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48 Cards in this Set

  • Front
  • Back
what are the neuro effects of mercury?
cerebral palsy, ataxia, hearing loss/deafness, visual impairment/blindness, peripheral neuropathy, parasthesia, tremors, seizures, psychiatric disturbances
what fish contain the most Hg?
shark and swordfish, canned tuna, bass, brown trout
what antioxidant peptide is being explored to be protective against neuronal and glial cell toxicity caused by methylmercury and ethylmercury?
glutathione (autistic children have lower levels of glutathione compared to normal; thus they have a reduced ability to detoxify reactive oxygen species)
cocaine can be ingested in many ways; what are the common forms?
COCAINE HCl - powder - snort,IV,oral; FREEBASE (purified using water, ether, and heat); CRACK (treat cocaine HCl with ammonia or baking-soda); COCAETHYLENE (cocaine + alcohol) lasts longer; COCAINE BINGE (repeated use often with no sleeping or eating)
how is cocaine broken down (metabolized) in the body?
cocaine is an ester and is metabolized by hepatic esterases and plasma cholinesterases
what is cocaine's MOA?
cocaine blocks the reuptake/transporters of dopamine, NorE and serotonin; also blocks Na+ and K+ channels (local anesthetic) - blocking K+ channels will have a proarrhythmic effect
list some common side-effects of chronic cocaine smoking.
chest pain, lung trauma, SOB, breaks down tooth enamel
what are the results of cocaine toxicity?
seizures, followed by respiratory and circulatory depression; death by respiratory failure, stroke, cerebral hemorrhage, heart-failure; highly pyrogenic which may cause muscle destruction and myoglobinuria resulting in renal failure. NO ANTIDOTE FOR COCAINE OVERDOSE - however, pharm book says that Chlorpromazine is used since it blocks alpha receptors that are responsible for CNS changes and HTN
list the effects of the stimulant, crystal meth also list effects with higher doses.
euphoria, alertness, well-being, confidence, sexual confidence, sexual enhancement; at higher doses: hypomania, gradiosity, extreme insomnia, irritability, frank psychosis, act like paranoid schizo with violent behavior
what is the MOA of crystal meth?
like all amphetamines, it releasing neuronal storage of catecholamines, esp norE and Dopamine
how are amphetamines, meth and MDMA (ecstasy) metabolized?why is this important to know?
CYP2D6 (isoform of the P450); 3-10% of the white population is deficient in the CYP 2D6, so it can be even more toxic
what is meth so neurotoxic?
MA accumulates in the brain in a 10:1 ratio to plasma; it leads to a reduction in dopamine transport levels (DAT) which cause an increase in dopamine in the cleft; the constant use of MA will cause a rewiring of the brain; impairs motor fx and verbal learning
Besides MethA users, what other virus targets dopamine neurons and how are they different?
HIV affects dopamine neurons in the basal ganglia; MA targets many regions (orbitofrontal cortex, dorsolateral prefrontal cortices, and amygdala)
IN regard to crystal meth withdrawal, what is a "terrible Tuesday"?
after the weekend of using drugs, by tuesday withdrawal sets in and pt gets depression, irritability, suicidal ideation, carb cravings; with Long-term USe: CHRONIC DEPRESSION: 62% REMAIN DEPRESSED 2-5 years after ABSTINENCE
what are the neurotransmitter functions of dopamine in the brain?
reward pathway and addiction pathway; control of movements; controls the flow of info from other areas of the brain
what are the neurotransmitter functions of serotonin?
mood, sleep, sex, appetite
what are the neurotransmitter functions of norepinephrine?
increases BP, gives energy, related to adrenalin
What neurotransmitters are mainly involved in crystal meth?
What neurotransmitters are mainly involved in ecstasy (MDMA)?
