Stimulants and Substance Use Ex 4 Flashcards
stimulants mostly act by increasing what?
the activity of CNS neurons
main stimulant drugs are?
amphetamine, methylphenidate, methylxanthine
Amphetamine and methylphenidate MOA
release of norepinephrine and dopamine
therapeutic effects of Amphetamine and methylphenidate
increased alertness
increased initiative
reduced fatigue
elevated mood
Amphetamine and methylphenidate pharmacokinetics
available PO
short and long duration forms
Amphetamine and methylphenidate adverse effects
excess CNS stimulation (Insomnia)
reduced appetite (weight loss)
vasoconstriction (HTN)
cardiac excitation (angina)
psychosis (excessive use)
overdose can cause seizures/coma
Methylxanthine (caffeine) MOA
blockade of adenosine receptors appears responsible for most effects
methylxanthine therapeutic effects
decreased drowsiness
decreased fatigue
increased intellectual exertion
headache relief
mild diuretic
less desirable effects of methylxanthine
nervousness
insomnia
convulsion (extreme doses)
substance use disorders relevance to nursing
abuse is common
causes significant health problems
affects nursing care for other diseases
knowledge of drug abuse enables nurses to
recognize abuse and toxicity
participate in treatment and withdrawal
educate pts who are struggling with addiction and recovery
what leads to drug abuse
acceptable use vs abuse is socially and culturally defined
exists on a spectrum from occasional use to compulsive use
what else leads to drug abuse
physiological vs psychological dependence
social factors
availability
individual vulnerability
substance use disorder definition has no connection with?
physical dependence
goal of substance use disorder tmt
complete cessation
addiction definition
chronic relapsing illness characterized by continued use of specific psychoactive substance despite physical, psych, or social harm
define tolerance
smaller response from same dose
cross tolerance
tolerance to one drug confers tolerance to another
psychologic dependence
an intense subjective need for a psychoactive drug
cross - dependence
one drug supports dependence on another drug
controlled substances act of 1970
federal leg that categorized potentially addictive substances into 5 categories
to prescribe controlled drugs, prescribers need DEA licenses
Alcohol two main CNS effects
GABA receptor activation
glutamate inhibition
—-> widespread CNS depression
What happens when you drink alcohol
reflexes diminished, impaired consciousness
depressant effect is dose dependent
high doses = state of general anesthesia
alcohol pharmacokinetics
metabolised quickly
primarily hepatic
constant rate of metabolism
adverse effects of alcohol
cardiovascular - cutaneous vasodilation elevation of BP
respiratory depression
liver damage
erosive gastristis
diureses
pancreatitis
sexual function
cancer
teratogen
alcohol interactions
other CNS depressants
NSAIDS
acetaminophen
disulfiram
withdrawal syndrome of alcohol
Gi distress, SNS over activation, hallucinations, tonic-clonic seizures, disorientation, delirium,
what drugs facilitate withdrawel
benzodiazepines (diazepam, aplrazolam)
beta blockers
clonidine (off label use)
antiepileptics
what drug can you used to maintain abstinence from alcohol
disulfiram
disulfiram (antabuse) only used for what
ETOH treatment
disulfiram (antabuse) MOA
irreversibly inibits aldehyde dehydrogenase causing acetaldehyde accumulation from ETOH ingestion
ETOH + disulfiram = ?
acetaldehyde syndrome
acetaldehyde syndrome
vomiting, flushing, headache, sweating, blurred vision, hypotension can be life threatening`
Nicotine MOA
at low doses, activates nicotine receptors in the reward center which stimulate dopamine release
adverse effects of nictoine
cardiovascular stimulation, nausea, appetite suppression, fetal harm
long term increased risk of CVD, cancer, COPD
trmt of nicotine addiction
gum/lozenges
patches
nasal spray
inhaler
> e cigs not FDA approved for smoking cessation
What is bupropion SR
Zyban/ Wellbutrin - an atypical antidepressant
Bupropion MOA
blocks uptake NE and DA
reduces cravings for nicotine and eases withdrawel symptoms
side effects of bupropion
dry mouth, insomnia, decreased appetite
> drug started before quit date, take 7-12 weeks
what is Vaenicline
Chantixx
MOA of Varenicline (Chantix)
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
adverse effects of Varenicline (Chantix)
nausea and psychologic changes
Cocaine MOA
prevents dopamine reuptake in the CNS neurons, which increases its levels in the brain
two forms of cocaine
Cocaine HCL and Cocaine base
what is Cocaine HCL
white powder usually diluted, taken intranasally
what is cocaine base
“crack” smoked, very fast absorption in lungs
adverse effects of cocaine
angina pectoris/ MI from coronary vasospasm
nasal mucosa atrophy and septum perforation
Methamphetamine (Meth) MOA
increases levels of norepinephrine and dopamine in the CNA
Meth causes?
arousal, improved mood, euphoria, decreased pain perception, decreased appetite and ned for sleep
can be snorted, injected, or smoked
adverse effects of meth
psychosis
cardiac stimulation and vasoconstriction
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