Substance use Disorders Pt.2

Question 1

Nicotine

Answer 1

Cholinergic nicotinic receptor genes
Stimulates a family of acetylcholinc receptors which are abundant on neurons that release DA.
Since DA is associated with reward, nicotine will be rewarding also

May reduce schizophrenia sx.
Bupropion (NDRI) for nicotine addiction/cravings
Chantix for tx (nicotinic receptor partial agonist)

Question 2

Caffeine neurochemistry

Answer 2

CNS stimulant
Effects: increased cortical tone, alertness, and arousal
Theophylline and caffeine (methylxanthines) are antagonists of adenosine (important for sedation)

Question 3

Alcohol use disorders

Answer 3

Type I: onset after age 25. Depends on more stressful life. Less severe and more likely to respond to treatment

Type II: rapid onset, before age 25. Most are men with family history

Question 4

Alcohol use genetics

Answer 4

The body converts ethanol to acetaldehyde (toxic) then the enzyme acetaldehyde dehydrogenase converts that into acetic acid (used for energy)
Those with a gene that produces less of this enzyme

COMT gene - alcoholism is more likely with those described as compulsive, risk taking, easily bored, etc in childhood.

Question 5

Alcohol use neurochemistry

Answer 5

CNS depressant

Increase in inhibitory neurotransmitters (GABA-important for sleep) and decrease in function of excitatory neurotransmitters (glutamate- important for encoding memories) amnesia more likely to occur with intoxication

Affects memory
Opioids and dopamine also released

Question 6

Stimulants genetics

Answer 6

Obesity associated gene (Fto) related to food addiction is also associated with alcoholism, cocaine use, and ADHD.

Reward deficiency syndrome: impairment of the brain reward circuitry resulting in hypo-dopaminergic function

Question 7

Stimulants neurochemistry

Answer 7

Increase the release and decrease the reuptake of catecholamines (DA & NE) which leads to greater effect of COMT (withdrawal state leads to deficit of DA)

Question 8

Opiates

Answer 8

In PNS: external opiates and endorphins bind to opioid receptors inhibiting the release of substance P and other proteins involved in transmission of pain

In CNS: external opiates and endorphins bind to opioid receptors and inhibit GABA which will increase DA production