Neuro 2 - Carrier - Non-Medical Drug Use I And Ii

Front 1

Destructive pattern of drug use leading to significant social, occupational, or medical impairment

Back 1

Substance abuse

Front 2

Define Addiction

Back 2

Compulsive, relapsing drug use despite negative consequences

A fraction of subjects develop a habit, lose control and become addicted

Front 3

Define natural reward

Back 3

Things we try to obtain

Ex = sex, food water

Front 4

What are the 3 components of the reward system?

Back 4

Prefrontral Cortex, nucleus accumbens, VTA = Ventral tegmental Area

Front 5

Describe the pathway of Dopamine in the brian

Back 5

From the VTA through substantia nigra to the striatum, From VTA to Frontal Cortex

Front 6

What brain regions must be considered in order to effectively treat addiction?

Back 6

inhibition control, motivation/drive, memory/learning, reward/salience

Front 7

Define Relapse

Back 7

When a drug user uses a drug again after a successful withdrawal.

Front 8

What are some relapse triggers?

Back 8

re-exposure to drug of abuse
stress
a context that recalls prior drug use (trigger) (for ex Vietnam vets did better when treated for their addictions at home, away from stimulus.)

Front 9

Define Tolerance

Back 9

Induction of adaptive changes with repetitive exposure of an addictive drug (inc dose to maintain effect).

Front 10

What are the ways tolerance can develop?

Back 10

Pharmacokinetic = reduction of druc conc. or shorter DOA
Pharmacodynamic = change in receptor function (desensitization and receptor internalization)

Cross-tolerance = pple tolerant to one drug in a class are likely tolerant to other drugs in the same class

Front 11

Define Dependence

Back 11

Exhibition of a combination of withdrawal symptoms (psychological or behavioral changes) when the addictive drug is no longer available; Occurs with chronic exposure; these systems are reversible upon resuming drug use

Front 12

Define Cross-dependence

Back 12

Different drugs in the same class produce similar dependence (ex = heroine, methadone)

Front 13

Define withdrawal

Back 13

Adaptive changes become evident upon removal of drug from system

-different for different classes/people

Front 14

Define Maintenance therapy

Back 14

Involves the use of drugs like methadone to continue opioid dependence, with psychological, social and vocational therapies to help with cravings

Front 15

Define Detoxification

Back 15

Used to treat dependence and consists of abruptly or gradually reducing the drug doses

Front 16

What two routes of drug administration give you the quickest high? Next highest?

Back 16

IV and Smoking (IV is highest)

Next highest is intranasal, followed by oral

Front 17

T/F: The faster the drug gets to the brain, the easier it is for the brain to link the reward system to that drug

Back 17

TRUE

Front 18

What are some of the drugs that are non-addictive because they alter perception WITHOUT causing sensations of reward and euphoria?

Back 18

Hallucinogens and dissociative anesthetics = activate receptors in prefrontal cortex or thalamus

ex = LSD and PCP

Front 19

What part of the brain does LSD stimulate?

Back 19

LSD = Lysergic acid diethylamide which activates the serotonin receptors in the prefrontal cortex

Front 20

What part of the brain does Phencyclidine (PCP) and ketamine inhibit?

Back 20

inhibit the glutamate NMDA receptor

Front 21

What receptor do opioids, cannabinoids, gamma-hydroxybutyrate, and hallucinogens activate?

Back 21

Gi/o-coupled receptors

Front 22

What receptor do nicotine, alcohol, benzos, dissociated anesthetics, and some inhalants activate?

Back 22

Ionotropic receptors or ion channels

Front 23

What receptor do cocaine, amphetamines, and ecstasy activate?

Back 23

Monoamine transporter activation

Front 24

What are the most commonly abused u opioids?

Back 24

Morphine, heroin, codeine and oxycodone

Front 25

What receptors do the Opioids work on?

Back 25

Inhibitory to adenyl cyclase
u Opioid receptor foun on GABA neurons --> euphoria

k opioid receptor found on dopamine neurons --> dysphoria

Front 26

A pt presents to the ER with track marks, pinpoint pupils (miosis), drowsiness, slurred speech, and impaired cognition

What were they on? How do we treat them?

Back 26

Opioids

Give Naloxine (IV) first in ER, then send them home with Naltrexone (oral)

Front 27

What can you tell a pt on Opioid to expect from withdrawal symptoms?

Back 27

Intense Dysphoria, N, V, D, muscle aches, watery eyes, running nose, sweating, yawning, fever, hyperactive bowel sounds

Front 28

Whats methadone substituted for?

Back 28

Heroin

Methadone works longer than heroin

Front 29

Whats the active ingredient in cannabinoids? What does it do?

Back 29

THC = psychoactive substance that inhibits presynaptic GABA neurons in VTA which inhibits dopamine neurotransmission.

Front 30

Within the 4 hours which is the half life of THC, what will users experience?

Back 30

Euphoira, relaxation, well-being, grandiosity, altered perception of time, inc. appetite, attenuation of N, relief of chronic pain

Front 31

What can you tell your 16 y/o kid who you just caught smokin' the refer about the withdrawal symptoms?

Back 31

restlessness, irritability, mild agitation, insomnia, N, cramping

Front 32

Whats the most commonly abused drug?

Back 32

marijauna

Front 33

T/F: THC is approved by the FDA

Back 33

TRUE (its just marijauna that's not cool....brownies anyone?)

