Neuro (Test 2) - Lect 5 & 6 - Non Medical Drug Use

Front 1

Define substance abuse

Back 1

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

Front 2

Define Designer Drugs

Back 2

chemical modifications to currently abused drugs (EX: China White)

Front 3

Define Addiction

Back 3

compulsive, relapsing drug use despite negative consequences.

**Has GENETIC and environmental factors

Front 4

Define Tolerance

Back 4

Induction of adaptive changes with repetitive exposure of an addictive drug.

**Needing an increased dose to achieve the same response of the drug

Front 5

Define Cross-Tolerance

Back 5

people tolerant to one drug in a class are likely going to be tolerant to other drugs in the same class.

Front 6

Define Dependence

Back 6

Exhibition of a combination of withdrawal symptoms (psychological or behavioral changes) when the addictive drug is no longer available.

Symptoms are reversible upon resuming drug use.


**Only occurs with CHRONIC exposure

Front 7

Define Withdrawal

Back 7

Adaptive changes become evident upon removal of drug from system

Front 8

Define Maintenance therapy

Back 8

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

Front 9

Define Detoxification

Back 9

used to treat dependence and consists of abruptly, or gradually, reducing drug doses.


**different from Maintenance therapy in that it doesn't substitute a drug.

Front 10

Even after successful withdrawal and prolonged drug-free periods, addicts are at a high risk of relapse, list some relapse triggers

Back 10

1.Re-exposure.

2.Stress.

3.Triggers that recall prior drug use (Only smoke when you drink)

Front 11

Define Club drugs

Back 11

drugs taken at raves or trance events.


**Ecstasy, Special K

Front 12

What is Primarily responsible for the "Reward" which causes the addictive aspects of drugs

Back 12

The Dopamine pathway involving:

1.Nucleus Accumbens.

2.VTA.

3.Frontal Cortex.


**Reward, pleasure, euphoria, compulsion

Front 13

Differentiate b/w Pharmacokinetic and Pharmacodynamic Tolerance

Back 13

1.Kinetic: Reduction of [drug] OR shorter duration of action in a target system.


2.Dynamic: Change in receptor function (desensitization and receptor internalization).

Front 14

How does the route of administration influence the drug addiction?

Back 14

The quicker the effect after administration, the stronger the reward/euphoria association to that drug is.


**IV > Inhaled > Intranasal > Oral

Front 15

Which 2 drugs of abuse are NON-addicting b/c they alter perception (hallucinogens) WITHOUT causing sensations of reward/euphoria?

Back 15

1.LSD (lasts 6-12hrs, hallucinations, N/V, dizziness, blurred vision, flashbacks).


2.PCP (lasts 1 hr, HTN, amnesia, visual alterations).

Front 16

Pt presents with pinpoint pupils, drowsiness, slurred speech. After an overnight stay the pt reports N/V, runny nose & watery eyes, sweating, yawning, and fever. What is the drug and what is the initial treatment for OD?

Back 16

Opiods: Morphine, heroin, codeine, oxydocodone.


**Treat with Naloxone (IV).

Front 17

What are 2 Maintanence therapies (long term Tx) for Opioid addicts?

Back 17

1.Methadone.


2.Suboxone (Buprenorphine+Naloxone).

Front 18

What is the FDA approved drug that can cause euphoria, relaxation, analgesia, and anti-emetic effects?

Back 18

Dronabinol (THC analog).

Front 19

What drug can cause hallucinations, extreme anxiety, and paranoia in ADDITION to the euphoria & relaxation seen with Marijuana?

Back 19

Spice... Common ingrediant in the SAAWWCE

Front 20

What receptor does GHB target?

Back 20

GABA(B) agonist

Front 21

Pt presents reporting feeling euphoria and enhanced sensory perceptions followed by no memories at all. What drug? What are the signs of withdrawal of this drug?

Back 21

GHB.


**Withdrawal:

1.Insomnia.

2.Anxiety.

3.Sweating.

4.Tremors

Front 22

Your pt presents with Euphoria, disinhibition, and drowsiness which quickly leads to sedation. You treat them with _______. What withdrawal symptoms will they experience if you dont taper them off this addiction?

Back 22

Flumazenil (Benzo overdose).


**Withdrawal from Benzo addiction:

1.Irritability.

2.Insomnia.

3.Phonophobia/photophobia.

4.Depression.

Front 23

What receptors is key in Nicotine addiction

Back 23

B2 of the a4B2 nACh Rec.


**Users experience enhanced cognitive function.

Front 24

Could you treat nictotine addictions pharmacologically?

