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18 Cards in this Set
- Front
- Back
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Limbic vs Cortical thought processes
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Limbic: drive (site of pharmacotx)
Cortex: decision making (counseling, pharmacotx) |
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Effect of low alcohol dose vs high alcohol dose
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Low alcohol dose: stimulating; act on membrane proteins, displaces water
High dose: sedative; non-specifically disrupts membrane functioning (fluidization) |
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Effect of alcohol on GABA receptors? Effect of alcohol withdrawal?
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Alcohol facilitates GABA receptor activity
GABA receptors are down-regulated during withdrawal |
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Disulifram: mechanism, use
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ANTABUSE
interferes with breakdown of acetaldehyde (via ADH inhibition); produces vasidilitation, hypotension, nausea, vomiting Used to produce unpleasant reaction when alcohol is consumed |
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ALDH2*2 allele
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genetic antabuse; prevalent in Asian populations
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Effect of alcohol on opioid systems?
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Alcohol results in release of endorphins which facilitate DA release
Alcoholics have reduced opioid peptides |
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Naltrexone: mechanism, use
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Opioid antagonist (blocks alcohol reward pathway)
Used to treat alcoholism with greatest beneft to pts with family hx EtOH, higher levels of craving |
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A118G allele
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associated with increased substance abuse risk (greater beta-endorphin binding); associated with naltrexone response
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Acamprosate: mechanism, use
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Glutamate antagonist, GABA agonist
Used to reduce post-synaptic withdrawal effects (Required daily ingestion of 2 tabs tid so compliance is impt for effectiveness) |
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Why are antiepileptic/mood stabilizing medications sometimes used to treat alcoholism?
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More commonly used to treat withdrawal symptoms bc antiepilectics/mood stabilizers inhibit neuronal excitation through actions at glutamate and GABA receptors (just like EtOH!)
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4 antiepilectics/mood stabilizers effective in treating alcohol dependence.
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Carbamazepine
Valproate Gabapentin Topiramate |
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When are reductions in drinking seen with use of SSRIs?
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When patients are NOT depressed
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Effect of clozapine on alcohol dependence.
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Clozapine: atypical antipsychotic, blocks D2's!
DOPAMINE ANTAGONISTS HELP REDUCE ALCOHOL DEPENDENCE |
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VNTR allele
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cue induced craving for alcohol is greater for those with VNTR allele of dopamine receptor
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Baclofen: mechanism, use
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GABA-B receptor agonist, used to reduce EtOH withdrawal
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Methadone: mechanism, use
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opioid agonist used to relieve narcotic cravings
Can be used as a lifelong tx for some pts |
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Buprenorphine: mechanism, use
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opioid agonist at low doses and antagonist at high doses; binds with HIGH affinity
Used as maintenance treatment of opiate addicts (milder withdrawal sypmtoms) |
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Naltrexone: mechanism, use
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mu opioid antagonist (blocks effect of opioids)
most effective in treating withdrawal symptoms in highly motivated pts (impaired professionals, probationers) and less effective in street addicts |
