Benzos, Addiction, Ethanol And Such

Front 1

A chronic, relapsing brain disease that is charactierized by compulsive drug seeking and use, despite harmful consequences is ________.

Back 1

Addiction

Front 2

Addiction is characterized by behaviors that include one or more of the following (Four C's of addiction):

Back 2

loss of Control over drug use.
continued use despite harmful Consequences.
Compulsive use and Craving.

Front 3

What 2 observable phenomena that comprise physical dependence are _________ & ___________.

Back 3

What 2 observable phenomena that comprise physical dependence are tolerance & withdrawl.

Front 4

T/F: Addiction produces persistent changes in the brain.

Back 4

TRUE

Front 5

___________ is due to compensatory pharmacodynamic changes, such as down-regulaiton and desensitization of receptors.

Back 5

Tolerance is due to compensatory pharmacodynamic changes, such as down-regulaiton and desensitization of receptors.

Over time these changes compel a person to take more of the drug to acheive the same effect; of the same level & pattern of consumption ceases to produce the desired effect.

Tolerance that develops to various effects of a givne drug can differ considerably.

Front 6

_________ is a specific sx that starts w/in a few hours of stopping a drug.

Back 6

Withdrawl is a specific sx that starts w/in a few hours of stopping a drug...occurring, in part, due to a down-regulation if receptors leading to unstable neurotransmission.

Front 7

Acute withdrawl starts within ______ of a drug.

Back 7

Acute withdrawl starts within a half-life of a drug (for most drugs), peaks within 3-5 half-lives and resolves within a week or two at the most. Effects of w/d are often opp. effects of the drug.

Front 8

T/F: During withdrawl, the sx are often the opposite of the drug's effects.

Back 8

TRUE

Front 9

Any self-adminstratino of a drug that deviates from approved medial or social patterns iwthin a culture.

Back 9

Drug or Substance Abuse (can be experimental, recreational or circumstantial)

Front 10

What is a Drug Reinforcer?

Back 10

A substance whose pharm effects drive the use to continue its use.

Positive reinforcer: drug that, when delivered following some behavior, increases the probability that the behavior will occur again.

Negative reinforcement: occurs when a behavior results in the termination of an aversive stimulus (using drugs during withdrawl).

Front 11

What are some drugs that reduce cravings?

Back 11

Acamposate
Modafinil
Clonidine
Baclofen

Front 12

What are some common reversal agents?

Back 12

Naloxone
Flumazenil
Naltrexone

Front 13

_________ is a primary, chronic, neurobioligical disease with genetic, psychosocial and env factors that influence its dev. and manifestations.

Back 13

Addiction is a primary, chronic, neurobioligical disease with genetic, psychosocial and env factors that influence its dev. and manifestations.

Front 14

Addiction is characterized by:

Back 14

Compulsive behavior
Continued abue of drugs despite negative consequences.
Persistent changes in the brain structure and fx.

Front 15

Compare and contrast the high of cocaine and opiates.

Back 15

Coke elicits feelings of poer, self-confidence and increased energy.

Opioids induce a uphoria followed by feelings of relaxation and satisfaction.

Front 16

What are some common reasons people abuse substances?

Back 16

To feel good: get high (duh..."Drink my drink and smoke my_____, my good friends is all I need.")

To feel better: lessen feelings of distress/stress.

To do better: performance enhancing drugs.

Curiosity and b/c others are doing it: socially reinforcing; adolescent particularly vulnerable.

Front 17

T/F: Genetic factors are thought to account for 40-60% of a person's vulnerability to addiction.

Back 17

TRUE

Front 18

Describe the several various factors that account for vulnerability of a person to become addictied to a drug?

Back 18

Env Factors (Homelife, peers, family)
Genetic Factors
Early Use (drug abuse usually begins in childhood or adol.)
Method of Admin. (smoking or Injecting increases addiction potential).
Availability & Cost (easy access increases risk of addiction).

Front 19

THC is a chemical imposter for what endogenous brain substance?

Back 19

Anandamide

Front 20

Whatever mechanism of operations drugs may have, what is the final common pathway all drugs of abuse share?

