Substance use disorder Flashcards
What is tolerance
adaptive state due to increase need to take more of a drug to experience the same effects
What is addiction
severe psycological dependence
What is dependence
Compulsion to take the drug
Psychological drive to experience pleasure or to avoid potential discomfort
What does dependence result in
desensitization and down-regulation of receptors
What is heroin
an opioid
MOA of heroin
inhibit GABA release
incr. DA release=euphoria, satisfaction and pleasure
Admin of Heroin
IV, IM, SC, Inhaled, smoked
SEs of heroin
Restlessness
Withdrawal symptoms of heroin
Mydriasis
yawning
fever
sweating
pilorection
nausea
diarhoea
insomnia
depression
nervousness
shaking
cramps`
Heroin intake symptoms
Pupillary miosis
conjunctival injection
injection sites identified on arms
decr. respiratory rate
bradycardia
absent bowel sounds
Treatment of opioid detoxification and substitution
Long-acting opioids: Buprenorphine, methadone
What is Buprenorphine
partial agonist at mu-opiod receptor
When is Buprenorphine used
for outpatient use
Overdose potential for Buprenorphine
Low
Drug used for suppressing Heroin withdrawal syndrome
Methadone
Drug used for maintenance therapy relapse prevention of Heroin
Naltrexone
MOA of Naltrexone
mu-opiod receptor antagonist, competitively blocks effects of heroin
When will Naltrexone be prexcribed
When the patient has high motivation
And has to be opioid free for 7-10 days before Naltrexone therapy
Drug used for opioid overdose
Naloxone
MOA of Naloxone
competitive mu-opioid receptor antagonist
=reverses acute effects of morphine/heroi in minutes (life-saving)
What is THC
psycoactive component of cabbinoids
MOA of THC
disinhibition of DA neurons by presynaptic inhibition of GABA neurons in VTA
half-life of THC
21.5 hrs
onset of THC
fast initial onset effects= euphoria and relaxation
half-life of CBD
56-61 hrs
acute withdrawal effects of Cabinnoids
anxiety attacks
acute psychosis
hallucination
Abrupt cabbinoid cessation symptoms
restlessness
irritability
agitation
insomnia
cramps
Treatment of Cabinnoid effects
BDZ: for hallucinations
MOA of Cannabis
Neurotransmitter bind to Cannabinoid R: CB1
= decr. GABAergic inhibition of DA release
=incr. DA release
Admin of Cannabis
smoking
What is Cannabis
Hallucinogen
Earlier onset age of Cannabis predisposes you to
Schizophrenia
MOA of alcohol
Enhance inhibitory neurotransimssion at GABA-A receptors, NR and 5HT3 Rs
Reduce excitatory neurotransmission at Glutamate Rs, NMDA Rs, Voltage gated Ca Rs
How does alcohol affect women differently
they have a lower total body water content
=higher peak conc.
Low conc. of alcohol are metabolised
safely by 2-sterp process
High conc. of alcohol are metabolised
in alternate pathways–> toxic by-products
Toxic by-product of alcohol metabolism
Actealdehyde
Enzyme that metabolises alcohol to its metabolite
Aldehyde dehydrogenase ADH
Which are the ADH inhibitors
Disulfiram
Metronidazole
Trimethorpin
Alcohol inhibits which reflex
the cough reflex
Alcohol poisoning symptoms
trouble with balance
problems with muscle co-ordination
progressive erratic behaviour
vomiting
Medical Treatment of alcohol
BDZs: curb withdrawal symptoms
Anticonvulsant protect against seizures
Long-term absitence: Naltrexone, Disulfuram, Acamprosate
Which are the psychomotor stimulants
Cocaine
Amphetamines
MOA of cocaine
inhibit Catecholamine reuptake of DA, NE and SE by blocking DA transporter (DAT)
Cocaine is also a
potent local vasoconstrictor
=block neuronal voltage sensitive Na channel
Half-life of cocaine
short: 30-90min
DOA of cocaine
6 hrs
shorter when inhaled/snorted
onset of action of cocaine
60 mins to reach peak conc.
Cocaine abuse symptoms
Euphoria
reduced appetie
hyperactive
sleep disturbance
anxiety
tachycardia
Cocaine abuse risks
intracranial hemorrhage
ischemic stroke
MI
ventricular arrythmia
seizures
Amphetamines are
synthetic, indirect acting sympathomimetic drugs
Amphetamine abuse symptoms
dehydration
sweating
excessive water intake: Hyponatraemia
MOA of amphetamines
release endogenous neurotransmitters like DA, NE and SE
Common amphetamines
methamphetamine
dextroamphetamine
methyphenidate
ecstasy
Amphetamine withdrawal symptoms
fatigue
depression
sleep problems
MOA of nicotine
agonist at NR in VTA
incr. DA release in NAc
What is nicotine
a CNS stimulant that incr. BP ad HR
