[PHARMA] DRUG ABUSE Flashcards
drug abuse definition
intentional inappropriate use of psychoactive drugs seeking euphoria & resulting in harmful consequences
drug abuse results in
physical dependence
tolerance
addiction
cravings
abuse is more likely to occur with
short acting agents
pleasure/reward pathway components
NAc
VTA
PFC
pleasure/reward pathway components
NAc
VTA
PFC
info in reward system flows from
VTA–> NAc–>PFC
drugs acting on VTA
Cannabis
Nicotine
Alcohol
BZDs
drugs acting directly on NAc
Cocaine
final activation chemical in reward pathway
Dopamine
reward deficiency
prolonged drug use= DA neurons degeneration= ↓ DA in NAc= chronic anxiety, depression, inability to feel good
key elements of withdrawal stage
activation of corticotrophin-releasing factor (CFR) & Noradrenergic neurons (n amygdala) in dependence
alcohol mechanism of action
GABA-A allosteric modulator
NMDA Antagonist
delirium tremens seens in
alcohol withdrawal
barbiturates withdrawal
crawling bugs sensation seen in
alcohol withdrawal
wernicke-korsakoff syndrome symptoms
ophthalmoplegia
ataxia
confusion
psychosis
managements of alcohol abuse
*Disulfiram
*Acamprostate
Thiamine supplements
psychotherapy
Naltrexone
Disulfiram mechanism
antabuse
(-) acetylaldehyde dehydrogenase= acetyladehyde accumulation= nausea + vomiting + flushing
SO patient stops drinking to avoid this reaction
Disulfiram reaction
nausea + vomiting + flushing
Acamprosate mechanism of action
weak NMDA antagonist
GABA-A activator
SO ↓ cravings
management of nicotine abuse
*Varenicline
Nicotine gum, transdermal path, oral inhaler, nasal spray
Psychotherapy
Buproprion
Varenicline mechanism of action
partial agonist at α2β4 receptor
blocks Nicotine from stimulating DA VTA system===>↓ cravings & withdrawal
cocaine abuse management
Bupropion
LSD abuse management
BZDs
Antipsychotics
calm patient during bad trip
nicotine mechanism of action
(+) α2β4 nicotinic Ach receptor in VTA
nicotine acute effects
euphoria
increased concentration
decreased anxiety
decreased appetite
nicotine risk of chronic abuse
cancer
lung diseases
IHD
withdrawal syndrome of nicotine
insomina
increased appetite
anxiety
aggression
alcohol acute effects
euphoria
relaxation
self confidence
withdrawal syndrome of alcohol
delirium tremens
crawling bugs hallucinations
risk of alcoholism (7)
1-withdrawn homicidal/suicidal pt
2-liver cirrhosis
3-peptic ulcer
4-cardiomyopathy
5-peripheral neuropathy
6-dementia
7-THIAMINE DEFICIENCY & WERNICKE KORSAKOFF SYNDROME
Cocaine acute effects
euphoria due to ↑catecholamines
increased alertness
decreased fatigue
insomnia
intravenous cocaine intake leads to
intense euphoria (the rush)
↑risk of infections
intranasal cocaine intake leads to
less euphoria (the high)
nasal septal perforation
smoking cocaine leads to
intense euphoria+ easy route
↑ abuse
cocaine withdrawal syndrome (6)
1-depression
2-disorientation
3-sleep
4-fatigue
5-overeating
6-apathy
risks of chronic cocaine abuse
psychosis + hallucinations + delusions
overdose toxicity of cocaine (7)
1-↑BP
2-MI
3-arrhythmia
4-cerebral accidents
5-convulsions
6-delusions
7-hallucinations
LSD acute effects
euphoria
sensory changes
hallucinations
delusions
illusions
philosophical & creative thinking
risks of LSD abuse
bad trips
flashbacks
psychosis
long term effects of LSD & PCP
peristent psychosis
flashbacks
Cannabis mechanism of action
THC act on C1 & V1 pain receptor
acute effects of cannabis
euphoria
uncontrollable laughter
↓motor & mental skills
increased perception
time slows
hallucinations & delusions
philosophical & creative thinking
risk of chronic cannabis abuse
↑ risk of psychosis
Red eyes (VD of conjunctival BV)
Gateway drug
Miscarriages
Ectopic pregnancy
Sexual & reproductive dysfunction
Apathy
Cocaine abuse management
Dronabinol
