
low to moderate as euphoria and reinforcement are less compared to other drugs also inherent harmfulness is low
33
tolerance of cannabis
occurs to - psychoactive properties of THC - effects on cardiovascular system - impairment of performance and cognitive function
34
withdrawal of cannabis
mid symptoms occurs - sleep disturbances - irritability - loss of appetite - nervousness - mild agitation - upset stomach - sweating
35
addiction of cannabis
persistent craving for cannabis risk of addiction higher for ppl using it to control psychological stress
36
what are opioids
class of drugs naturally found within the opium poppy plant it is any natural or synthetic substance that exerts action of the body through binding to the opioid receptors
37
classes of opioids (list)
- endogenous opioids - natural opioids - semi syntehtic opioids - synthetic opiods
38
endogenous opioids
not administered drugs made in the body and binds to opioid receptors, exerting analgesic effects effects perception of pain, emotional response to pain, mood and are associated with reward pathways in the brain
39
three families of endogenous opioids
- enkephalins - dynorphins - beta-endorphins
40
natural opioids
not made by human body, derived by opium poppy plant morphine and codeine
41
morphine - natural opioids
binds directly to opioid receptors used to treat severe acute and chronic pain and causes euphoria
42
codeine - natural opioids
converted into morphine in the body by liver enzymes morphine is more potent than codeine
43
semi synthetic opioids
slightly altered version of morphine that have different pharmacological properties
44
types of semi synthetic opioids
hydromorphone - used for analgesia - five times more potent than morphine diacetylmorphine (heroin) - used in injectable opioid agonist therapy to manage OUD - two to five time more potent that morphine - synthesized for illicit use (illegal)
45
synthetic opioids
not derived by morphine but chemically synthesized to bind to opioid receptors
46
types of synthetic opioids (list)
- fentanyl and related compounds - loperamide - methadone
47
fentanyl and related compounds
100 times more potent that morphine treat severe acute and chronic pain illegal synthesis and use contribute to the OUD crisis
48
loperamide
over the counter drug helps with the opioid side effect of constipation and treats diarrhea very little enters and remains in circulation but stays in the intestine or is quickly metabolized does not cause analgesia or euphoria
49
methadone
used for analgesia and treatment of OUS prevents withdrawal symptoms but doesn't cause euphoria
50
opioid receptors and type (list)
found in CNS and PNS as well as GI track (responsible for constipation caused by opioids) types: - mu - kappa - delta
51
mu receptors
present in all structures of the brain and spinal cord mediate analgesia, responsible for morphine mediates depression of respiration in the brain stem involved in compulsive misuse
52
kappa receptors
involved in analgesia, dysphoria and miosis (pinpoint pupils)
53
delta receptors
involved in analgesia at level of the spinal cord and brain modulate emotional response to opioids
54
mechanisms of action of opioids
block pain pathway in spinal cord and brain effect primarily through the activation of the mu opioid receptor reduces neurotransmitter release from the presynaptic neurons and reduces the effect on the postsynaptic neurons reduces emotional reaction to pain through modulation of the limbic system
55
short term effects of opioids (list - 8)
- analgesia - sedation and hypnosis - suppression of cough centre - respiratory depression - endocrine effects - miosis - heart rate and thermoregulation - decreases intestinal motility
56
opioid - analgesia
produce analgesia and indifference to pain, reducing intensity and perception/reaction to pain no limit to intensity of pain relieved - respiratory depression limiting factor
57
opioid - sedation and hypnosis
produce sedation and hypnosis but not as intense as CNS depressant causes arousal but at the same time a drowsy, dreamy, mild dozing state all opioid analgesics produce sedation
58
opioid - suppression of cough centre
causes relief or prevention of cough through suppression of cough centre in the medulla
59
opioid - respiratory depression
suppresses the respiratory centre in the brain stem - response to respiratory drive by CO2 lessened receptors: mu and delta main cause of death in overdose
60
opioids - endocrine effects
reduce the release of hormones responsible for regulating the release of sex hormones from the hypothalamus reductions in production of testosterone, estrogens and progesterones drop in libido (sex drive) in men
61
opioid - miosis
access to CNS causes contraction of pupils in the eyes (pinpoint)
62
opioid - heart rate and thermoregulation
high dose - irregular heart rate, body temp low and skin is cold and clammy
63
opioid - decreased intestinal motility
experience constipation as adverse effect
64
opioid long term use
no physiological deterioration or psychological impairment associated with long term use
65
therapeutic uses of opioids (list)
- relief of severe pain - treatment of diarrhea - cough suppression
66
opioids - relief of severe pain
used as an analgesia mitigate post surgical pain and pain experienced by some terminally ill patients
67
opioids - treatment of diarrhea
loperamide (over the counter opioid) controls diarrhea - not an analgesic - doesn't produce withdrawal
68
opioids - cough suppression
all opioids can be used as a cough suppressant - better alternatives with lower misuse potential avaliable
69
opioid misuse potential
very powerful euphoric effects so large risk for misuse
70
inherent harmfulness of opioids
low-moderate doses: - not very high for morphine high doses: - life threatening - illicit opioids at higher risk, as actual dose may be unknown and a lethal dose may be administered
71
opioid risks of injections
higher risk of developing abscesses at site of administration and other infections contaminated needles lead to risk of pathogens
72
opioid overdose
produce respiratory depression > lead to death
73
treatment of opioid overdose
consists of opioid antagonists to support respiration and other vital functions
74
opioid antagonists
naloxone primarily used naltrexone also used
75
tolerance of opioids
tolerance occurs to pharmacological effects except constriction of pupils and constipation develops more slowly to respiratory depression than the analgesic effects tolerance reverses upon discontinuation
76
opioid cross tolerance
occurs between all opioids analgesics, if they act on same receptor tolerance to morphine have tolerance to methadone
77
opioid withdrawal
can occur after discontinuation - not life threatening symptoms, severity and duration determined by particular drug, chronicity and pattern use, typical daily dose, route of administration and whether there is concurrent use of the drug includes: - restlessness, anxiety, insomnia - sweating, fever, chills, increased respiratory rate - cramping, retching and vomiting - diarrhea
78
opioid addiction
craving and compulsion can develop addiction is due to euphoric action use of opioids with other psychoactive drugs (cocaine) can occur to achieve greater euphoria
79
opioid use during pregnancy
opioid dependency increases risk of premature delivery and low birth weight at birth the infant gets ubrupt termination of opioid exposure - result in withdrawal - may last weeks to months
80
treatment of OUD
- psychosocial support - counselling - treatment of concurrent physical and mental health issues
81
buprenorphine opioid treatment
buprenorphine is a long acting synthetic opioid that binds to mu receptors provides enough opioid agonist activity to prevent withdrawal symptoms has decreased euphoria and sedation
82
buprenorphine + naloxone treatment
in combined treatment naloxone blocks opioid receptor that causes withdrawal symptoms cant be oral/sublingually because naloxone gets broken down before entering circulation
83
methadone opioid treatment
synthetic opioid effective following oral administration - taken orally, removes potential risks of injection has long duration of action - taken less often, lowers misuse potential misuse potential must lower oral administration leads to slower pharmacological effects and less euphoria

PHAR 100 (4 decks)

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