quiz 2 Flashcards
physical dependence
the body is adapted to the presence of the drug
- if drug use is stopped withdrawal symptoms occur
what comes first - tolerance or physical dependence
tolerance
psychological or behavioral dependence
craving, tendency to relapse after stopping use
how is behavior maintained
by negative reinforcement
early medical model
true addiction involves physical dependence. the key is the treatment of withdrawal symptoms
positive reinforcement model
drugs can reinforce behavior without physical withdrawal - users will say they take drugs because they enjoy using them or it decreases negative symptoms so they want to continue using it
psychiatric diagnosis of substance use disorders
a problematic pattern of substance use leading to clinically significant impairment or distress
dsm 5 tr substance use disorder
2 of 11 symptoms within 12 months
- using more for longer than planned
- inability to stop
- substantial time
-cravings
- inability to meet obligations,
- knowing they have a problem
- giving up other activities because of use
- using despite risk and harm, -using despite knowledge that substance is causing problems
- tolerance
- withdrawal
for a diagnosis you need
9 behavioral symptoms
2 physiological symptoms (doesnt need to be present to receive diagnosis )
is dependence caused by the substance or the method used to do substance
the method used
biopsychosocial perspective
dependence is related to dysfunction of biology, personality, and social interactions - biology, genetics, social, and psychological factors
why do we regulate drugs
to protect society from the dangers of some types of drug use = legitimate social purpose
reformism -
legislation from the early 1900s
racist fears about deviant behaviors
laws were developed to regulate undesirable behaviors and people
when was the first drug law that forbidded the sale of alcohol to native Americans
1830
issues leading to legislation
fraud in patent medicines - exotic names and ingredients, false therapeutic claims, some ingredients designed to hint at medicinal effects, habit forming drugs
- 7up originally contained lithium citrate and was marked as hangover cure
muckraking journalism
focuses on what people have done wrong
the great American fraud
attacking patent medicines and their makers
drugs associated with outcast groups
opium smoking brought to the US by chinese workers, cocaine-associated with southern african americans
1906 pure food and drug act
required accurate labeling and listing of ingredients
caveat emptor
let the buyer beware, side effects weren’t the producers problems but yours
- this led to the pure food and drug act
the pure food and drug act lead to
changes in technology and the market = more foreign products, mass production led to dangerous business practices
sellers of medicine had a _____ legislation that released them from ___
red clause
advertising contracts in case of legislation
Harrison act of 1914
a law that required those who dealt with opiates/coca to register and pay tax
problems with Harrison act of 1914
other countries demanded that if you wanted to control opium you had to control other drugs as well
what did the Harrison act of 1914
it enacted to secure favored trade status with China, which wanted to reduce opium importation
who is the pure food and drugs act run by
the US department of agriculture
who is the Harrison act run by
by the US treasury
regulation of pharmaceuticals = purity
contents of the product must be accurately noted
1912 sherly amendment
outlawed false fraudulent therapeutic claims on labels
ex: brand fraud
1938 food drug and cosmetic act
required pre-market testing for toxicity companies are required to submit a new drug application to the FDA
regulation of pharmaceuticals
purity, safety, effectiveness
regulation of pharmaceuticals = safety
there originally was no requirement that medications by safe
regulation of pharmaceuticals= effectiveness
advertising must include information about adverse reactions
- every new drug must be demonstrated to be effective for the illness mentioned on the label
1962 kefauver-harris amendments to FDCA
spurred on the thalidomide tragedy and marketing to ineffective products
marketing a new drug
- preclinical research and development
- clinical research and development
- permission to market - could require 10+ years to do this
phases a marketing a new drug
phase 1 - small doses, healthy volunteers
phase 2 - small number of patients
phase 3 - a larger number of patients
orphan act drug
tax and other financial incentives for developing drugs for a rare disease
prescription drug marketing act of 1988
regulation of free samples and reimportation of drugs - establishes a legal framework for the safe and effective distribution of prescription drugs
1997 FDA modernization act
guidelines for post-marketing reporting
- allows an applicant for market approval for new drug to use methods other than animal testing to establish the drug’s safety and effectiveness
off labeling using
use for which drug may be prescribed but for which it has not been formally approved
dietary supplements
regulated more food than drugs
labels must be accurate
must contain a warning that claims are unverified by the FDA
products can be marketed without first proving safety
18th amendment
prohibition from alcohol to narcotics
jones miller act 1922
more than doubled penalties for dealing illegally imported drugs
- users came to prefer the most potent opioids
drug czar
harry Anslinger held this post for 30 years, enforcer of drug laws, influential on drug legislation
marijuana tax act
meant legal control of marijuana similar to cocaine/opiates
1956 narcotic drug control act
making the cultivation, production, preparation, manufacture, export, import, purchase, possession, sale, and consumption of most abused drugs illegal
drug abuse control act amendments of 1965
the bureau faced widespread disregard of drug laws by youth counterculture
-added new classes of drugs - amphetamines, barbiturates, hallucinogens
prevention and control act of 1970
replaced all previous laws - drugs controlled under federal jurisdiction