Back 24

YES:

1.Bupropion (antidepressant).


2.Varenicline (partial nAChR agonist).

Front 25

Pt presents with a feeling of euphoria, lightheadedness, moody, and an apparent chemical rash around his mouth. Besides Homo things, what else could this pt have been doing? (list the possible agents)

Back 25

Bagging:

1.Benzene,

2.Toluene.

3.NO.

Front 26

Cocaine blocks the reuptake of what 3 NTs through their respective transporters

Back 26

1.Dopamine.

2.NE.

3.Serotonin (HTN, tachycardia, Ventricular arrhythmias).


**Chronic use will lead to down regulation of these receptors in the brain (pharmacodynamic tolerance).

Front 27

Pt presents with dilated pupils, HTN, Inc HR and body temp. They report to you that they have had NO appetite and haven't slept in a few days. You notice they are very hyperactive. What is their drug of abuse?

Back 27

Cocaine

Front 28

Cocaine mixed with _____ produces ______, which intensifies the euphoric effect of cocaine.

Back 28

Alcohol, cocaethylene

Front 29

Amphetamines indirectly cause the release of ______ and _______

Back 29

dopamine and NE.


**this is done by reversing the action of their respective transporters by blocking the uptake of the NT into vesicles and INC their concentrations in the axon terminal cytoplasm

Front 30

Pt presents agitated and confused but reports euphoria and inc alertness. What are the signs of withdrawal from this drug?

Back 30

Amphetamines:

1.Dysphoria.

2.Drowsiness.

3.Insomnia.

4.Irritability.

Front 31

This drug Inc extracellular serotonin causing Inc intimacy and empathy w/o impairing intellectual capacities. What are the adverse reactions

Back 31

Ecstasy (MDMA):

1.Hyperthermia + dehydration.

2.Serotonin Syndrome.

3.Seizures.

Front 32

How does Caffeine cause decreased fatigue, elevated mood, increased alertness, concentration, motivation, and talkativeness

Back 32

By blocking adenosine receptors:

1.Inh dopamine release.

2.Inh phosphodiesterase.

Front 33

Users of this drug report hallucinations, tremors, changes in heart rate, GI distress, difficulty breathing, seizures and hypotension

Back 33

Cathinones (Bath Salts)

Front 34

Compulsive, relapsing Drug use despite negative consequences

Back 34

Addiction

Front 35

What are the primary reward systems of the brain to know?

Back 35

She wanted us to know the Nucleus Accumbens, because this is where the most drugs interact.

However, others are the Ventral Tegmental Area (VTA) and the prefrontal cortex

Front 36

What pathway has functions like reward/motivation, pleasure, euphoria, compulsion, and perseveration?

Back 36

the (mesolimbic) Dopamine Pathway

Front 37

What pathway has functions such as mood, memory, sleep, and cognition?

Back 37

The Serotonin pathway

Front 38

Induction of adaptive changes with repetitive exposure of an addictive drug

*must increase dose to maintain effect*

Back 38

Tolerance

Front 39

Exhibition of a combo of withdrawal symptoms when the drug is no longer available. Occurs with Chronic exposure, and these symptoms are reversible upon resuming the drug

Back 39

Dependence

Front 40

What are the NON-addictive Drugs of Abuse? Why?

Back 40

LSD and PSP/ketamine

They activate the receptors in the prefrontal cortex or thalamus

Front 41

How are drugs of abuse categorized?

Back 41

By receptor activation:
- Gi/o coupled
- Ionotropic receptors or ion channels
- Monoamine transporter activation

Front 42

What drugs are the Gi/o Receptor activators (4)?

Back 42

Opioids

cannabinoids

gamma-hydroxybutyrate

hallucinogens

Front 43

What drugs active the ionotropic/ion channels(5)?

Back 43

Nicotine

alcohol

Benzos

dissociative anesthetics

and some inhalants

Front 44

What drugs activate Monoamine Transporters? (3)

Back 44

Cocaine

amphetamines

ecstasy

Front 45

Name the pertinent opioids (4)

Back 45

Morphine

heroin

codeine

oxycodone

Front 46

What are some withdrawal symptoms from opioids? (9)

Back 46

1. Intense dysphoria

2. N/V/D

3. muscle aches

4. watery eyes

5. runny nose

6.sweating

7.yawning

8. fever

9. hyperactive bowel sounds

***Except for codeine***

Front 47

How do we treat Opioid addiction? (4)

Back 47

Naloxone (IV) for overdoses.

Naltrexone LATER if needed (oral),

Methadone for supervised tapering off, and

Buprephrenone as a Naloxone alternative

Front 48

What substance is important in cannabinoids (Marijuana)?

