[PHARMA] DRUG ABUSE

Question 1

drug abuse definition

Answer 1

intentional inappropriate use of psychoactive drugs seeking euphoria & resulting in harmful consequences

Question 2

drug abuse results in

Answer 2

physical dependence
tolerance
addiction
cravings

Question 3

abuse is more likely to occur with

Answer 3

short acting agents

Question 4

pleasure/reward pathway components

Answer 4

NAc
VTA
PFC

Question 5

pleasure/reward pathway components

Answer 5

NAc
VTA
PFC

Question 6

info in reward system flows from

Answer 6

VTA–> NAc–>PFC

Question 7

drugs acting on VTA

Answer 7

Cannabis
Nicotine
Alcohol
BZDs

Question 8

drugs acting directly on NAc

Answer 8

Cocaine

Question 9

final activation chemical in reward pathway

Answer 9

Dopamine

Question 10

reward deficiency

Answer 10

prolonged drug use= DA neurons degeneration= ↓ DA in NAc= chronic anxiety, depression, inability to feel good

Question 11

key elements of withdrawal stage

Answer 11

activation of corticotrophin-releasing factor (CFR) & Noradrenergic neurons (n amygdala) in dependence

Question 12

alcohol mechanism of action

Answer 12

GABA-A allosteric modulator
NMDA Antagonist

Question 13

delirium tremens seens in

Answer 13

alcohol withdrawal
barbiturates withdrawal

Question 14

crawling bugs sensation seen in

Answer 14

alcohol withdrawal

Question 15

wernicke-korsakoff syndrome symptoms

Answer 15

ophthalmoplegia
ataxia
confusion
psychosis

Question 16

managements of alcohol abuse

Answer 16

*Disulfiram
*Acamprostate
Thiamine supplements
psychotherapy
Naltrexone

Question 17

Disulfiram mechanism

Answer 17

antabuse
(-) acetylaldehyde dehydrogenase= acetyladehyde accumulation= nausea + vomiting + flushing
SO patient stops drinking to avoid this reaction

Question 18

Disulfiram reaction

Answer 18

nausea + vomiting + flushing

Question 19

Acamprosate mechanism of action

Answer 19

weak NMDA antagonist
GABA-A activator
SO ↓ cravings

Question 20

management of nicotine abuse

Answer 20

*Varenicline
Nicotine gum, transdermal path, oral inhaler, nasal spray
Psychotherapy
Buproprion

Question 21

Varenicline mechanism of action

Answer 21

partial agonist at α2β4 receptor
blocks Nicotine from stimulating DA VTA system===>↓ cravings & withdrawal

Question 22

cocaine abuse management

Answer 22

Bupropion

Question 23

LSD abuse management

Answer 23

BZDs
Antipsychotics
calm patient during bad trip

Question 24

nicotine mechanism of action

Answer 24

(+) α2β4 nicotinic Ach receptor in VTA

Question 25

nicotine acute effects

Answer 25

euphoria increased concentration decreased anxiety decreased appetite

Question 26

nicotine risk of chronic abuse

Answer 26

cancer lung diseases IHD

Question 27

withdrawal syndrome of nicotine

Answer 27

insomina increased appetite anxiety aggression

Question 28

alcohol acute effects

Answer 28

euphoria relaxation self confidence

Question 29

withdrawal syndrome of alcohol

Answer 29

delirium tremens crawling bugs hallucinations

Question 30

risk of alcoholism (7)

Answer 30

1-withdrawn homicidal/suicidal pt 2-liver cirrhosis 3-peptic ulcer 4-cardiomyopathy 5-peripheral neuropathy 6-dementia 7-THIAMINE DEFICIENCY & WERNICKE KORSAKOFF SYNDROME

Question 31

Cocaine acute effects

Answer 31

euphoria due to ↑catecholamines increased alertness decreased fatigue insomnia

Question 32

intravenous cocaine intake leads to

Answer 32

intense euphoria (the rush) ↑risk of infections

Question 33

intranasal cocaine intake leads to

Answer 33

less euphoria (the high) nasal septal perforation

Question 34

smoking cocaine leads to

Answer 34

intense euphoria+ easy route ↑ abuse

Question 35

cocaine withdrawal syndrome (6)

Answer 35

1-depression 2-disorientation 3-sleep 4-fatigue 5-overeating 6-apathy

Question 36

risks of chronic cocaine abuse

Answer 36

psychosis + hallucinations + delusions

Question 37

overdose toxicity of cocaine (7)

Answer 37

1-↑BP 2-MI 3-arrhythmia 4-cerebral accidents 5-convulsions 6-delusions 7-hallucinations

Question 38

LSD acute effects

Answer 38

euphoria sensory changes hallucinations delusions illusions philosophical & creative thinking

Question 39

risks of LSD abuse

Answer 39

bad trips flashbacks psychosis

Question 40

long term effects of LSD & PCP

Answer 40

peristent psychosis flashbacks

Question 41

Cannabis mechanism of action

Answer 41

THC act on C1 & V1 pain receptor

Question 42

acute effects of cannabis

Answer 42

euphoria uncontrollable laughter ↓motor & mental skills increased perception time slows hallucinations & delusions philosophical & creative thinking

Question 43

risk of chronic cannabis abuse

Answer 43

↑ risk of psychosis Red eyes (VD of conjunctival BV) Gateway drug Miscarriages Ectopic pregnancy Sexual & reproductive dysfunction Apathy

Question 44

Cocaine abuse management

Answer 44

Dronabinol