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Psych Final Final > Pharmacology of Alcohol and Drugs of Abuse - Linger > Flashcards

Pharmacology of Alcohol and Drugs of Abuse - Linger Flashcards

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1
Q

most commonly abused drug in world

A

ethanol

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2
Q

75% adults in US

A

use alcohol

only 8% become disorder

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3
Q

ethanol PK

A

amphipathic - hydrophilic and hydrophobic

first pass metabolism
zero order kinetics

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4
Q

BAC sedation, high, slower rxn time

A

50-100

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5
Q

BAC impaired motor fxn, slurred speech, ataxia

A

100-200

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6
Q

BAC emesis, stupor

A

200-300

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7
Q

BAC coma

A

300-450

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8
Q

BAC resp depression and death

A

> 500

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9
Q

0.08% BAC

A

= 80mg/dL blood alcohol concentration

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10
Q

tolerance

A

decrease in responsiveness to drug following repeated exposure

can happen in acute alcohol consumption

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11
Q

sensitization

A

reverse tolerance

increase in responsiveness to drug following repeated exposure

with cocaine

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12
Q

drugs sedative hypnotics

A

class B - benzos and newer drugs - plateau

class A - barbs, alclhol, older sedative hypnotic - linear - to coma

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13
Q

enzyme of alcohol metabolism

A

alcohol dehydrogenase (ADH)

aldehyde DH (ALDH)

microsomal ethanol oxidizing system (MEOS)
-CYP450s

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14
Q

enzyme mutations

A

hyperactive AHD
low active ALDH

accumulate of acetaldehyde

adverse effects

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15
Q

disulfram

A

inhibit ALDH

aka anabuse

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16
Q

fomepizole

A

inhibit ADH

tx - methanol OD - so don’t metabolize it

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17
Q

ethanol vs. methanol

A

ethanol higher affinity for ADH

tx of methanol poisoning

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18
Q

acetaldehyde

A

toxic - from alcohol metabolism

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19
Q

metabolize 1 mol of ethanol

A

need 2 mol NAD+

saturate enzymes quickly - zero-order kinetics

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20
Q

tx of alcohol intox

A 
resp support
gastric lavage - naloxone (short acting)
fluid replacement
short acting benzo
thiamine (prevent wernicke)
glucose

mostly supportive

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21
Q

receptors for ethanol

A

NMDA - glutamate - excitation (memory impairment)
-ethanol decrease NMDA

GABA-A - inhibition
-ethanol increase NMDA

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22
Q

liver and alcohol

A

fatty liver > hepatitis > cirrhosis > liver failure

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23
Q

CV and alcohol

A 
cardiomyopathy
HF
arrhythmia
HTN
stroke
coronary heart disease
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24
Q

cancer and alcohol

A

increased risk

-mouth, pharynx, esophagus, liver

25
Q

CNS and alcohol

A

altered expression - NMDA and GABA-A receptors

26
Q

tolerance to alcohol

A

has a limit

still get resp depression

27
Q

tx for seizure in alcohol OD

A

diazepam - fasting acting - IV

28
Q

diazepam vs. oxazepam

A

diazepam - fast and IV

oxazepam - slow and PO

29
Q

thiamine

A

prevents wernicke encephalopathy

30
Q

alcohol withdrawal syndrome

A

anxiety, insomnia, tremor, palps, nausea, anorexia

go away days

may persist for months

31
Q

delirium tremens

A

tachy, HTN, low grade fever, tremor, diaphoresis, delirium, agitation

with alcohol withdrawal

32
Q

detox from alcohol

A

benzos

33
Q

long acting benzos

A

diazepam and chlordiazepoxide

cause liver damage

34
Q

short acting benzos

A

lorazepam and oxazepam

for pt with liver disease

35
Q

tx of alcohol depedence

A 
naltrexone
acamprosate
disulfiram - anabuse
topiramate
ondansetron
36
Q

naltrexon

A

longer acting

opioid receptor antagonist

reducing craving and relapse rates - alcohol dependence

37
Q

acamprosate

A

weak NMDA antagonist
GABA-A agonist

reduce short and long term relapse rates alcohol dependence

38
Q

disulfiram

A

inhibit ALDH

  • discomfort in pt who drunk alcohol
  • accumulation of adehyde
39
Q

abuse

A

pattern of substance use leading to significant impairment

40
Q

dependence

A

compulsive use of substance despite significant problems resulting from such use

psych
physio

41
Q

psych dependence

A

addiction

42
Q

physical dependence

A

dependence - withdrawal syndrome occurs

43
Q

withdrawal

A

evidence of physical dependence

44
Q

drugs of abuse in brain

A

mesolimbic dopamine system

VTA
MFB - medial forebrain bundle - DA neurons

45
Q

sensitization

A

with cocaine

more higher response to same dose over time

46
Q

drugs of abuse on GPCRs

A

opioids
cannabinoids
GHB
hallucinogens - LSD, mescaline, psilocybin

47
Q

drugs of abuse on monoamine transporters

A

cocaine
amphetamines
ecstasy

48
Q

drugs of abuse on ion channels

A 
nicotine
alcohol
benzos
dissociative anesthetics - phencyclidine and ketamine
inhalants
49
Q

GABA

A

inotropic

50
Q

cocaine

A

inhibit DAT

51
Q

methadone

A

long acting opioid used for substitution therapy

52
Q

buprenorphine

A

mix agonist/antagonist

53
Q

smoking cessation

A

bupropion - antidepressant

54
Q

varenicline

A

partial neuronal nAChR agonist
-for smoking cessation only

suicidal ideation

55
Q

lozenge

A

nicotine dependence

56
Q

adverse of lots of methanol

A

blindless

tx - fomepizole or ethanol and sodium bicarb

57
Q

benzo antagonist

A

flumazenil

58
Q

spike alcohol

A

benzo

Psych Final Final (9 decks)

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