pathophysiology of substance use disorder (Barker) Flashcards
controlled substance act - drug classification
schedule I: no medical use, high abuse potential. Safety not guaranteed
- heroin, ___ , THC, ___ , GHB, psilocybin, MDMA
schedule II: medical use, high abuse potential, large risk of dependence
- morphine, fentanyl, ___ , ritalin, ___ , barbiturates, oxycodone, hydromorphone, Vicodin, Percocet, nabilone (synthetic cannabinoid)
schedule III: medical use, moderate abuse and dependence
- ketamine, buprenorphine, ___ (THC in oil capsule)
schedule IV: medical use, low abuse and dependence
- ___
schedule V: lower risk relative to IV
- cough suppressants with small amount of ___
- lomotil
- marijuana, LSD
- cocaine, PCP
- marinol
- BZDs
- codeine
substances of abuse that act directly on G protein-coupled receptors
opioids (heroin, prescription meds)
- opioid receptors ( ___ )
LSD, mushrooms (psilocybin, psilocin)
- ___ receptor (5HT2A, 5HT2C)
marijuana, K2, spice
- ___ receptors (CB1)
Gamma Hydroxy Butyric acid
- GABA ___
Caffeine
- ___ receptors
- mu
- serotonin
- cannabinoid
- B
- adenosine
substances that act indirectly on G protein-coupled receptors
cocaine, amphetamine
- dopamine ___ (dopamine receptors)
- noradrenaline, serotonin transporters
- release dopamine, noradrenaline, serotonin → GPCRs
MDMA/ecstasy
- monamine transporters: ___ and ___
EtOH
- ___ channels, 5HT3, NMDAR, nAchR, KiR3
- causes release of endogenous ___
- → GPCRs
- transporter
- dopamine, serotonin
- GABA
- opioids
substances of abuse that act on ion channels
nicotine
- ionotropic ___ receptors (Naa)
- ___
PCP, ketamine
- ionotropic ___ receptor (Ca, Na, K)
- ___
BZDs, barbiturates
- ionotropic GABA __ receptors (Cl)
- ___ allosteric modulators
- acetylcholine
- agonist
- NDMA
- antagonist
- GABA A
- positive
- nucleus accumbens - ___ valuation
- frontal cortex - ___ making impulsivity
- striatum - reward/value
- hippocampus - ___ learning
- VTA - source of ___
- pleasure
- decision
- memory
- dopamine
T or F: stimulants, depressants and psychedelics all act on the mesolimbic system
True
the dopamine hypothesis of addiction
- ___ events release dopamine
- parkinson patients only develop addiction during ___
- dopamine important for assigning value to ___ prediction error
- value provides the drug with an ___ salience
- salience = state or quality of an item that ___ relative to neighboring items
- pleasurable
- treatment
- reward
- incentive
- stand out
limits of dopamine hypothesis
dopamine not required for reward learning
- dissociation between ___ (direct effect) and ___ (motivation)
- “you don’t always like what you want”
- ___ to pleasurable effect (decrease liking) enhancing craving
- dopamine dose not encode liking but involved in making reward ___ and learning from the outcome error
- liking, wanting
- tolerance
- predictions
glutamate hypothesis
glutamate can increase ___ activity in NAcc
- glutamte projection to ___
- destruction of this pathway reduces cocaine/morphine ___
- mGluR5 KO mice show reduced cocaine ___
- ___ antagonist blocks aquisition of reinforcement learning
- intra NAcc AMPA (glutamate agonist) injection causes relapse
- dopamine controls glutamte activity in ___
dopamine
- VTA
- reward
- reward
- NMDA
- amygdala
drug use induces long term changes in neuronal plasticity
LTP = long term potentiation
- persistent increase in synaptic ___ following intense ___
- rewarding substances cause relative ___ in glutamatergic AMPA receptors
- strength, stimulation
- increase
persistent memory of addiction
- drug abuse (green line) followed by ___ (red line)
- formation of Drug/cue ___ (dotten green line)
- formation of ___ abstinence memory (striped red line)
- ___ to assist abstinence (dotted blue line)
- abstinence
- memory
- competing
- CBT
drug abuse versus misuse
drug abuse - the use of a drug for a ___ effect
drug misuse - ___, illegal, or ___ use of prescription or nonprescription drug
- taking more / more frequently then prescribed
- taking it for a different indication
- taking someone else’s medication
- nontherapeutic
- inappropriate, excessive
substance use disorder criteria
mild __ - __ , moderate __ - __ , or severe ( > __ )
2-3, 4-5, 6
physical verus psychological dependence
physcial
body needs more drug - ___
- cellular adaptations upon repeated activation of receptors
- body ___ without the drug
tolerance
withdraws
physical verus psychological dependence
psychological dependence (addiction)
- mental urge to take drug to ___
- compulsive need/craving
- even in absence of ___
function
withdrawal
drug reward and its relation to positive and negative reinforcement
drug is “rewarding” or produces ___ reinforcement when the user feels pleasure/satisfaction
- of value, strengthen behavior to repeat
- just liking isn’t enough
___ reinforcement: reward by escaping negative/painful stimulus or event (NOT same as punishment)
- avoiding withdrawal
positive
negative