Back 20

The Mesolimbic Dopamine System is the prime target of addictive drugs. Drugs of abuse share a final common pathway by which they increase levels of DA within the core structures of this "Brain Reward Center".

Front 21

T/F: Hallucinogens are an exception to the Mesolimbic DA System rule for drugs of abuse.

Back 21

TRUE: probably mediated by serotonin pathways.

Front 22

The mesolimbic dopamine system originates in the Ventral Tegmental area and projects where?

Back 22

The mesolimbic dopamine system originates in the Ventral Tegmental area and projects to the Nucleus Accumbens, the amygdala and the prefrontal cortex.

All addictive drugs strongly increase DA in the mesolimbic projection.

Front 23

___________ occurs when a larger dose of the drug is required to produce the same degree of respons ora given dose ofa drug produces a diminished response.

Back 23

Tolerance

Front 24

________ _________ is due to pharmacokinetic differences that reduce plasma levels of a drug after its chronic use.

Back 24

Dispositional Tolerance is due to pharmacokinetic differences that reduce plasma levels of a drug after its chronic use.

Most common mechanism is induction of drug metab. enzymes.

Front 25

___________ __________ represents and adaptive change at drug sites of action (receptors) such that higher concentration of drug are required to produce the previous pharmacological response.

Back 25

Pharmacodynamic Tolerance represents and adaptive change at drug sites of action (receptors) such that higher concentration of drug are required to produce the previous pharmacological response.

Front 26

___________ ___________ occurs when changes in the response to a drug due to behavioral mechanisms.

Back 26

Behavioral Tolerance occurs when changes in the response to a drug due to behavioral mechanisms.

Usually a learned behavior and predominates when the effect of the drug has a behavioral cost to the individual

Front 27

_______ _______ describes a set of adaptive changes in an individual produced by repeated admin of a drug such that cont'd administration is req'ed to maintain physiological fx.

Back 27

Drug Dependence describes a set of adaptive changes in an individual produced by repeated admin of a drug such that cont'd administration is req'ed to maintain physiological fx.

Front 28

What is the difference between abrupt withdrawl and precipitated withdrawl?

Back 28

Abrupt w/d occurs when a drub is d/c'ed or when abstinence is enforced.
Precipitated w/d occurs shortly after admin of an antagoinst that displaced the dependent drug from its receptors.

Front 29

Intensity of w/d sx is ________ for shorter acting drubs and especially severe after ______ withdrawl.

Back 29

Intensity of w/d sx is more _intense_ for shorter acting drubs and especially severe after _precipitated_ withdrawl.

Front 30

What phenomena occur between drugs with common mechanisms?

Back 30

Cross-dependence and Cross-tolerance.

This is the basis for treating withdrawl of certain drugs of abuse with other similar acting drugs. Can stretch withdrawl out more slowly & less intensely.

Ex: diazepam (long acting benzo) for etoh withdrawl.
Methadone (long acting opioid agonist) or partial opioid agonst buprenorphrine) for tx of heroine addiction.
Transdermal nicotine patch for tx of tobacco cessation.

Front 31

Heroine is a more lipid soluble form of _____.

Back 31

Morphine...it is actually diacetyle morphine.

Front 32

Other factors that contribute to drug abuse:

Back 32

Route of Admin: IV/inhal routes speed deliver of drug to CNS and are more reinforcing.

Dose of Drug: doses that activate the reward pathways or prevent withdrawl.

Env Setting & repeated behaviors: old playmates and playgrounds associated with drug abuse can be reinforcing.

Lipid Solubility: lipophilic enter brain faster and are thus more reinforcing (ex - heroine more reinforcing than MSO4)

Front 33

What is the number 1 problem in the tx of drug abuse?

Back 33

Relapse

Front 34

Relapse is usually triggered by one of three conditions. What are they?

Back 34

Rexposure to drugs of abuse.

Stress

Context that recalls prior drug use.( cues from people, places, paraphenalia for ex.)

(Got to stay tight on your daily disciplines - from the day you stop using until the day you stop breathing.)

