Other Psychoactive Drugs Flashcards
A person will experience nausea, shortness of breath, and other unpleasant symptoms when he drinks alcohol after taking ____?
disulfiram
As a treatment for anxiety, propranolol (Inderal) is more effective for ___(A)___ symptoms than ___(B)___ symptoms.
(A) somatic
(B) psychological
Benzodiazepines have a ___(A)___ half-life for older adults than for younger adults and, therefore, are often prescribed for older adults at a ___(B)___ dose than they are for younger adults.
(A) longer
(B) lower
Benzodiazepines and barbiturates enhance the effects of which of neurotransmitters?
GABA
Drugs used to slow down the progression of Alzheimer’s disease by delaying the breakdown of acetylcholine.
- galantamine
- rivastigmine
- donepezil
A potential side effect of carbamazepine is agranulocytosis, which is a(n) ______ disorder.
blood
Benzodiazepines
- (-pam)
- diazepam (Valium)
- alprazolam (Xanax)
- lorazepam (Ativan)
Effects of benzos on which neurotransmitter?
increase GABAnactivity
Most common side effects of benzos?
- drowsiness & sedation
Generic names of 3 benzos
1) diazepam (Valium)
2) alprazolam (Xanax)
3) lorazepam (Ativan)
Benzos increase activity of what neurotransmitter and are used to treat what disorders?
- GABA
- anxiety, insomnia, seizures, and alcohol withdrawal
Most common side effects of benzos
- drowsiness & sedations
- weakness & unsteadiness
- impaired memory & concentration
- anticholinergic effects
- sexual dysfunction
Side effects of benzos for older adults
- disorientation & confusion
Benzos can have a ___(A)___ effect and cause excitability and anxiety, and chronic use can result in ___(B)___, ___(C)___, and ___(D)___ symptoms which may cause rebound anxiety and depression, anorexia, delirium, and seizures.
(A) paradoxical
(B) tolerance
(C) dependence
(D) withdrawal symptoms
Discontinuation of benzos after long-term use requires ________, which prevents symptom reemergence and __________.
gradual tapering; severe withdrawal symptoms
Optimal tapering of benzos depends on what factors?
- dose
- half-life
- how long person has been taking benzo
Generic name for benzos with shorter half-life
- alprazolam (Xanax)
- lorazepam (Ativan)
Combining benzos with alcohol can have a ________ effect that can be lethal.
synergistic depressant
Combining a benzos with certain _________ can cause a dangerous drop in blood pressure.
high blood pressure medications (e.g., central agonists, alpha blockers)
Generic names for 3 barbiturates
1) thiopental (Pentothal)
2) amobarbital (Amytal)
3) secobarbital (Seconal)
Barbiturates enhance ______ activity and are used for anesthetic and treatment for what disorders?
- GABA activity
- anxiety, insomnia, and seizures.
Side effects of barbiturates
- drowsiness
- dizziness
- confusion
- ataxia
- cognitie impairment
- paradoxical excitement
Sudden withdrawal from barbiturates can cause what side effects?
- seizures, delirium, and death
Generic name for 1 azapirones
1) buspirone (BuSpar)
Disorders buspirone treats and side effects
- GAD and other anxiety disorders
- dizziness, dry mouth, sweating, nausea, & headache
What is an advantage of prescribing buspirone?
does NOT cause sedation, dependence, or tolerance
Narcotic-analgesics mimic the effects of the body’s natural analgesics, such as… ?
endorphins & enkephalins
Narcotic-analgesics include natural, synthetic, and semi-synthetic opioids. Give examples of each.
- Natural opioids: opium, morphine, heroin, codeine
- synthetic & semi-synthetic opioids: methadone, oxycodone, hydrocodone, & fentanyl
________ are used as a pre-surgery anesthetic and to treat pain, and ________ is used for heroin detoxification.
Narcotic-analgesics; methadone
Effects of methadone
reduces the craving for heroin & withdrawal symptoms
Side effects of narcotic-analgesics
- dry mouth
- nausea
- pupil constriction
- postural hypotension
- drowsiness & dizziness
- constipation
- respiratory depression
Outcomes of overdose on narcotic-analgesics
- convulsions, coma, death
Initial withdrawal symptoms of narcotic-analgesics
similar to fly
- runny nose, watery eyes, nausea, muscle aches, fever, yawning
Later stage withdrawal symptoms associated with chronic use of narcotic-analgesics
insomnia, abdominal cramps, vomiting, diarrhea, rapid heartbeat, elevated blood pressure
______ are the most frequent cause of accidental deaths in US
opioids
________ inhibit the activity of the sympathetic nervous system and are used to treat hypertension, cardiac arrhythmias, migraine headache, and essential tremor.