Front 34

What is Spice? K2 = fake marijauna...a safe and legal alternative to marijauna. The symptoms reported by users are?

Back 34

Euphoria, relaxation, altered perception, hallucinations, extreme anxiety, paranoia

Front 35

How does Gamma-Hydroxybutyrate (GHB) work?

Back 35

Mediated through GABA-A receptor, its an odorless and readily absorbed liquid. (date rape drug)

Front 36

How long after giving someone GHB= Gamma-Hydroxybutyrate will they experience symptom?

Back 36

30-60 min

Front 37

Whats the half life of GHB?

Back 37

30 min

Front 38

What are the symptoms reported by users of GHB (date rape drugs)

Back 38

euphoria, enhanced sensory and perceptions, amnesia, feelings of social closeness

Front 39

A woman is slipped some GHB into her drink at the pub but fortunately her friends recognize her behavior as odd and take her home. She shows up at your office with what withdrawal symptoms the next day?

Back 39

Insomnia, anxiety, sweating, tremors

Front 40

T/F: Hallucinogens are non-addictive and don't cause dependence

Back 40

TRUE

Why? They fail to stimulate dopamine release. Repetitive exposure leads to tolerance (tachyphylaxis)

Front 41

What symptoms do users of hallucinogens experience?

Back 41

psychosis-like manifestations (depersonalization, hallucinations, distorted time perception, dizzy, blurred vision, N, flashbacks years after last drug exposure

Front 42

You inject a research lab mouse with ketamine. Whats this drug's MOA?

Back 42

Blocks NMDA receptors

Front 43

What are the effects of ketamine?

Back 43

Psychedelic effects last 1 hr and include inc. BP, impaired memory function and visual alterations

Front 44

A pt accidentally took his wifes Benzos by mistake. What can you tell him he'll experience?

Back 44

relief of anxiety, euphoria, disinhibition and sleep promotion

Front 45

When will withdrawal symptoms from benzos occur?

Back 45

within days depending on half life of elimination = irritability, incomnia, phonophobia and photophobia, depression

Taper off after 1- 2 weeks

Front 46

The same pt who accidentally took his wife's Benzos....what do we give him to reverse the effect?

Back 46

Flumazenil = competitive antagonist at benzo site reverses sedative effects of Overdose

Front 47

Addiction to what exceeds all other forms of addiction?

Back 47

nicotine

Front 48

Pt comes in wanting to get off cigs. Whta do you give them?

Back 48

nicotine in gum, patches, inhaled to slow pharmacokinetics and reduce exposure to cig smoke

OR Bupropion

Front 49

Pt states he was huffing ketones, nitrates and hydrocarbons. What can you guess his symptoms are?

Back 49

euphoria, lightheadedness, similar to alcohol or marijauna

effects last 15-30 min

Front 50

T/F: cocaine is used as a local anesthetic and dilates pupils

Back 50

TRUE

Front 51

What are cocaine's effects on the CNS and PNS?

Back 51

CNS = blocks re- uptake of dopamine, norepi, and serotonin through transporters.

PNS = inhibits voltage-gated Na+ channels

Front 52

What are some of the symptoms cocaine users will present with?

Back 52

Lose appetite, hyperactive, sleep little, intense cravings, dilated pupils, Inc BP, HR and body temp.

Front 53

Snorting cocaine can lead to what symptoms?

Back 53

Nosebleeds, loss of sense of smell, irritation of the nasal septum, hoarseness

Front 54

Overdose of cocaine can lead to what?

Back 54

hyperthermia, coma, death

Front 55

Amphetamines MOA?

Back 55

INDIRECTLY Cause RELEASE of dopamine (vs cocaine which blocks re-uptake) via block NT up-take into vessicles and reducing NT release, excess NT in cyto causes reversal of the transporter which begins to release NT into synapse

Front 56

How are amphetamines used?

Back 56

Pill, smoked, injected

Front 57

Symptoms of amphetamine use?

Back 57

inc. alertness, euphoria, agitation, confusion

Front 58

Withdrawal symptoms of amphetamines?

Back 58

dysphoria, drowsiness, insomnia, irritability

Front 59

MDMA AKA exstasy works how?

Back 59

similar to amphetamines = binds serotonin transporter --> inc extracellular serotonin

Fosters feelings of intimacy and empathy without impairing intellectual capacities

Front 60

What are the adverse effects of Ecstasy (MDMA?)

Back 60

Hyperthermia, dehydration --> can be fatal

INC water consumption can lead to water intoxication

Front 61

T/F: Withdrawal from Ecstasy can cause depression

Back 61

Yep

Front 62

Whats the most widely ingested drug in the world?

Back 62

caffeine

Front 63

Symptoms of caffeine? Withdrawal symptoms?

Back 63

Symptoms = dec fatigue, Inc mood, inc. alertness, concentration, motivation, talkativeness

Withdrawal Symptoms = H, impaired conc., irritability, depression, anxiety

Front 64

Define Salva divinorum

Back 64

Member of the mint family

Active ingredient = Salvinorin A

Potent hallucinogen = users report sense of calm, inc mood, uncontrolled laughter, introspection

Front 65

Define Cathinones

Back 65

Bath crystals, plant food, herbal incense abused as a recreational drug. (smoked, injected, snorted, atomized)

Marketed as FAKE COCAINE = its a CNS stimulant

Front 66

What do users of Cathinones experience?

Back 66

hallucinations, tremors, changes in HR, GI distress, difficulty breathing, seizures and hypotension