Front 35

The risk of relapse due to contextual cues suggests what?

Back 35

The role of learning and memory in drug abuse.

Front 36

What is the single best tx for drug abuse?

Back 36

there is none - the best approach is a multimodal approach.

Pharm interventions may be useful at all stages of the disease.

Front 37

Naloxone and flumazenil are used to antagonize the effects of what drugs, respectively?

Back 37

Naloxone - opioids.
Flumazenil - sedative effects of benzodiazepines.

Front 38

How can clonidine (selective Beta 2 CNS effects) be beneficial in treating some sx of drug OD/withdrawl?

Back 38

It tempers the increased sympathetic nervous system activity induced by many drugs or withdrawl from certain drugs.

Front 39

Methadone is a legally available agonist for what? Is used to treat what?

Back 39

opiate receptors
Tx for heroine addiction.

Front 40

Does dependence persist when a drug abuser is treated with a longer acting legal agonist in place of their drug of abuse?

Back 40

Yes. It is most beneficial if person includes behavioral interventions to gradually reduce the dose and remain abstinent.

Front 41

What is Naltrexone? What are its advantages and disadvantages?

Back 41

Naltrexone is a long acting form of Naloxone - an opioid receptor ANTAGONIST. It blocks the effects of opioid drugs of abuse (exogenous)...they can do all the opioids they want, but are not going to get high.

Naltrexone is also good for diminishing rewarding effects of Cocaine abuse, smoking and ethanol abuse.

It is orally active and does not have to be injected like Naloxone.

But Naltrexone also blocks the receptors from endogenous substances that are part of the normal pleasure pathway. Things like food & sex are diminished.

KNOW***CANNOT be used in combo with disulfiram (antibuse) since both drugs are hepatotoxic***

Front 42

What is Baclofen?

Back 42

Baclofen is a high-affinity GABAb-receptor AGONIST that can significantly reduce drug craving.

Front 43

Acomprosate is useful in reducing relapse in what?

Back 43

Recovering alcholics. It mimics some of the effects of ethanol without the same level of impairment. Is useful in tx of ethanol withdrawl.

Front 44

T/F: Methamphetamine abusers will develop hyper-reactive neuromuscular activity s/t chronic stimulant abuse.

Back 44

FALSE: Loss of dopamine transporters in methamphetaine abusers may result in slowing of motor reactions.

Front 45

T/F: Loss of dopamine transporters in methamphetamine abusers may result in memory impairment.

Back 45

TRUE.

Front 46

T/F: Extended abstinence is Predictive of Sustained Recovery.

Back 46

TRUE: After 5 years of abstinence, there is an 86% chance of remaining sober.

Always have a risk of relapsing, though.

Front 47

What are some indicators that a person will remain in recovery?

Back 47

Abstinence over a long period of time.

Functionality in the Family, Work and Community arenas. They need to feel like they are contributing.

Front 48

What is an advantage of acomprosate over antibuse in treating ethanol addiction?

Back 48

Acomprosate does not have a buildup of nasty metabolites like Antibuse has... Acomprosate has fewer SE.

Front 49

What is the drug Modafinil good for?

Back 49

In combination with behavior thx, the stimulant drug modafinil may be effective for tx of cocaine addiction

Front 50

T/F: Drug abuse and mental disorders often coexist.

Back 50

TRUE: (but it is often a chicken & egg question).

Front 51

IV drug abuse accounts for _____ of new HIV/AIDS cases.

Back 51

IV drug abuse accounts for _1/3_ of new HIV/AIDS cases

Front 52

How are controlled substances classed?

Back 52

By abuse potential. With Schedule I drugs having the most abuse potential and Schedule V the least.

Front 53

An alcoholic relearned certain skills by practicing while under the infuence of ethanol is an example of....

Back 53

Behavioral (learned) tolerance

Front 54

Serotonin regulates what?

Back 54

Mood, sleep among other things.

Can be part of addictive pathways (halluc.)

Front 55

What is glutamate?

Back 55

An excitatory NT. Regulates learning and memory, etc.
Implicated in addiction pathways.