Beta-blockers
Generic name for 1 beta-blocker used to treat anxiety
propranolol (Inderal)
Research suggests that propranolol is more effective for alleviating ______ symptoms of anxiety.
somatic
side effects of propranolol
- hypotension
- decreased sex drive
- insomnia
- nausea & vomiting
- dry eyes
- dizziness
- depression
Abrupt discontinuation of propranolol can cause what rebound symptoms?
hypertension, tremors, headaches, confusion, and cardiac arrhythmia
The mood stabilizers are used to treat bipolar disorder and include _______ and _______ medications.
lithium; anticonvulsant
First-line drug for acute mania & classic bipolar disorder (euphoric mania without rapid cycling)
lithium (Eskalith, Lithobid)
Common side effects of lithium
- nausea
- vomiting
- diarrhea
- metallic taste
- increased thirst
- weight gain
- hand tremor
- fatigue
- impaired memory & concentration
Lithium levels must be regularly checked to avoid _________, which can cause seizures, coma, and death.
lithium toxicity
_________ drugs are used to treat acute mania and bipolar disorder with mixed episodes
Anticonvulsant
Generic names for 2 anticonvulsant drugs
- carbamazepine (Tegretol)
- valproic acid (Depakene)
Side effects of anticonvulsant drugs
- nausea
- dizziness
- sleepiness & lethargy
- ataxia
- tremor
- visual disturbances
- impaired concentration
Blood levels must be monitored to avoid liver failure when taking which anticonvulsant drugs?
valproic acid or carbamazepine
Blood levels must be monitored to avoid agranulocytosis (low white blood cell count) and aplastic anemia when taking which anticonvulsant drug?
carbamazepine
Drugs for treating _________ include cholinesterase inhibitors and an NMDA receptor antagonist
Alzheimer’s Disease
Cholinesterase inhibitors delay the breakdown of ________ associated with Alzheimer’s disease
acetylcholine
Generic names of 4 cholinesterase inhibitors used to treatte mild to modera Alzheimer’s
1) tacrine (Cognex)
2) donepezil (Aricept)
3) rivastigmine (Exelon)
4) galantamine (Razadyne)
Which cholinesterase inhibitor has been FDA-approved for treating severe Alzheimer’s?
donepezil (Aricept)
Which cholinesterase inhibitor is no longer commonly prescribed because of it’s risk for live failure?
tacrine (Cognex)
Generic name for 1 NMDA receptor antagonist
memantine (Namenda)
Memantine (Namenda) has been approved to treat _________ and is believed to exert its effects by regulating the activity of what neurotransmitter?
- moderate to severe Alzheimer’s
- glutamate
Generic names for meds used to treat ADHD
- methylphenidate (Ritalin, Concerta)
- pemoline (Cylert)
- amphetamine-dextroamphetamine (Adderall)
- lisdexamfetamine (Vyvanse)
Effects of solely using _______ for academic achievement associated with ADHD are unclear.
psychostimulants
Methylphenidate and other psychostimulants exert their therapeutic effects by increasing dopamine and norepinephrine activity in what brain area?
prefrontal cortex
Side effects of psychostimulants
- insomnia
- nervousness
- decreased appetite
- weight loss
- abdominal pain
Psychostimulants can suppress growth in children, but this can be reversed with _______ during school vacations.
drug holidays
some evidence suggests that when psychostimulants are used by people without ADHD, these drugs increase attention and positive mood but do not improve ________ and ______, and may have negative effects on _______ and ________.
- reading comprehension & fluency
- working memory & academic performance
Generic names for 3 second-line pharmacological treatments for ADHD
- atomoxetine (Strattera)
- guanfacine (Intuniv)
- clonidine (Kapvav)
Under what conditions are second-line meds for ADHD prescribed?
- inadequate response to psychostimulants
- unable to tolerate side effects of psychostimulants
- have significant comorbidities that interfere with treatment
- are at high risk for stimulant misuse
________ is a norepinephrine reuptake inhibitor and is the most commonly prescribed nonstimulant drug for ADHD.
Atomoxetine (Strattera)
Atomoxetine (Strattera) has been found to improve the core symptoms of ADHD and to be more effective than stimulants for patients with certain comorbidities, including what disorders?
tic, sleep, anxiety, or depression disorders
_____ and _____ are both alpha-2-adrenergic agonists that were developed as treatments for high blood pressure.
Guanfacine & clonidine
Guanfacine and clonidine improve the core symptoms of ADHD but are usually prescribed only when patients also have what disorder(s)?
Tourette’s & other tic disorders
Generic names for 2 antidepressants considered as third-line treatments for ADHD, which reduce symptoms of ADHD by increasing brain levels of which neurotransmitter(s)?
1) tricyclic desipramine (Norpramin)
2) bupropion (Wellbutrin)
- dopamine & norepinephrine
Generic names for 4 drugs used to treat Alcohol Use Disorder
1) disulfiram (Antabuse)
2) naltrexone (ReVia)
3) acamprosate (Campral)
4) topiramate (Topamax)
Medication for Substance Use Disorders: ________ causes nausea and vomiting, shortness of breath, tachycardia, a throbbing headache, dizziness, and other unpleasant symptoms when taken in conjunction with alcohol.
Disulfiram
________ reduces the pleasurable effects of and craving for alcohol, ________ just reduces craving.
Naltrexone; acamprosate
_______ is an anti-seizure medication that has not been approved by the FDA for treating alcohol use disorder but is used off-label to reduce cravings for alcohol and pleasurable effects of alcohol.