Back 48

THC

Front 49

What is the MoA for THC, and what's it's FDA version?

Back 49

inihibits presynaptic GABA neurons in the VTA, which inhibits dopamine neurotransmission


Dronabinol/Marinol

Front 50

Side Effects of Cannabinoids? (7)

Back 50

1. euphoria

2. relaxation

3. well-being

4. grandiosity

5. altered perception of time

6. increased appetite

7. RELIEF of Chronic pain/Nausea

Front 51

What are the withdrawal symptoms for Cannabinoids? (6)

Back 51

1. restlessness

2. irritability

3. mild agitation

4. insomnia

5. nausea

6. cramping

Front 52

What is Spice, and what's it do?

Back 52

A "fake and safe" alternative to marijuana, also called K2.

Users report:

1. euphoria

2. relaxation

3. altered perception

4. hallucinations

5. extreme anxiety

6. paranoia

Front 53

Where do Rufies (Gamma-hydroxybutyrate) act?

what do users feel?

what are the s/s of withdrawal?

Back 53

1. acts on GABA-B receptors.

2. users feel
- euphoria
- enhanced sensory perceptions
- feelings of social closeness
- amnesia (Watch the Hangover).

3. Withdrawal leads to:
- insomnia
- anxiety
- sweating
- tremors

Front 54

What's unique about LSD?

Back 54

it's a hallucinogen that has no addictive or dependence properties, and can induce visual perceptions, like shapes and colors.

Can have flashbacks years later

Front 55

Ketamine and PCP:

MOA's?

Intoxication s/s?

Back 55

Both are use-dependent, non-competitive antagonists at the NMDA receptor.

PCP is used in crystalline form, snorted, ingested, smoked or injected.

Effects usually last around an hour, and cause:

1. increased BP

2. impaired memory function

3. visual alterations.

4. higher doses cause an unpleasant out of body/ near-death experience

Front 56

Benzo's cause users to feel...

Withdrawal s/s?

Back 56

Users feel:

1. relief of anxiety

2. euphora

3. disinhibition

4. promotion of sleep.



Withdrawal occurs within days depending on half life, and can cause:

1. irritability

2. insomnia

3. phonophobia

4. depression.

Front 57

Where does Nicotine effect (specific receptor)?

Back 57

alpha2Beta2 on the nicotinic acetylcholine receptor

Front 58

How do you treat nicotine addiction/smoking?

Back 58

Buproprion and Varenicline

Front 59

how addictive is Cocaine?

what are its medical uses?

Back 59

Highly addictive


used as a local anesthetic and to dilate pupils

Front 60

Describe how Cocaine effects the Peripheral NS

Back 60

It inhibits the voltage gated sodium channels and blocks the initiation and conduction of AP's

Front 61

Describe how Cocaine effects the CNS

Back 61

blocks the reuptake of dopamine, NE, and serotonin thru their respective transporters

Front 62

What's some effects of using cocaine?

Back 62

users:

1. lose appetite

2. are hyperactive

3. sleep very little

4. exhibit intense cravings

5. have dilated pupils

6. elevated BP, HR, and body temp.


- Long term have nose bleeds/trackmarks, and hoarseness(from directly effecting the Vagus)

Front 63

MOA of Amphetamines/Methamphetamines

Back 63

Similar MoA to cocaine;

indirectly cause the release of dopamine and NE.

Front 64

Meth s/s of intoxication?

s/s of withdrawal?

Back 64

users report:

1. increased alertness

2. cause euphoria

3. agitation

4. confusion.


withdrawal has:

1. dysphoria

2. drowsiness

3. insomnia

4. irritability

Front 65

MOA of MDMA/Ecstasy?

Back 65

Similar to meth, but binds to the serotonin transporter and increases extracellular serotonin

Front 66

What do users of Ecstasy experience?

withdrawal s/s?

Back 66

Causes feelings of intimacy and empathy without impairing intellectual capacities

However, causes hyperthermia and dehydration that can be fatal, or also fatal due to water intoxication.

Can also cause serotonin syndrome and seizures.


Withdrawal exhibits depression

Front 67

basics of Caffeine

Back 67

methylxanthine blocks adenosine receptors and inhibits Dopamine release

Front 68

What are Cathinones?

what type of drug is it?

what are s/s of intoxication?

Back 68

marketed as fake cocaine, and is a CNS stimulant, with users experiencing:

1. hallucinations

2. tremors

3. changes in HR

4. GI distress

5. difficulty breathing

6. seizures

7. hypotension