Pharm: Drugs of Abuse Flashcards
What is Abstinence Syndrome?
S/S that occur on withdrawal of a drug in a dependent person
What is an addiction?
Compulsive drug-using behavior in which the person uses the drug for personal satisfaction, often in the face of known risks to health
What is a controlled substance?
drug deemed to have abuse potential that is listed on government schedules of controlled substances
What is dependency?
state characterized by s/s, frequently the opposite of those caused by a drug, when it is withdrawn from a chronic user or when the dose is lowered suddenly.
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 achieve the same effect
can be behavioral, metabolic, or functional
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 a physical dependencence
What is the criteria of a schedule I drug
What are some examples?
No medical use, high addiction potential
Flunitrazepam, Heroin, LSD, Mescaline, PCP, MDA, MDMA, STP
What is the criteria for schedule II drugs
What are some examples?
Medical use, high addiction potential
Amphetamines, cocaine, methylphenidate, short acting barbiturates, strong opioids
What is the criteria for Schedule III drugs
What are some examples?
Medical use, moderate abuse potential?
Anabolic steroids, barbiturates, dronabinol, ketamine, moderate opioid agonists
What is the criteria for Schedule IV drugs
What are some examples?
medical use, low abuse potential
Benzos, chloral hydrate, mild stimulants, most hypnotics, weak opioids
What is the duration of symptoms for ETOH?
What are some other sx?
Approx. 1hr per serving
odor on breath, slurred speech, lack of coordination
What is the duration of sx for tobacco?
What are some other sx?
20 min
odor on breath/clothes
stained fingers/teeth
What is the duration of sx for Marijuana?
What are some other sx?
2-4hrs
red eyes, odor, eyelid tremors, muscle tremors, increased appetite
What is the duration of sx for Inhalants?
What are some other sx?
5 min to 8hrs
jittery, talkative, runny nose or dry mouth
What is the duration of sx for depressants?
What are some other sx?
1-16hrs
disordiented, drowsy, uncoordinated, slow/slurred speech
What is the duration of sx for hallcuinogens?
What are some other sx?
5 min - 12hrs
spacey, hallucinations, paranoia, memory loss, uncoordinated
What is the duration of sx for narcotics?
What are some other sx?
4-24 hrs
Sleepy, droopy eyelids, soft/low voice, euphoria
What is the duration of action for PCP?
What are the other sx?
4-6 hrs
Confused, aggressive, sweaty, repetitive
(so every medical student ever)
What are the most abused prescription painkillers?
Fentanyl
hydrocodone
oxycodone
What are the most commonly abused prescription depressants
Alprazolam (Xanny)
Zolpidem
Zaleplon
what are the most abused prescription stimulants?
Adderal
Methylphenidate
What overdose sx do you see with amphetamines, methylphenidate and cocaine?
agitation
HTN
tachycardia
delusions/hallucinations
hyperthermia
Sz
death
What withdrawal sx do you see with amphetamines, methylphenidate, and cocaine?
apathy, irritability, increased sleeping, disorientation, depression
What overdose effects are seen with barbiturates, benzos, and ETOH?
slurred speech, drunk behavior, dilated pupils, weak/rapid pulse, clammy, shalow respirations, coma, death
What are the withdrawal sx of barbiturates, benzos, and ETOH?
anxiety
insomnia
delirum
tremors
sz
death
What are the overdose effects of heroin and other storng opioids?
constricted pupils, clammy skin, nausea, drowsiness, respiratory depression, coma, death
What are the withdrawal sx of heroin/strong opioids?
nausea, chills, cramps, lacrimation/rhinorrhea, yawning, hyperpnea, tremor
What drug can be given to decrease desire to drink ETOH?
Acamprosate
What drugs are abused but not really addictive?
LSD (can cause flashbacks/altered perception)
Mescaline
Psilocybin
PCP (can lead to psychosis)
Ketamine
What is the main use of caffiene?
improve mental alertness
treating migraines in comination with aspirin or acetaminophen
post-epidural headaches
Caffeine can be used for several conditions, including:
Asthma
ADHD
OCD
Memory
Weight loss in combo with ephedrine
What is binge drinking?
What is heavy drinking?
For women: 4 or more drinks during a single occasion
For men: 5 or more drinks during a single occasion
For women: 8/week
For men: 15/week
ETOH has 0 order kinectics, meaning:
rate remains constant and is independent of concentration or amount of chemical
the biological system is the rate-limiting factor
t1/2 increases with dose (not a true t1/2)
Describe the metabolism of ETOH
ETOH undergoes extensive first pass metabolism thus a 70kg adult can metabolize 7-10g of ETOH per hr
(IE one drink per hour)
What is the clinical care required in someone with acute alcohol intoxication?
monitor respiratory depression and aspiration of vomit
glucose can treat metabolic alterations such as hypoglycemia and ketosis
thiamine to protect against WKS (double vision, drooping eyelids, loss of coordination)
In chronic alcohol abuse, what must be monitored for?
acute withdrawal syndrome vs. alcohol dependence
What is acute alcohol withdrawal syndrome?
can be life-threatening
the major pharmacologic objective is to prevent Sz, delirium, and arrhythmias, as well as electrolyte, rebalance and thiamine therapy
Tx with Benzos
What is alcohol dependence?
psychosocial therapy serves as the primary treatment for alcohol dependence
often depression or anxiety disorders coexist with alcoholism and therapeutic intervention for these other psychiatric problems decreases the rate of relapse
What is Naltrexone and it’s use?
approved for tx of ETOH and opiate dependence
MOA: u-opioid receptor antagonist to reduce craving and relapse in ETOH dependence
Must be opioid-free prior to beginning otherwise may precipitate acute withdrawal syndrome
What is Acamprosate?
weak NMDA receptor antagonist and GABA A receptor agonist
reduces long- and short-term relapse rates
What is disulfiram?
MOA: irriversibly inhibits aldehyde dehydrogenase and causes extreme discomfort in pt’s who drink (makes them really sick with headache, n/v, etc)
should not be administered with any drug that contains alcohol (even mouthwashes, cough/cold meds)
Patients must be highly motivated