- direct control of drugs, not control through taxation
who is responsible for drug law enforcement
attorney general
who makes recommendations for which drugs to control
health and human services
possession penalties
imprisonment/fines or prohibition
selling penalties
mandatory minimum sentences
drug precursors
chemicals or supplies used to make drugs
1984 drug analog act
designed to deal with designer drugs
1988 omnibus drug act
death penality for “kingpins” forfeiture of property and federal benefits
1996 comprehensive methamphetamines control act
restricted access to equipment and chemicals for making meth
neurons
nerve cells that analyze and transmit information
- stimulation of neurons by psychoactive drugs can excite or inhibit a neuron
4 regions of a nerve cell
- dendrite
- cell body
- axon
- axon terminals
dendrite
inputs messages into the neuron cell body
cell body
houses the nucleus
axon
a threadlike extension of a neuron that carries nerve impulses away from the cell body
axon terminal
end part of an axon that makes synaptic contact with another cell
action potential
electrical impulse that travels down the axon to terminal buttons
ion
electrically charged particles
- NA and K
are there more NA ions inside or outside
outside
synapse
junctions between the axon of the sender and the dendrite of the receiver
neurotransmitter
chemicals move across synaptic gaps bind to receptor sites, then detach they are taken up again by sending axon -reuptake
excitatory neurotransmitters
increase the probability of firing
inhibitory neurotransmitters
decrease the probability of firing
dopamine
movement, drug use reinforcement “survival signal”
what do lower levels of dopamine lead to
parkinsons
nigrostriatal pathway
muscle movement
- the pathway that stretches between Substantia nigra to the striatum
mesolimbic dopamine pathway
stretches from ventral tegmental area to the nucleus accumbens - every drug of abuse causes DOP activity here
acetylcholine
involved in learning and memory
found in the cerebral cortex
nucleus basalis - created here
what is acetylcholine involved in
learning and memory - decreases in this is linked to Alzheimers disease
norepinephrine
fight or flight
regulates the level of arousal and attentiveness
-digestion slows down with high state of stress
serotonin
may have a role in regulating impulsivity, aggression, depression, control of food intake
what kind of drugs influence serotonin pathways?
hallucinogenic drugs
where is serotonin made
raphe nuclei
GABA
inhibitory neurotransmitter - shuts down areas of the brain - alcohol, depressants
found in most regions of the brain
glutamate
primary excitatory
- found in most of regions of the brain but dont want too much of it because it can destroy neurons = excitotoxicity
endorphines
opium-like class of drugs of chemicals occurring naturally in the brain - regulate pain/pleasure
“runners high”
endocannabinoids
regulate several bodily functions such as sleep, mood, appetite, learning, memory, body temperature, pain, immune functions and fertility
the life cycle of a neurotransmitter 7 steps
- neurotransmitter
- uptake
- synthesis
- storage
- release
- binding
- metabolism
neurotransmitters
precursors are found circulating in the blood supply and in the brain
- brain turns L-DOPA into dopamine when given
uptake
selected precursors are taken up by cells
synthesis
precursors are synthesized into neurotransmitters through the action of enzymes
storage
neurotransmitters are stored in synaptic vesicles near the terminal from which they will be released
released
when the action potential arrives, neurotransmitters are released into the synapse
binding
released neurotransmitters bind with receptors on the membrane of the post synaptic cell
metabolism
once a signal has been sent, neurotransmitters are removed from the synapse
drug actions
alter neurotransmitter availability in the synapse through actions on synthesis, storage, release, reuptake or metabolism
- antidepressants block reuptake of dopamine, serotonin and norepinephrine
agonist
mimics the action of neurotransmitters by activating the receptor
antagonist
occupies the receptor and prevents the neurotransmitter from activating it (blocks it )
inverse agonist
occupied the receptor but produces an opposite effect relative to the neurotransmitter
inhalation
drugs move faster from the lungs into the bloodstream through capillary walls
-effects are rapid
topical application
absorption through the skin and can provide slow steady drug delivery
THC
high affinity, slow and steady effect, slowly removed from the blood
ethanol
low affinity, rapid effect, quickly removed from the blood
= primarily exists as unbound in the body
blood brain barrier
only lipid soluble substance can pass through lipid bilayer surrounding brain capillaries
what increases the difficulty of passing through blood brain barrier
capillaries covered with glial cells
active transports systems
molecules that are in the blood brain barrier that bind to chemicals (chemicals need active transport systems to be able to cross the blood brain barrier
drugs may alter the availability of a neurotransmitter by changing
- rate of synthesis
- metabolism (MAOIs- wipe out neurotransmitters that normally break down enzymes)
- release (methamphetamine)
- reuptake (prozac, cocaine)
why is meth so addictive
works directly on the reward center
meth mimics dopamine and is picked up by dopamine receptors and overload causes dopamine to be pushed out into the synapse
drug deactivation
happens when the drug is excreted unchanged from the body or is chemically changed
key drug metabolizing liver enzymes
CYP450
the resulting metabolite no longer has the same action as the drug and can be excreted by the kidneys
tolerance enzyme induction
when the bodys cell detect the foreign drug, triggers the production of more of the specific metabolizing enzyme
asian flush
body converts ethanol to acetaldehyde at a rapid rate but does nor convert acetaldehyde quickly
drug disposition tolerance
occurs when repeated doses of a drug result in accelerated metabolism
behavioral tolerance
the drug may have the same biochemical effect but a reduced behavioral effect
