Substance Abuse Flashcards
Substance abuse Facts
Almost all abused drugs affect CNS
- altered mental state
- euphoria
Substance abuse is not inherently addiction
Addiction occurs in a minority of drug users T/F
True
Risk factors for drug abuse
Genetics Risk takers Societal norms/ peer influences Cost and availability Mode of admin. onset of action
Reinforcing Drug
Greater likelihood of abuse
Induce neuronal activity in reward areas of the brain (inc dopamine)
Physical Dependance
Adaption of the cells of the body to repetive drug use
Psychological Dependance
No obvious discomfort occurs after discontinued use of drug but have continued desire to take the drug
Usually occurs after prolonged use and can last for years
Withdrawal Syndrome
Go cold turkey and symptoms are opposite of drugs effect
Tolerance types
Pharmacodynamic- system desensitization
Pharmacokinetic- inc/dec metabolism
Cross tolerance- extend to related drugs
Tolerance Facts
Need higher and higher dose
Tolerance can develop for side effects and at different rates for different drugs
CNS Depressant addiction mechanism
Inc dopamine in reward pathway-euphoria
CNS depressant-sedative-hypnotic drugs
Zolpidem(ambien)
Zaleplon(Sonata)
Gaba system agonism and suppress respiratory centers in brain stem
Withdrawal can be life threatening (like EtOH)
CNS depressant-Barbs drugs
Pentobarbital (nembutal)
Phenobarbital (luminal)
Gaba system agonism and suppress respiratory centers in brain stem
Withdrawal can be life threatening (like EtOH)
CNS depressants- Benzos drugs
Diazepam(valium)
Lorazepam (atvian)
Alprazolam(Xanax)
Gaba system agonism
When combined with EtOH heroin OD can be lethal
CNS Depressants- opioids drugs
Codeine Fentanyl(duragesic) Methadone(dolophine) Morphine Hydromorphone(dilaudid) Oxycodone(oxycontin) Vixodin, Percocet Heroin
Opioid receptor agonism
Opioid Withdrawal
Intense, not life threatening
Methadone,suboxone given orally which dec IV related risks (hepatitis, HIV)
CNS Depressant-Alcohol
Ethyl alcohol, ethanol, alcohol
Gaba agonism and glutamate antagonism
Alcohol Withdrawal Tx
Cold turkey alcohol withdrawal can be fatal- hyperexcitability
Tx: benzodiazepine step down therapy allows receptors to return to normal
Alcohol Addiction TX
Disulfiram(antabuse)
Inhibits acetaldehyde dehydrogenase
Patient becomes ill if use alcohol at same time
Cannabinoids Drug/MoA
Marijuana- agonize cannabinoid receptors all over body
THC is major psychoactive component
Endogenous cannabinoid- anandamide, 2-AG
THC isolate drugs
Dronabinol(marinol)
Nabilone (cesamet)
CB receptor (+) schedule 3
Other Cannabinoid
Rimonabant
CB1 (-) pulled from market
Hallucinogens moa
Strong 5HT2a receptor (+)
Can be used in guided trip therapy
Hallucinogens: indoleamines
LSD, DMT, Psilocybe mushrooms
5HT2a (+)
LSD dependence
Dependence is extremely unlikely/ has altered consciousness not so much euphoria
DMT drug
Ayahuasca
Usually both MAOI and DMT are drugs ingested as MAOI prevents DMT breakdown
Hallucinogens:Phenethylamines
MDMA-aka molly and ecstasy
(+) 5HT, DA, NE release
Withdrawal: serotonin depletion causing depressive symptoms
Not really addictive (more 5HT not DA)
Stimulants:Nicotine
Most often through smoking tobacco
Tx: varenicline (chantix)
Nicotinic Ach receptor partial agonist causing no reward to smoking
Stimulants cociane moa
Mainly DAT (-) (-) SERT amd NET to lesser extent
Stimulants:Amphetamines moa
Highly addictive
Methamphetamine, crystal meth, crank, glass
Reversal of DAT- nonexocytotic release of DA
Also blocks NET and SERT
(-) MAO
(+) snthesis of DA
Cocaine and Meth Tx drug
Modafinil (provigil) Mild DAT (-)
Stimulants:Caffeine moa
Adenosine receptor (-)
Adenosine promotes sleep and builds up throughout day to make us sleepy
