Schrifer: Non Medical Drug Use

Front 1

(1) use of a drug in a way that differs from the accepted patterns in a society. (2) use of drugs in a manner which causes major and continuing problems in life.

Back 1

Drug Abuse

Front 2

Continued use of a drug DESPITE adverse medical or social consequences.

Back 2

Compulsive Drug Use (Dependence)

Front 3

drug needed for optimal state of MENTAL well being; Minimax principle drug minimizes discomfort or maximizes pleasure.

Back 3

Psychological dependence

Front 4

An altered physiological state produced by repeated use of a drug, which requires continued use of drug in order to prevent an abstinence or withdrawal syndrome.

Back 4

Physical Dependence

Front 5

The ability of one drug to block the withdrawal syndrome of another drug and to maintain the dependent state.

Back 5

Cross Dependence

Front 6

Decreased response to a given dose of drug after repeated doses.

Back 6

Tolerance

Front 7

Decreased response to receptor

Back 7

Pharmacodynamic tolerance

Front 8

Increased metabolism

Back 8

pharmacokinetic tolerance

Front 9

Tolerance to a class of drugs

Back 9

Cross-tolerance

Front 10

What factors contribute to compulsive drug abuse?

Back 10

1.escape from reality
2. obtain a sense of euphoria
3. escape high levels of anxiety
4. gain membership in a social group
5. relieve physical pain
6. bolster a poor self image
7. enhance introspection or creativity
8. have a novel experience

Front 11

12 24 hrs restless sleep, DILATED PUPILS, anorexia, piloerection, irritability, tremor.
What drug class withdrawal?

Back 11

Opiods

Front 12

How long does opioid withdrawal symptoms last?

Back 12

7-10 days. Abstinence syndrome may last for months.
Withdrawal is tramatic but SELDMON life threatening.

Front 13

RX for opiod withdrawal?

Back 13

1. Methadone maintence (levomethadyl also)
2. Naloxone
3. Clonidine (A2 agonist)
4. Buprenorphine (partial opiod agonist)

Front 14

Describe tolerance to benzos, methaqualone, GHB, and ketamine.

Back 14

Chronic intox results in pharmacokinetic and pharmacodynamic tolerance. Considerable tolerance develops to the sedative and intoxicating effects of these drugs but NOT to the lethal effects.

Front 15

Withdrawal symptoms in benzos, ghp, ketamine?

Back 15

Mild paroxysmal EEG abnormalities, REM rebound, insomnia, anxiety. Moderate tremulousness and weakness. Severe seizures and delirium.

Front 16

Is withdrawal from benzo's, ghp, and ketamine LETHAL?

Back 16

potentionally lethal

Front 17

Is withdrawal from benzo's, ghp, and ketamine LETHAL?

Back 17

Lethal.

Front 18

Is withdrawal from benzo's, ghp, and ketamine LETHAL?

Back 18

Yes. Can result in status epiletpicus

Front 19

What type of tolerance develops from barbs, benzos, GHB, and ketamine?

Back 19

1. Chronic use: pk and pd tolerance
2. Tolerance to sedative and intoxicating effects, but NOT TO LETHAL effects

Front 20

Does tolerance develop for amphetamines and cocaine?

Back 20

1. Tol to Desired effects of amphetamines
2. Tol to some effects of cocaine, but sensitiziation to other effects.

Front 21

Does physical dependence develop for amphetamines, cocaine?

Back 21

PD strong for cocaine, but the withdrawal signs are so mild that they aren't recognized (fatigue, increased appetite, depression w/suicidal ideation)

Front 22

Does tolerance develop to nicotine?

Back 22

Yes, but not to ALL effects.

Front 23

What are withdrawal signs of nicotine?

Back 23

Irribility, anxiety, restlessness, sleep disturbances, headaches, etc.

Front 24

Does tolerance develop to marijiana?

Back 24

Not really, they sensitivity may INCREASE.

Front 25

Withdrawal of marijiana?

Back 25

Irritability, restlessness, nervousness, decreased appetite, insomnia.

Front 26

Tolerance and withdrawal effects of LSD, psilocybin, mescaline, and Salvia (hallucinogens)?

Back 26

1. Tolerance develops to behavioral effects
2. Physical dependence and withdrawal signs DO NOT occur.

Front 27

Tolerance, withdrawal, or physical dependence of inhalants?

