Substance Abuse Flashcards
stages of addiction
drug seeking (craving) –> drug taking (‘rush’, tolerance) –> drug cessation (w/d sx)
disulfiram
inactivates alcohol dehydrogenase, resulting in acetaldehyde buildup/ Antabuse-alcohol dose-dependent reaction;
ADHERENCE
naltrexone
acts on opioid receptors; reduces ‘reward feeling’ w/ heavy drinking; reduces craving to drink EtOH
acamprosate
mechanism unclear; glutamate-receptor antagonist
topiramate
increase GABA, decrease NMDA
barbiturates
allosteric modulator of GABA-r; increases duration of channel opening
benzodiazepines
allosteric modulator of GABA-r; increases frequency of channel opening
rimonibant
CB-1 antagonist; improves cessation of smoking
marijuana
THC acts at endocannabinoid receptors CB-1 and CB2; withdrawal; relaxation, decreased N/V, memory impairment; associated with psychosis at high doses
PCP, ketamine
block NMDA-r Ca2+ influx; increases dopamine release; dissociation effects, can produce psychosis-like sx
hallucinogen
bind at 5-HT2A receptor; produce illusions (misinterpretation of sensory stimuli), synesthesia, flashbacks; no physiologic dependence, tolerance disappears w/in 7d
MDMA (ecstasy, Molly)
stimulant + hallucinogenic; release of NE, serotonin and dopamine; side fx: anorexia, hyperthermia; dehydration followed by hyponatremia and seizures
amphetamine, methamphetamine
increases release of vesicular stores of dopamine and serotonin; reverse transport by DAT and SERT; rapid onset ~15s IV
methylphenidate
blocks reuptake of dopamine and NE (no effect on serotonin); reduce risk of abuse
cocaine
block reuptake of dopamine, NE and serotonin; rebound dysphoria; side fx: MI, seizures, paranoia
cathinone, cathine
“bath salts”; block reuptake AND stimulate release of dopamine, NE
heroin
pro-drug, 2-3x more potent than morphine; side fx: constipation, opiod-induced hyperalgesia
methadone
opiod mu agonist; relieves w/d, DO NOT PRESCRIBE >40mg initially
buprenorphine
partial mu agonist, high affinity; can relieve or cause w/d;; given sublingually
naloxone
short-acting opiod (mu, kappa and delta) antagonist; block effect of any opiod; ADHERENCE
