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Pharm unit 3 > substance use > Flashcards

substance use Flashcards

0
Q

ethanol intoxication sx:

  1. low dose (25-100mg%BAC)
  2. higher dose (>100mg)
A
  1. mild intox; impairment: loss of inhibitions, altered mood and cognition, incoordination, sedation –> results from preferential involvement of polysynaptic neuronal pathways in reticular formation (cerebral cortex, brain stem, cerebellum)
  2. diplopia, nystagmus, dysarthria, ataxia –> from cerebellar and vestibular disfnc –> stuper –> death
    ,
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1
Q

what are 4 agents that augment GABA at GABAa receptors?

A

ethanol, barbs, benzos, anesthetics

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2
Q

antabuse

A

disulfiram

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3
Q

mechanism of antabuse?

A

inhibits aldehyde dehydrogenase –> if drink more –> toxic from inc acetaldehyde –> pulsating ha, nausea, hot, vomit, CP, weak, dizzy

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4
Q

“drygas”, windshield washer antifreeze

A

methyl alcohol

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5
Q

what is methyl alcohol?

A

formaldehyde and formic acid –> very toxic: acidosis, visual disturbances (blindness)

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6
Q

tx for methyl alcohol (methanol) and ethylene alcohol toxicity?

A

ethyl alcohol and bicarb (ties up alcohol dehydrogenase)

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7
Q

automotive antifreeze that’s oxidized to oxalic acid (very toxic to kidney); causes renal insuff, acidosis, and CNS excitement –> depression

A

ethylene glycol

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8
Q

rubbing alcohol that causes gastritis, acidosis, CNS sx. no tx –> sx/supportive tx only

A

isopropyl alcohol

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9
Q

which is more important for CNS stimulation: NE, 5HT, or DA?

A

DA: central and peripheral stimulant: wakefulness, alertness, dec fatigue sense, elevate mood, inc concentration ability, improve physical performance.

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10
Q

CNS (and peripheral) stimulant that blocks reuptake of DA, NE, 5HT; has a free base called ___

A

cocaine, crack

but its the DA that’s most important for CNS stimulation (and pleasure-reward)

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11
Q

how is cocaine metabolized?

A

rapidly by plasma cholinesterase.

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12
Q

used as a topical anesthetic for URT (combined vasoconstrictor and local anesthetic). has sympathetic effects that include paranoia and aggression.

A

cocaine

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13
Q

class: methylxanthines; competitive antagonists at adenosine (“purinergic”) receptors.
(adenosine makes u sleepy (sedative, anxiolytic, anticonvulsant, analgesic)
at higher doses: inhibits phosphodiesterases (thus, inc cAMP and cGMP)

A

caffeine (also theophyline and theobromine ), in coffee, tea, chocolate, energy drinks, some drug preps

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14
Q

CNS: stimulation, nervousness, anxiety, irritability, restlessless, insomnia, tremors
PNS: inc capacity for sk mm work, bv dilate (but brain’s bv’s constrict (therefore tx headaches)), inc force of contraction and HR, DIURETIC, relieve bronchoconstriction and reduce inflm (theophylline is used to tx asthma

A

methylxanthines (caffeine, etc)

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15
Q

leading cause of preventable deaths in this country

A

nicotine

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16
Q
  • activates nicotinic ach receptors in periphery and CNS
  • ganglionic stimulant
  • depolarizing ganglionic blocker
  • CNS stimulant
A

nicotine!

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17
Q

10 opioids

A
  1. morphine
  2. codeine
  3. tramadol
  4. fentanyl
  5. methadone
  6. oxycodone
  7. meperidine
  8. propoxyphene
  9. loperamide
  10. diphenoxylate
18
Q

do opioids cross tolerate and exhibit cross dependence?

