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43 Cards in this Set
- Front
- Back
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Cocaine Class
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Psychomotor stimulant
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Cocaine MOA in CNS
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Indirectly by blocking pre-synaptic DA reuptake, increasing extracellular DA
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Cocaine MOA in PNS
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Blocks reuptake of NE into presynaptic neuron leading to autonomic efx
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Cocaine half life
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10-30 min
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Cocaine toxicity
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CV, cerebral ischemia, seizures
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Cocaine w/d Sx
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dysphoria, depression, fatigue, craving
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Rx for cocaine adxn
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12 step program
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Fetal efx of Cocaine
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Direct-ischemic lesions in CNS, changes in DA-R fxn
Indirect-premature, lack of prenatal care, malnutrition |
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Amphetamine Class
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Psychomotor stimulant
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Amphetamine CNS MOA
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Increases DA release from non-vesicular stores
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Amphetamine PNS MOA
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Increases NE release from non-vesicular stores
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Amphetamine Toxicity
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Auditory hallucinations resembling schizo.
DA+MAO=free radicals, not seen with cocaine extreme tolerance |
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d-lysergic acid diethylamid
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LSD
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LSD Class
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Hallucinogen
Psychotomimetics Psychedelics |
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Hallucinogen MOA
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Partial agonists @ 5HT2A and 5HT2C Receptors in brain in cortex, hippocampus, caudate, cerebellum, motor nuclei
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MDMA Damage
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Serotonin nerve terminals, taken w/SSRI to prevent neurotox
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Pharmacokinetic tolerance
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Microsomal enzymes
Increase dose |
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Pharmacodynamic tolerance
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Cellular changes
Most important |
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Behavioral tolerance
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Change environment can change efx of drug
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Inverse tolerance
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Sensitization
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PCP, Ketamine, Dizoclipine
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Dissociative anasthetics
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PCP, Ketamine, Dizoclipine MOA
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Non-competitive blockers of NMDA Ca++ channel
Also used to prevent ischemic brain damage after stroke |
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PCP, Ketamine, Dizoclipine AEs
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Emotional w/d
concrete thinking/bizarre responses to projective tests catatonic posture hallucinations hostility, assault hippocampus neurotoxicity w/d=agitated psychotic state, Rx with diazepam, haloperidol |
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Marijuana Active ingredient
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Delta9-tetrahydrocannabinol (THC)
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Marijuana MOA
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Ligand for GPCRs leading to inhibition of cAMP
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Marijuana CB1
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Brain, cerebral cortex, hippo, striatum, hypothal, mesencephalon, cerebellum
Analgesia, hypothermia, catalepsy, decreased locomotion, memory disturbances |
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Marijuana CB2
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Periphery-testes, spleen, leukos, lymphos, cerebellar granule cells
Impaired immune respons |
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Marijuana W/D
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Restlessness, irritability, mild agitation, insomnia, nausea-cramping
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Rx uses for marijuana
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Anorexia in AIDS pts
Anti-emetic in cancers Analgesic in chronic pain movement disorders glaucoma |
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Dronabinol
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Cannabinoid agonist
anti-nausea anti-emetic |
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Levonantradol
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Cannabinoid, analgesic, anti-spasmodic
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EtOH
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CNS depressant
Reduces excitation by inhibition of NMDA-R/ enhances inhibition by axn @ modulatory site on GABA-A and @5HT3-R located on GABA neurons |
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EtOH Toxicity
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Liver disease, CV, endocrine, GI, malnutrition, CNS, severe depression, Korsakoff's syndrome
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EtOH W/D
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Craving, tremor, irritability, nausea, sleep disturbances, tachycardia, htn, sweating, perceptual distortions, DTs, severe agitation, confusion, visual hallucinations, fever, profuse sweating, tachycardia, nausea, diarrhea, dilated pupils, seizures
Rx-short acting bzd (oxazepam) |
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Rx for EtOH Adxn
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12 step
Disulfram, naltrexone, Li, fluoxetine |
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Barbiturates MOA
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Block excitatory (glut) axn @NMDA-R and enhance inhibitory (GABA) axn @GABA-A
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Barbiturate dependence
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upreg of NMDA -r and w/d Sx
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Opioids
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mu receptor agonists
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Methadone
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Mu agonist, given at low doses and titrated, weaned off, w/d milder
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Clonidine
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decreases hypervigilance of opioid withdrawal
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Rx of acute BZD overdose
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Flumanzenil-a BZD antagonist
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Caffeine
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Antagonist at adenosine receptor
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Nicotine
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agonist at nicotinic receptor
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