SEROTONIN and dopamine
What neurotransmitters are mainly involved in cocaine?
dopamine, serotonin, and norE
opiates bind to opiate receptors on the _______________.
opiate receptors on the presynaptic GABA terminal
GABA inhbits dopamine; if there is an decrease in GABA there is a ______________ in dopamine.
decrease inhibition; increase in dopamine
if there is increased amount of dopamine, there is increased activation of Dopamine receptors; what happens to cAMP; what happens to the neuron?
increased activation means increased production of cAMP (if D1 or D5) inside teh post-synaptic cells, which will alter the normal activity of the neurons (including the firing pattern); more impulses will activate the reward system
how do opiates cause an increase in dopamine?
opiates bind to presynaptic GABA and decrease GABA release. this increases the dopamine release
where in the brain is most of the METH induced damage to nerve terminals of dopamine producing cells?
striatum; in mice it also kills off cells in the frontal cortex, hippocampus, and striatum
Since chronic Crystal meth depletes dopamine in teh nigro-striatal pathway, what are these patients at risk for developing?
Parkinson's Disease
in animal research, crystal meth has shown to increase __________________ in the brain by 5-15 fold.
viral replication
what is the difference in a cocaine vs meth induced psychosis?
cocain is brief and MA may last for days or weeks (10% of long-term abusers will have a psychoses that mimic schizophrenia)
Chronic crystal meth users are also at large risk for developing what psychiatric disorder?
Major Depression
activating what dopamine receptor may reduce drug cravings?
D1 (increases cAMP)
activating what dopamine receptor may increase drug cravings?
D2 may increase cravings (decreases cAMP)
dopamine agonists bromocriptine and pergolide show no efficacy in treated drug cravings. why?
they are D1/D2 agonists - combat eachother; D1 reduces cravings and D2 increases cravings
what are some big problems with HIV pts using crystal meth?
don't take their HIV meds and loss of judgement (unsafe sex)
what are the effects and side effects of taking MDMA?
elevated mood, heightened perception, decreased appetite, increased thirst and temp; S/E: ecstasy causes an increase in HR and BP, nausea, blurred vision, faintness, chills, sweating, confusion, depression, insomina, severe anxiety, paranoia, psychotic episodes; Danger of SEIZURE; Long-term: depression
what are some acute and chronic effects of THC (cannabinoids)?
acute: tachycardia, red conjunctiva, increased appetite; CHRONIC: tobacco-like complications with lungs, amotivational syndrome
What receptors does THC attach?
THC is an agonist at CB1 and CB2 (throughout brain)
what is anadamide and what is its relationship with THC?
anadamide is a endogenous cannabinoid ligand that works with THC to enhance food intake
Name some therapeutic uses of cannabinoids.
relief of N/V from Cancer tx; appetite stimulant esp. in AIDs pts; chronic pain;;;;Dronabinol is the pill form of THC
Name some hallucinogens.
LSD (acid); Mescaline (peyote cactus); Psilocybin (shrooms); Phencyclidine (PCP)
What is special about LSD in regard to tolerance and physical dependence?
lots of tolerance, no physical dependence
what are the hallucinogen effects?
amphetamine like hyperarousal; mydriasis, hyperthermia, HTN, enhanced sensations from all sensory inputs, visual and auditory hallucinations (synesthesias - see sounds and hear colors)
what are the mechanisms of hallucinogens?
interacts with serotonin; CNS serotonin agonism and CNS serotonin receptor antagonism???
what should you give someone for any acute psychotic episode due to hallucinogens?
barbs or benzos
what is the most dangerous hallucinogen?
PCP (causes dissociative behavior - loss of reality, inability to communicate, aggression, amnesia, insensitivity to pain) similar to ketamine
If a patient presents with hyperreflexia, rigidity and hypersalivation, nystagmus, catatonic posturing, and seizures, what drug do you think of?
PCP - phencyclidine
what is the MOA of PCP?
NMDA (glutamate receptor) antagonist; and blocks reuptake of serotonin
if you are seeing someone in the ER that is on PCP, what drug do you give them?
Benzodiazepines to protect against seizure and an ANTIPSYchotic
the nucleus accumbens is important for the reward pathway;it contains 3 neuron terminals/neurons:
1. the most common neurons are the medium spiny neurons that produce GABA; 2. dopamine terminal 3. post-synaptic cell containing dopamine receptors