A

yes! thats why you can use methadone for heroin addicts

19
Q

3 schedule 1 hallucinogens

A
  1. LSD
  2. mescaline
  3. psilocybin
20
Q

from ergot fungus

A

LSD

21
Q

how do hallucinogen’s work? (mechanism)

A
  1. agonist at inhibitory 5HT2a receptors on Raphe cell body —> inhibits raphe nuclei firing –> increased sensory input
  2. partial DA agonist
22
Q

physiological effects of hallucinogens

A

mydriasis (dilation), inc HR/BP/RR, hyperreflexia, inc mm tone, occasionally N/V and ataxia

23
Q

sensory effects of hallucinogens

A

simple to complex hallucinations (distortion of perceptions), often more than 1 modality

24
Q

psychic effects of hallucinogens

A

magical/religious, sometimes paranoid.
may include: synesthesia (hear colors, see sounds), changes in mood (usually euphoria) (can shift from fear/panic/bad trip)
sense of temporal and physical detachment, fluid mental state

25
Q

LSD effects

A

altered perceptions: magical thinking, loss of ego boundaries, mood changes (ecstasy –> panic), heightened sensory awareness, mild sympathomimetic effects (inc BP, mydriasis, etc).
trip ends in 8-12hrs

26
Q

does hallucinogens cross tolerate?

A

yes. LSD with mescaline and Psilocybin (not with THC or PCP)

27
Q

how do raphe nuclei work in human brain?

A

raphe nuclei fires tonically to inhibit postsynaptic neurons. raphe nuclei are serotonergic and firs tonically to inhibit reactiveness to stimuli

28
Q

T/F: LSD excites post synaptic neurons, thus, heightens response to stimuli and produce sensory and emotional flood.

A

T or F: LSD releases post-synaptic neurons from tonic inhibition, so raphe nucleus inhibits post neurons, but LSD release that inhibition

29
Q

tx for LSD toxicity?

A
  1. talk down; LSD pts are very susceptible to suggestion; (pts on PCP are not)
  2. diazepam
30
Q

LSD (dont die from it), what are some sx of toxicity?

A
  1. bad trips: anixety, panic-attack
  2. flashbacks
  3. chronic psychosis
  4. street drug life style
31
Q

hits cannabinoid receptors, (CB1, CB2 –> both GPCRs)

A
  1. marijuana (THC=delta9-tetrahydrocannabinol)
  2. anandamide
  3. dronabinol
  4. nabilone
32
Q

of the drugs that hit canabinoid receptors, which one is an endogenous cannabinoid?

A

anandamide (derived from arachidonic acid)

33
Q

which two are synthetic THCs?

A

dronabinol and nabilone

34
Q

which of the cannabinoids is approved for tx of chemo-induced N/V, that has not responded to conventional antiemetics, and it is useful in tx of anorexia and weight loss in AIDS pts? and it also have less psychoactive SEs than marijuana

A

nabilone

35
Q

schedule 1 hallucinogen, antiemetic, antinausea, appetite stimulant for chemo and AIDs pts,

  • analgesic for neuropathic pain
  • potentially glaucoma, asthma, anxiolytic, migraine, MS tx.
A

marijuana

36
Q

SE of marijuana?

A
  • vasodilation –> tachy, dilation of conjunctival vessels –> dec IOP,
  • bronchodilation
  • hunger
  • may impair reproductive fnc in adolescents, and heavy use may impair development in young kids, possible respiratory damage due to tar
37
Q

structure and activity thats similar to iv. anesthetic, ketamine?

A

PCP - phencyclidine

38
Q

agonist at mu opioid receptors, antagonist of ion channel assoc with NMDA receptor

A

PCP

39
Q

effects: violent behavior, coma, seizures, arrest, inexplicable psychosis (schizo’s + and -‘s);
- dissoc, confusion, ataxia, marked nystagmus.

A

PCP (highly lipid soluble and have active metabolites (long T1/2))

40
Q

TX of PCP “bad trip”

A

isolation (no talk down)

diazepam (sometimes anti-pscyhotic (haloperidol))

41
Q 
indirect sympathomimetic (release biologic amines from nerve terminals in periphery and CNS), DA most important. 
-tx narcolepsy, ADHD
A

amphetamines

42
Q

ecstasy

A

MDMA (3,4 methlenedioxymethamphetamine) –> may be a 5HT neurotoxin

43
Q

substituted amphetamine analogues based on cathinone structures (cathinone is the active stimulant in “khat”)

A

bathsalts

Pharm unit 3 (19 decks)

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