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42 Cards in this Set
- Front
- Back
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What class of drugs is marijuana in? MOA?
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Cannabinoids
Primary psychoactive component = THC, which is a partial agonist at the GPCR CB1 |
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What is the endogenous ligand of the CB1 receptor? function?
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Anandamide
Represents a class of endocannabinoid retrograde neuromodulators that act as a feedback mechanism to reduce neuronal excitation |
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What are signs and symptoms of cannabinoid intoxication?
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Euphoria, drowsiness, sedation
Anxiety and tachycardia Sensation of slowed time, auditory or visual distortions Increased appetite |
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Treatment of cannabinoid overdose?
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Activated charcoal
Benzodiazepines for anxiolysis |
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LSD: MOA?
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Serotonin agonist, resulting in activation of phosphatidylinositol hydrolysis and increased excitability of neurons, mimicking overstimulation of the serotonergic systems involved in processing sensory information.
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PCP: MOA?
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Blocks NMDA type glutamate receptors, which mediate excitatory synaptic transmission.
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MDMA: known as? MOA?
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Ecstasy
Causes serotonin release into synaptic cleft, inhibition of synthesis, and block of reuptake. |
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What are the hallucinogens? Signs and symptoms of overdose?
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LSD
PCP MDMA Marked anxiety or depression Perceptual changes Autonomic arousal Impaired judgment |
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Treatment of hallucinogen overdose?
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Treat hypoxia and hypoglycemia
Rapidly absorbed, so gastric decontamination isn't useful Benzodiazepines |
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What are the 3 types of acquired tolerance?
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Metabolic (change in capacity of the body to eliminate the drug so that a lower molar concentration is available)
Functional (reduced response from the same concentration) Behavioral (compensatory changes in behavior) |
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What is conditioned tolerance?
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Conditioned tolerance: environmental cues associated with exposure to a drug induce pre-emptive reflexive compensatory changes, called a conditioned opponent response.
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What is another name for inverse tolerance? When does it occur?
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Sensitization
Repeated uses of CNS stimulants Stimulatory component of the biphastic responses characteristic of CNS depressants |
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What is the most common feature of withdrawal from most drugs that are rapidly eliminated from the body, faster than the brain can adapt?
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Activation of ANS, related to stress response of disturbed homeostasis
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CNS depressants: affect of long term use?
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Down regulates GABAa receptors by neuroadaption
Up regulation of NMDA receptors Sympathetic hyperactivity |
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Clinical manifestations of withdrawal from CNS depressants?
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Anxiety
Tremor Autonomic hyperactivity Sensory distortions N/V Seizures, delirium |
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Detoxification from CNS depressants
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Alcohol: long-acting benzodiazepine like diazepam
Benzodiazepines: phenobarbital or clonazepam Barbiturates: phenobarbital |
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Long term effects of CNS stimulants?
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Upregulation of transporters
Down regulation of post-synaptic receptors Depletion of biogenic amines in presynaptic storage vesicles |
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Symptoms of CNS stimulant withdrawal
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Intense craving
Depression, dysphoria Psychomotor retardation Fatigue Increased appetite |
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Detox from CNS stimulants
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Supportive
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Symptoms of opioid withdrawal
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Intense craving
Depressed mood Joint/muscle aches N/V/D Pupillary dilation and photophobia |
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Detox of opioids
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Clonidine (reduces symp component)
Methadone Buprenorphine |
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Main symptoms of nicotine withdrawal
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Intense craving
Irritability, anxiety, depression Increased appetite Autonomic hyperactivity |
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Detox from nicotine
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Behavioral methods
Clonidine (autonomic hyperactivity) |
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Marijuana: tolerance mechanism?
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Down regulation of CB1 receptor expression and modifications that reduce signal transduction efficacy
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Symptoms of marijuana withdrawal
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Anger or aggression
Dcreased appetitie Irritability, restlessness Sleep difficulties, strange dreams |
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Detox: marijuana?
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Behavioral methods
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Withdrawal symptoms of hallucinogens?
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Few if any reliably reported withdrawal symptoms
Flashbacks? |
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What is protracted abstinence syndrome?
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After acute withdrawal, subtle signs of brain dysfunction may persist after discontinuation of drug use
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What are characteristics of protracted abstinence syndrome?
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Increased CNS excitability and stress reactivity (panic attacks, irritability, depression)
Dysregulation of neuroendocrime systems (sleep disturbances) Anhedonia Craving Very rapid emergence of dependence syndrome after relapse Neurocognitive impairments (due to direct toxic effects) |
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Allostasis: define.
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Enduring, progressively evolving adaptive processes in brain reward pathways resulting from repeated exposure to abused drugs.
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Disulfiram: MOA?
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Inhibitor of acetaldehyde dehydrogenase that causes elevated levels of acetaldehye when alcohol is ingested
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What are the symptoms of the aversive acetaldehyde reaction?
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Flushing
Accelerated HR SOB N/V |
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Naltrexone: MOA?
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Opioid antagonist that competitively blocks the binding of opioids to the gamma-opioid receptor
Can also be used to treat alcohol dependence |
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Acamprosate: MOA? use?
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Modulates glutamate hyperactivity to reestablish a more normal state
Preventing relapse to alcohol drinking |
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Topiramate: MOA? Use?
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Anticonvulsants which inhibits the AMPA/KA class of glutamate receptors
Reduces alcohol drinkin |
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Medications for CNS stimulant addiction?
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None
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Methadone: MOA and usage?
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MOR agonist administered as substitution therapy to opioid dependent individuals
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Buprenorphine: MOA and usage?
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MOR partial agonist/antagonist used for opioid maintenance treatment
Alleviates withdrawal symptoms and reduces cravings by activating MOR and enhancing mesolimbic dopaminergic neurotransmission |
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Varenicline: MOA? effects?
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Nicotinic partial receptor agonist, resulting in enhanced mesolimbic dopaminergic neurotransmission, reducing withdrawal symptoms and diminished cravings.
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Treatment of cannabinoids addiction?
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No medications
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Treatment of hallucinogens addiction?
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No medications
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What drugs for co-occuring psychiatric disorders have been shown to be helpful with addiction?
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Mood stabilizers for those with bipolar and mood instability
Antipsychotics (drug use disorders secondary to psychotic and affective disorders) |
