Week 3 - Alcohol and drugs

Question 1

Which neurotransmitter pathway do sedatives act on?

Answer 1

GABA

Question 2

How does alcohol cause pleasure?

Answer 2

Acts on dopamine and opioid pathways.

Question 3

How does alcohol cause ataxia?

Answer 3

Acts on GABA receptors

Question 4

How does alcohol cause amnesia?

Answer 4

Acts on GABA receptors, blocks NMDA receptors.

Question 5

What are the long term effects of alcohol?

Answer 5

Wernicke-Korsakoff syndrome
Peripheral neuropathy
Cerebellar degeneration
Myopathy
Cognitive decline
Seizures
Withdrawal effects
Injury / intracranial haemorrhage

Question 6

At which synapses do stimulants enhance neurotransmission?

Answer 6

catecholaminergic / dopaminergic /

serotonergic synapses

Question 7

What is the effect of stimulants?

Answer 7

Increase behavioural and motor activity
Increase alertness / disruption of sleep
Euphoria
Confidence

Question 8

What are the side effects of stimulants?

Answer 8

Anxiety
Insomnia
Irritability

Question 9

What are the signs of stimulant misuse?

Answer 9

Tachycardia
Hypertension
Risk of arrhythmia
Sweaty
Hallucination
Agitation
Dilated pupils
Elevated temperature

Question 10

What is serotonin syndrome?

Answer 10

Triad of;
Altered mental status – Agitation / confusion / seizures
Autonomic changes - Hyperthermia, diaphoresis, diarrhoea, tachycardia,
hypertension, salivation
Neuromuscular effects - Myoclonus, clonus, hyperreflexia, tremor, rigidity

Hallucinations are also common.

Question 11

What is the onset of action of cocaine?

Answer 11

Seconds to minutes.

Question 12

What is the peak level of cocaine use?

Answer 12

30 minutes

Question 13

What is the half life of cocaine?

Answer 13

30-90 minutes

Question 14

How does cocaine have high concentration in the brain?

Answer 14

Rapid blood brain barrier penetration.

Question 15

What effect does cocaine have on neurotransmitters in the brain?

Answer 15

Blocks DA, NE & 5-HT re-uptake.
Exerts inhibitory effect on postsynaptic dopamine receptors
Blocks the presynaptic transporter protein for DA
• Dopaminergic pleasure effect
• Noradrenergic excess (readiness)

Question 16

What is the onset of action of amphetamines?

Answer 16

Seconds to minutes

Question 17

At what time is the peak level of action of amphetamines?

Answer 17

Minutes to 30 minutes.

Question 18

What is the half life in plasma of amphetamines?

Answer 18

12 hours.

Question 19

What is the effect on the neurotransmitters of amphetamine use?

Answer 19

Enhance release of DA & NE from pre-synaptic terminals
• Dopaminergic pleasure effect
• Noradrenergic excess (readiness)

Question 20

For how long are amphetamines detectable in the urine?

Answer 20

48 hours

Question 21

What are the acute neurological problems with stimulants?

Answer 21

Motor
Tremor / Myoclonus / Rhabdomyolysis / Movement disorders
Seizures
Neuropsychiatric
Restlessness / Irritability / Violence / Psychosis
Autonomic
Hyperpyrexia

Question 22

What are the chronic neurological problems with stimulants?

Answer 22

Anxiety
Sleep deprivation
Paranoia
Aggression
Paranoid psychosis (more with amphetamines)
Cognitive dysfunction
Simple negative feedback

Question 23

How do stimulants cause vasospasm?

Answer 23

Mediated by alpha-adrenergic stimulation.
Platelet aggregation is increased.
Evidence for accelerated atherosclerosis.

Question 24

Which receptors do opiates act on?

Answer 24

Sedation:  receptors
Dysphoria: k receptors

Question 25

What effect do opiates have on GABA release?

Answer 25

Reduces it

Question 26

What effect do opiates have on dopamine?

Answer 26

Increases it

Question 27

What is GHB used for?

Answer 27

Date rape drug.

Question 28

What are the effects of GHB?

Answer 28

Dysphoria (stimulates dopamine release) Sedation (GABA receptor activation) Muscle twitching

Question 29

What are the 7 signs of opiate toxicity?

Answer 29

``` Pinpoint pupils Respiratory depression Bradycardia Hypotension Hypothermia Pulmonary edema Seizures ```

Question 30

What are the effects of too much sedatives or hypnotics?

Answer 30

``` Ataxia Blurred vision Coma Confusion Delirium Sedation Pupils likely to be normal ```

Question 31

Give some examples of drugs that can cause sedative toxicity.

Answer 31

Anticonvulsants Benzodiazepines GHB Ethanol

Question 32

What are the complications of drug injection?

Answer 32

``` Embolic infarction Infective endocarditis Abscesses Discitis Meningitis HIV related illness ```

Question 33

What are the indirect neurlogical effects of sedative use?

Answer 33

Coma Compressive nerve palsies Anoxic brain injury

Question 34

Which neurotransmitters do hallucinogens act on?

Answer 34

Serotoninergic (5-HT systems) Noradrenergic (NE systems) Cholinergic (ACh systems)

Question 35

What are the overall effects of hallucinogens?

Answer 35

Psychedelics Dissociative anesthetics Deliriants

Question 36

What are the signs of cholinergic toxidrome?

Answer 36

``` Defecation Urination Miosis (small pupils) Bronchoconstriction Bradycardia Emesis Lacrimation Salivation ```

Question 37

What is the effect on neurotransmitters of MDMA?

Answer 37

Blocks 5HT and NE reuptake

Question 38

What are the side efffects of MDMA use?

Answer 38

Thermoregulatory problems Hallucinations CV complications

Question 39

What are the neurological effects of hallucinogens?

Answer 39

Rare reports of stroke Toxic psychosis Dangerous behaviour Wernicke’s type syndrome – Angel dust

Question 40

Name some organic solvents.

Answer 40

Toluene Hexane Benzene

Question 41

What are the acute effects of organic solvents?

Answer 41

Lightheadedness | Hallucinations

Question 42

What are the effects of prolonged use of organic solvents?

Answer 42

Cognitive impairment Diplopia / ataxia / nystagmus Coma

Question 43

What is the active component of marijuana?

Answer 43

THC

Question 44

What are the effects of cannabis?

Answer 44

Agonist at cannabinoid receptors – G protein linked receptors Alters mood Increases dopamine release Modulates opiod receptors

Question 45

What are the long term effects of cannabis use?

Answer 45

Psychosis Altered neural connectivity on fMRI analysis Cognitive effects

Question 46

What is mephedrone more commonly known as?

Answer 46

Bath salts

Question 47

Which drug is mephedrone similar to?

Answer 47

Amphetamine

Question 48

What are the effects of mephedrone?

Answer 48

Increased energy Euphoria Confidence Empathy

Question 49

What is the effect of ivory wave?

Answer 49

Reduces dopamine reuptake

Question 50

How long can the effects of ivory wave last?

Answer 50

A week

Question 51

What are the unpleasant effects of ivory wave?

Answer 51

Agitation Hallucinations Myoclonus

Question 52

What is steatosis?

Answer 52

The process describing the abnormal retention of lipids within a cell.