Stimulants

Question 1

Caffeine MOA

Answer 1

Works 2 different ways:

1. Adenosine receptor antagonist:
   - adenosine has inhibitory effects on neurons: it normally blocks NT release and inhibits Ca++ conductance. It decrease neuronal firing rates and induces slow wave sleep. Caffeine is an antagonist, which is why you become more stimulated after drinking coffee.
2. Phosphodiesterase inhibition:
   - PDE’s normally break down cAMP and cGMP. Caffeine inhibits this breakdown and terminates 2nd messenger activity.

Question 2

Nicotine MOA

Answer 2

Interacts with nicotinic-acetylcholine receptor (nAChR). Normally, acetylcholine binds to nAChRs, but as their name suggests, nAChR’s can also be activated by nicotine. The interaction with nicotine opens the channel and allows Na+ to enter a cell causing depolarization

1. Nicotine replacement therapy (NRT)
   - patch, gum, lozenge, inhaler, nasal spray
2. Bupropion- sustained release antidepressant
3. Varenicline – partial agonist at nicotine receptors

Question 3

Brought into the cell and causes the DA/NE transporter to “flip.” As a result, amphetamines pump dopamine out of the cell and into the synapse. This process is fast and potent.
High levels of amphetamine can also get in the cell and affect the VMAT –> dopamine is pushed out of the vesicles.

What drug?

Answer 3

amphetamine

1. CBT
2. CM (contingency management)

CBT + CM = :)

Question 4

DA/NA reuptake inhibitor (used for ADHD, narcolepsy, appetite control)

Normally, does not cause withdrawal because of long half-life

What drug?

Answer 4

methylphenidate

Question 5

Inhibits reuptake of DA

Wha tdrug

Answer 5

cocaine

Primarily supportive

• Cardiac monitoring
• Control agitation and hyperthermia with benzos