[PHARM] Alcohol, Caffeine, Drugs of Abuse [Iszard] Flashcards
What is abstinence syndrome?
The signs and symptoms that occur on withdrawal of a drug in a dependent person
What is a controlled substance?
A drug deemed to have abuse liability that is listed on governmental schedules of controlled substances
What is a designer drug?
A synthetic derivative of a drug, with slightly modified structure
What is tolerance?
A decreased response to a drug, necessitating larger doses to acheive the same effect
What is sensitization?
An increase in response with repetition of the same dose of the drug
What is withdrawal?
Adaptive changes that become fully apparent once drug exposure is terminated
Withdrawal is the evidence of physical dependence
What is the criteria for a schedule I drug?
Some examples?
No medical use; high addition potential
Heroin, LSD, PCP, MDA, MDMA
What is the criteria for a schedule II drug?
Some examples?
Medical use; high addition potential
Amphetamines, cocaine, methylphenidate, short acting barbiturates, strong opiods
What is the criteria for a schedule III drug?
Some examples?
Medical use; moderate abuse potential
Anabolic steroids, barbiturates, dronabinol, ketamine
What is the criteria for a schedule IV drug?
Some examples?
Medical use; low abuse potential
Benzodiazepines, chloral hydrate, mild stimulants, most hypnotics, weak opioids
What are commonly abused prescription painkillers? (3)
Fentanyl
Hydrocodone
Oxycodone
What are commonly abused prescription depressants? (3)
Alprazolam
Zolpidem
Zaleplon
What are commonly abused prescription stimulants? (2)
Adderal
Methylphenidate
What are the overdose effects of [Amphetamines, methylphenidate & cocaine]?
Agitation
HTN
Tachycardia
Delusions
Hallucinations
Hyperthermia
Seizures
Death
What are the overdose effects of [Barbiturates, Benzodiazepines, Ethanol]?
Slurred speech
Drunken behavior
Dilated pupils
Weak and rapid pulse
Clammy skin
Shallow respiration
Coma
Death
What are the withdrawal symptoms of [Barbiturates, benzodiazepines, ethanol]?
Anxiety
Insomnia
Delirium
Tremors
Seizures
Death
What are the overdose effects from [Heroin and other strong opioids]?
Constricted pupils
Clammy skin
Nausea
Drowsiness
Respiratory depression
Coma
Death
What drugs do you use to treat opioid dependence/addiction? (4)
Opioid receptor Antagonists: Naloxone (Narcan) & Naltrexone
Synthetic opioid: Methadone
Partial mu-opioid receptor agonist: Buprenophrine
What drugs do you use to treat smoking dependence/addiction? (1)
Nicotinic receptor partial agonist”: Varenicline (Chantix)
What are two drugs you can give to alleviate benzodiazepine dependence/addiction?
Oxazepam
Lorazepam
What is the one NMDA receptor antagonist used to reduce desire to drink alcohol?
Acamprosate
What are examples of drugs that are abused but aren’t necessarily addictive?
LSD
Mescaline
Psiolcybin
Phencyclidine
Ketamine
What are the potential long term effects of abusing drugs like (LSD, ketamine, PCP)?
Irreversible schizophrenia-like psychosis
Flashbacks of altered perception years after consumption
What is caffeine most commonly used for?
Improve mental alertness
What can caffeine be used to treat?
Migraine headaches
Asthma
ADHD
Memory
What is a “drink”?
0.6 ounces
What is a “drink” for the following?
Beer
Liquor
Wine
Beer = 12 oz
Liquor = 8 oz
Wine = 5 oz
How long does 1 oz of alcohol take to metabolize?
1 ounce takes 1 hour to metabolize
Describe the metabolism of alcohol
Alcohol –(alcohol dehydrogenase)–> Acetaldehyde –(acetaldehyde dehydrogenase)–> Acetic acid –> Oxygen –> CO2
Ethanol undergoes ____________ metabolism
Ethanol undergoes 1st pass metabolism
What are the major considerations a physician should make for acute alcohol intoxication?
Monitor respiratory depression
Monitor aspiration of vomitus
Glucose can treat metabolic alterations (hypoglycemia/ketosis)
Thiamine to protect against Wernicke-Korsakoff syndrome
What is the presentation of wernicke-korsakoff syndrome?
Double vision
Drooping upper eyelid
Loss of muscle coordination
What are the (4) drugs used for the treatment of acute alcohol withdrawal syndrome?
Diazpam (Valium)
Lorazepam (Ativan)
Oxazepam
Thiamine (vitamin B1)
What are (3) drugs used for the prevention of alcohol abuse?
Acamprosate
Disulfiram
Naltrexone
What are (2) drugs used for the treatment of acute methanol or ethylene glycol poisoning?
Ethanol
Fomepizole
Naltrexone
Indication?
MOA?
Treatment of alcohol and opiate dependence
Mu opioid receptor antagonist (long acting)
Acamprosate
Indication?
MOA?
Reduces relapse rates during alcohol/opioid rehabilitation
Weak NMDA receptor antagonist and GABA(A) receptor agonist
Disulfiram
Indication?
MOA?
Treatment of alcohol dependence
Irreversibly inhibits aldehyde dehydrogenase and causes extreme discomfort in patients who drink alcoholic beverages (flushing, throbbing headache, N/V, sweating, hypotension)