Back 27

No tolerance, withdrawal, but does produce PSYCHOLOGICAL dependence.

Front 28

Why use methadone for opioid withdrawal?

Back 28

Methadone has a big T1/2. This will slowly wean pts off opiods while decreasing withdrawal effects. Levomethadyl is also available.

Front 29

What role does buprenorphine have in opiod withrdrawal?>

Back 29

It is the first drug to maintain opioid dependence OUTSIDE of specialized clinics. Physicians must be certified by FDA to prescribed.

Front 30

What's the relationship of tolerance and physical dependence?

Back 30

1. T and PD contributed to drug abuse.
2. T to euphoria-->more drug--> more PD
3. The more PD the individual, the more drug they have to use to avoid adverse WITHDRAWAL syndrome.

Front 31

What are symptoms of opiod abuse?

Back 31

1. No direct toxicity to organs
2. W/D symptoms begin 6-12 hours after last dose of heroin
(lacrimation, sweating, DILATED PUPILS)
3. W/D is not life threatening.

Front 32

What are the symptoms of CNS depressants (barbs, BDZ, flunitrazepam, GHB, and ketamine?

Back 32

1. May not be signs of chronic use
2. Mild intox, rapid mood changes, slurred speech, nystagmus, diplopia, vertigo.
3. Withdrawal--opposite effects include anxiety, tremors, seizures, STATUS EPILEPTICUS (LETHAL)

Front 33

A patient presents with euphoria, increased energy, libido, motor restlessness, paranoia, hallucitnations (tactile and visual.) What are they taking?

Back 33

Amphetamines or Cocaine

Front 34

What are adverse affects of ACUTE use of amphetatmines/cocaine/MDMA

Back 34

anorexia, insomnia, tachycardia, tachypnea, HTN, hyperthermia, seizures.

Front 35

Which lasts longer, methamphetamines or cocaine?

Back 35

Methamphetamine.

Front 36

Why do long users of intranasal cocaine present with septal damage?

Back 36

Cocaine is a vasoconstrictor and causes necrosis of nasal septum.

Front 37

What are the side effects of chronic cocaine use?

Back 37

arrhythmias, MI, myocarditis, high output CHF, dilated cardiomyopathy, intercerebral hemorrhage, aortic dissection, DIC.

Front 38

Memory loss, learning impairment, motor deficits, DENTAL DECAY, and psychiatric disorders.

Back 38

Chronic methamphetamine use (Meth mouth)

Front 39

What are symptoms of nicotine use?

Back 39

Reinforcing properties, alerting and muscle relaxing effects, euphoria, mortality.

Front 40

What are the effects of marjiana use?

Back 40

1. Apathy, loss of interest (Amotivational Syndrome.)
2. No evidence of Irreversible changes in brain.
3. Effects of young adolscents may be serious.

Front 41

What are the effects of using inhalants?

Back 41

1. Euphoria, hallucinations, short duration of action = frequent use, psychological dependence,

Front 42

What are the effects of industrial solvents and flurocarbons as inhalants?

Back 42

IS: brain, liver, kidney damage, permanent PNS damage, bone marrow suppression, pulmonary dz.
FC: Sudden Death d/t asphyxiation or ventricular arrhythmias.

Front 43

What makes one person more likely to use drugs compulsively or non compulsively?

Back 43

1. Vulnerability (Genetics and Environment).
2. Impulsive nature, rebelliousness, low frustration tolerance, friends, quality of life.

Front 44

What is the treatment of withdrawal of barbs, BDZ, GHB, ketamines?

Back 44

Long acting BZD and slowly withdraw.

Front 45

What is the treatment of withdrawal of amphetaines, cocaine, and MDMA?

Back 45

1. Drug treatment to prevent abuse has LITTLE success.
2. anti-cocaine vaccine?

Front 46

Treatment of nicotine withdrawal (3)?

Back 46

1. Nicotine replacement (gum, patch, spray)
2. Bupropion and other AD's to stop cravings.
3. Varenicline

Front 47

What is Varenicline?

Back 47

Partial nicotinic rec agonist. Relieves cravings and blocks pleasurable effects if people do smoke. MOST EFFECTIVE AND WEIGHT GAIN!

Front 48

What is the part of the brain that is invovled with reward system and the final NT?

Back 48

1. Nucleus accumbens and insula.
2. dopamine!