Topiramate
Generic names 3 for drugs used to treat tobacco use disorder
1) nicotine replacement therapy (NRT)
2) buoriorion
3) vareniciline
The use of _______ is based on the assumption that a stable low level of nicotine prevents the withdrawal symptoms that often trigger relapse when a person stops smoking.
nicotine replacement therapy (NRT)
__________ was originally used to treat major depressive disorder but has also been found to prevent relapse following smoking cessation by reducing nicotine craving and withdrawal symptoms.
Bupropion
________ reduces nicotine craving, and there’s evidence that it also reduces the rewarding effects of smoking.
Varenicline
No medication has been approved by the FDA for _______ use disorder, and the research has not provided strong support for the effectiveness of any particular drugs
cocaine
A recent meta-analysis on cocaine use disorder found that there is some evidence that what 5 drugs may be effective for increasing abstinence.
1) bupropion
2) topiramate
3) psychostimulants, includng modafinil, dextroamphetamine, & mixed amphetamine salts
THC exerts its psychoactive effects by stimulating the release of what neurotransmitter in what brain area?
dopamine; ventral striatum (nucleus accumbens)
the ventral striatum (nucleus accumbens) is an essential component of the brain’s ______?
mesolimbic dopaminergic reward pathway
Dronabinal oral solution (Syndros) contains THC and has been approved by the U.S. Food and Drug Administration for the treatment of what disorders/illnesses?
- anorexia nervosa
- weight loss associated with AIDS
- patients w/ cancer experiencing chemotherapy-induced nausea & vomiting
The U. S. Food and Drug Administration (FDA) has granted breakthrough therapy designations for what 2 psychedelic drugs?
1) LSD
2) psilocybin
LSD has been granted FDA breakthrough therapy designation to treat what disorder(s)?
generalized anxiety disorder
psilocybin has been granted FDA breakthrough therapy designation to treat what disorder(s)?
- MDD
- treatment resistent depression
Both LSD and psilocybin are ______ agonists, but LSD also increases the effects of _____, and psilocybin also alters _____ levels.
serotonin; dopamine; glutamate
The ______ of a drug is the time needed for the blood level of the drug to decrease to 50% of its peak level and is used to determine the time interval between doses. For drugs with a short half-life, the interval between doses is _______, and vice versa.
half-life; short
3 types of drugs that have a longer half-life for older (versus younger) adults due to age-related changes in the metabolism and elimination of these drugs.
1) anxiolytics
2) antipsychotics
3) antidepressants
Because of the increased half-life of many drugs for older adults and their greater sensitivity to the effects of these drugs, the rule of thumb when prescribing them for these individuals is to start at a _______ dose and gradually _______ the dose until the desired effects are obtained.
(“start low and go slow”)
- low; increase
The most commonly prescribed anxiolytics are the benzodiazepines, which are categorized as having either a short or long half-life. Benzos that have a long half-life are ordinarily eliminated from the body in ______ hours but, for older adults, elimination may take more than _____ hours
24; 72
_________ occurs when repeated use of a drug results in a gradual reduction in the drug’s effects, resulting in the need to increase the dose of the drug to produce the effect previously produced by a lower dose
Tolerance
_________ occurs when tolerance to one drug produces tolerance to other drugs in the same class.
Cross-tolerance
Alcohol is a _______ depressant, and tolerance to alcohol produces tolerance to ________ and ________.
central nervous system; benzodiazepines; barbiturates
The ________ is used to measure a drug’s safety.
therapeutic index (TI)
Most common way to calculate therapeutic index (TI) in animal studies?
divide LD50 by ED50 (LD50/ED50)
LD50 stands for ______ and indicates the _______ drug dose that had a _____ effect in 50% of the test sample.
lethal dose 50; minimum; lethal
A drug with a low LD50 is MORE or LESS lethal than a drug with a high LD50.
more
ED50 stands for ________ and is a measure of the drug’s ______ and indicates the minimum drug dose that produced the __________ in 50% of the test sample.
effective dose 50; effectiveness; therapeutic (desired) effect
In human studies, the most common way to calculate TI is to divide ________.
TD50 by ED50 (TD50/ED50)
TD50 stands for ______ and indicates the minimum drug dose that had a ______ effect in 50% of the test sample
toxic dose 50; toxic (harmful)
When a drug’s ED50 is the same as or higher than its LD50 or TD50, TI equals 1.0 or less, and the drug is said to have a ______ therapeutic window because the dodse that produces the desire therapeutic effect is equal to or hight than the dose that produces a lethal or toxic effect.
narrow
Drugs with a _______ therapeutic window are not very safe and require close monitoring
narrow
When ED50 is lower than LD50 or TD50, TI is larger than 1.0 and the drug is said to have a ______ therapeutic window because the dose that produces the desired therapeutic effect is lower than the dose that produces lethal or toxic effects.
wide
Drugs with a _____ therapeutic window are most desirable because they are safer.
wide
