Neurology class 3 Flashcards

1
Q

psychological dependence

A

caused by decreased activity in the ventromedial prefrontal cortex which leads to decreased impulse control

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2
Q

opioids, ketamine, PCP, mushrooms, DMT, benzodiazepines

A

‘downers’

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3
Q

cannabinoids, alcohol, nicotine

A

‘mixed’

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4
Q

CNS stimulants, psychoactive stimulants

A

‘uppers’

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5
Q

altered mood, relaxation (euphoria), uninhibited behaviour

A

desired effect of downers

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6
Q

modulate serotonin, increase dopamine, inhibit substance P, decrease glutamate, inhibit ion channel transport

A

dynamics of downers

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7
Q

opioid dynamics

A

inhibition of substance P produces analgesia and the more drug there is the more dopamine (reward pathway) is released
- decreased neuronal excitation which causes CNS depression

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8
Q

most potent opioid

A

fentanyl

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9
Q

least potent opioid

A

codeine

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10
Q

what to monitor for patients on opioids

A
  • orthostatic hypotension due to peripheral vasodilation
  • itching due to mast cell stimulation and histamine release
  • nausea due to substance P binding
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11
Q

fentanyl

A

‘downer’
extremely potent and commonly laced into other drugs

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12
Q

Heroin

A

‘downer’
highly lipophilic and crosses the BBB quickly
- commonly combined with fentanyl and if so then it is poison

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13
Q

ketamine

A

dissociative anesthetic; ‘downer’
- potent, high sedation, causes amnesia, and respiratory depression
- known as date rape drug

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14
Q

PCP

A

derivative of ketamine; ‘downer’
- originally developed for anesthesia
- goes from excitation to sedation but depends on dosage

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15
Q

mushrooms

A

hallucinogenic; ‘downer’; increases GABA and decreases glutamate
- low potency and low addiction

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16
Q

DMT (dimenthyltryptamine)

A

‘downer’

17
Q

altered mood, relaxation, un-inhibition of behaviour

A

desired effects of mixed drugs

18
Q

addiction

A

negative neuroplasticity in the brain

19
Q

vape

A
  • safety testing based on ingestion not inhalation
  • aerosols more toxic when heated
  • formaldehyde, glycidol, acetol
20
Q

nabilone, dronabinol

A

cannabinoids

21
Q

CB1

A

target CNS

22
Q

CB2

A

target PNS

23
Q
  • modulate serotonin which deals with mood alterations
  • increased anandamide which results in memory loss
  • stimulate dopamine release
A

CB1 and CB2 receptors

24
Q

competition of these cannabinoids at receptors to create a balance

A

CBD and THC

25
antagonizes adrenergic NS producing a "calming" effect
high CBD
26
modulates adrenergic NS producing alertness, focus, and agitation along with VS changes and hallucinations
high THC
27
binds nicotinic receptors (cholinomimetic and adrenergic) - vasoconstriction, decreased GI motility - stimulates dopamine release - lipophilic - oxidizes lipoproteins causing plaque formation in atherosclerosis
nicotine
28
increase in Ach and serotonin --> stimulation of dopamine --> increase in GABA --> decrease in glutamate
effects of alcohol (in order)
29
- absorbed via gastric mucosa - crosses BBB - hepatic metabolism (uses vitamin B) - zero order kinetics - withdrawal syndrome 'delirium Tremens'
alcohol
30
metadoxine
accelerates the removal or clearance of alcohol by enhancing metabolism to inactive metabolites
31
altered mood, excitation (euphoria), uninhibited behaviour - increases norepi, serotonin, dopamine
'uppers' abuse desired effect
32
hallucinogenic, psychedelic, altered reality, visual alterations
stimulant abuse desired effect
33
sympathomimetics, amphetamines
stimulants
34
cocaine, crystal meth
stimulants
35
cocaethylene
cocaine and alcohol
36
amphetamine-type, hallucinogenics
psychoactive stimulants
37
LSD (acid), ecstasy (MDMA)
psychoactive stimulants