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Pharmacology > Stimulants and Substance Use Ex 4 > Flashcards

Stimulants and Substance Use Ex 4 Flashcards

1
Q

stimulants mostly act by increasing what?

A

the activity of CNS neurons

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2
Q

main stimulant drugs are?

A

amphetamine, methylphenidate, methylxanthine

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3
Q

Amphetamine and methylphenidate MOA

A

release of norepinephrine and dopamine

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4
Q

therapeutic effects of Amphetamine and methylphenidate

A

increased alertness
increased initiative
reduced fatigue
elevated mood

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5
Q

Amphetamine and methylphenidate pharmacokinetics

A

available PO
short and long duration forms

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6
Q

Amphetamine and methylphenidate adverse effects

A

excess CNS stimulation (Insomnia)
reduced appetite (weight loss)
vasoconstriction (HTN)
cardiac excitation (angina)
psychosis (excessive use)
overdose can cause seizures/coma

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7
Q

Methylxanthine (caffeine) MOA

A

blockade of adenosine receptors appears responsible for most effects

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8
Q

methylxanthine therapeutic effects

A

decreased drowsiness
decreased fatigue
increased intellectual exertion
headache relief
mild diuretic

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9
Q

less desirable effects of methylxanthine

A

nervousness
insomnia
convulsion (extreme doses)

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10
Q

substance use disorders relevance to nursing

A

abuse is common
causes significant health problems
affects nursing care for other diseases

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11
Q

knowledge of drug abuse enables nurses to

A

recognize abuse and toxicity
participate in treatment and withdrawal
educate pts who are struggling with addiction and recovery

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12
Q

what leads to drug abuse

A

acceptable use vs abuse is socially and culturally defined
exists on a spectrum from occasional use to compulsive use

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13
Q

what else leads to drug abuse

A

physiological vs psychological dependence
social factors
availability
individual vulnerability

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14
Q

substance use disorder definition has no connection with?

A

physical dependence

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15
Q

goal of substance use disorder tmt

A

complete cessation

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16
Q

addiction definition

A

chronic relapsing illness characterized by continued use of specific psychoactive substance despite physical, psych, or social harm

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17
Q

define tolerance

A

smaller response from same dose

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18
Q

cross tolerance

A

tolerance to one drug confers tolerance to another

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19
Q

psychologic dependence

A

an intense subjective need for a psychoactive drug

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20
Q

cross - dependence

A

one drug supports dependence on another drug

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21
Q

controlled substances act of 1970

A

federal leg that categorized potentially addictive substances into 5 categories
to prescribe controlled drugs, prescribers need DEA licenses

22
Q

Alcohol two main CNS effects

A

GABA receptor activation
glutamate inhibition
—-> widespread CNS depression

23
Q

What happens when you drink alcohol

A

reflexes diminished, impaired consciousness
depressant effect is dose dependent
high doses = state of general anesthesia

24
Q

alcohol pharmacokinetics

A

metabolised quickly
primarily hepatic
constant rate of metabolism

25
Q

adverse effects of alcohol

A

cardiovascular - cutaneous vasodilation elevation of BP
respiratory depression
liver damage
erosive gastristis
diureses
pancreatitis
sexual function
cancer
teratogen

26
Q

alcohol interactions

A

other CNS depressants
NSAIDS
acetaminophen
disulfiram

27
Q

withdrawal syndrome of alcohol

A

Gi distress, SNS over activation, hallucinations, tonic-clonic seizures, disorientation, delirium,

28
Q

what drugs facilitate withdrawel

A

benzodiazepines (diazepam, aplrazolam)
beta blockers
clonidine (off label use)
antiepileptics

29
Q

what drug can you used to maintain abstinence from alcohol

A

disulfiram

30
Q

disulfiram (antabuse) only used for what

A

ETOH treatment

31
Q

disulfiram (antabuse) MOA

A

irreversibly inibits aldehyde dehydrogenase causing acetaldehyde accumulation from ETOH ingestion

32
Q

ETOH + disulfiram = ?

A

acetaldehyde syndrome

33
Q

acetaldehyde syndrome

A

vomiting, flushing, headache, sweating, blurred vision, hypotension can be life threatening`

34
Q

Nicotine MOA

A

at low doses, activates nicotine receptors in the reward center which stimulate dopamine release

35
Q

adverse effects of nictoine

A

cardiovascular stimulation, nausea, appetite suppression, fetal harm
long term increased risk of CVD, cancer, COPD

36
Q

trmt of nicotine addiction

A

gum/lozenges
patches
nasal spray
inhaler
> e cigs not FDA approved for smoking cessation

37
Q

What is bupropion SR

A

Zyban/ Wellbutrin - an atypical antidepressant

38
Q

Bupropion MOA

A

blocks uptake NE and DA
reduces cravings for nicotine and eases withdrawel symptoms

39
Q

side effects of bupropion

A

dry mouth, insomnia, decreased appetite
> drug started before quit date, take 7-12 weeks

40
Q

what is Vaenicline

A

Chantixx

41
Q

MOA of Varenicline (Chantix)

A

partial nicotinic receptor agonist, so it prevents most of the nicotine from binding
most effective aid for smoking cessation - reduced cravings and intensity of symptoms

42
Q

adverse effects of Varenicline (Chantix)

A

nausea and psychologic changes

43
Q

Cocaine MOA

A

prevents dopamine reuptake in the CNS neurons, which increases its levels in the brain

44
Q

two forms of cocaine

A

Cocaine HCL and Cocaine base

45
Q

what is Cocaine HCL

A

white powder usually diluted, taken intranasally

46
Q

what is cocaine base

A

“crack” smoked, very fast absorption in lungs

47
Q

adverse effects of cocaine

A

angina pectoris/ MI from coronary vasospasm
nasal mucosa atrophy and septum perforation

48
Q

Methamphetamine (Meth) MOA

A

increases levels of norepinephrine and dopamine in the CNA

49
Q

Meth causes?

A

arousal, improved mood, euphoria, decreased pain perception, decreased appetite and ned for sleep
can be snorted, injected, or smoked

50
Q

adverse effects of meth

A

psychosis
cardiac stimulation and vasoconstriction

51
Q

e

A

Pharmacology (8 decks)

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