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15 Cards in this Set
- Front
- Back
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Definition of Substance Abuse
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Three or more of: "TW CRUEL"
1) Tolerance 2) Withdrawal 3) Continued use despite knowing worsens physical/psychological problem 4) Reduced social, occupation, recreation 5) Unsuccessful reduction/control 6) Excessive time in obtaining 7) Larger amt/longer period than intended |
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Reward circuit for behavior and addiction
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VTA (Ventral Tegmental Area)
NAcc (Nucleus Accumbens) PFC (Prefrontal Cortex) Amygdala VTA Innervation to NAcc is CRITICAL for reinforcement Drugs addictiveness correlates w/ DA release in NAcc |
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Types of Tolerance
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Innate: Genetic
Acquired: a) Pharmacokinetic: changes in distribution/metabolism -> reduce blood [C] b) Pharmocodynamic: changes in systems affected by drug c) Learned: Reduction in effects c/o compensatory mechanisms from past experience i) Behavioral: decreased potency on a specified behavior (ex: DWI) ii) Conditioned tolerance: same but physiological (shoot up in same place) Cross-tolerance |
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Cocaine
MOA Methods admin |
MOA: block Na channel, NE & DA Reuptake inhib
Freebase: Lungs -> blood -> Left Ventricle (NO 1st PASS or Dilution) -> rapid intense high |
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Med Conseq. of Cocaine Abuse:
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"A BIRTH"
Anorexia (NERI stim satiety center) Bowel Ischemia/gangrene Ischemia/Atherosclerosis (increase myocardial demand: supply-demand deficit) Resp. depression (block Na+ channel) Tremor/seizure/convulsion Hyperpyrexia (block Na+ in thermoregulatory; NERI -> vasoconstrict followed by rebound vasodilation) Nasal Septum Necrosis (Hypoxia c/o vasoconstrict from NERI |
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4 Variables influencing substance dependence
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1) Agent Variables (Availability, Cost, Purity, Reinforcing Properties)
2) User Variables (Genetics (Asian flush, children of EtOH), Psych status) 3) Environmental Variables (setting, peers, values, culture) 4) Pharmacological Variables (Acquired tolerance, Sensitization, cross-tolerance) |
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Onset abuse liability
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More rapid onset -> Greater abuse liability
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Delta FosB role in addiction
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Delta FosB: Long Term (Sensitivity & Cravings)
1) DA -> production of Delta FosB 2) Delta FosB represses Dynorphin synth & activates specific genes (diff. from CREB genes) 3) Genes -> proteins sensitizing to response & reminders of past use (cravings) a. Ex: CDK5 -> Nacc more sensitive to drugs & cues |
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CREB role in addiction
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CREB (cAMP Response Element Binding Protein): Short term (Tolerance & Dependence)
1) DA release -> ↑cAMP & Ca++ 2) cAMP & Ca++ activate CREB -> changes gene expression 3) Proteins -> tolerance & dependence: a. Ex: Dynorphin to VTA -> depress DA release (thus reward circuit); Result: need more drug to feel high |
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Medical Conseq of EtOH abuse
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Flush (increase flow to gut, depress vasomotor -> vasodilation)
Enzyme induction (can increase metab of some drugs) Diuresis (decrease ADH release from pituitary) Resp. Depression (GABA hyperpolarization in resp center) CV (anti-coag (good); decrease contractility + vasodilate -> increase work load (bad)) Esophagitis, Gastritis, Diarrhea (Mallory-Weiss lesion) Cirrhosis (NAD+ depletion -> FFA cannot be metabolized & NADH -> lipid synth) FAS (Fetal Alcohol Syndrome) Wernicke-Korsakoff Niacin Encephalopathy |
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EtOH effects on Neurotrans
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EtOH: ↑ GABA-R potency -> ↑ DA release in NAcc; ↓NMDA-R activity
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CAGE Questions
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Cut down on use?
Annoyed by people criticizing use? Guilty about use? Eye-opener (Ever drink fist thing in morning to steady your nerves/get rid of hangover?) |
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One Standard Drink (definition)
Effect on Blood Alcohol Level Processing of drinks |
12oz beer (5% EtOH)
5oz wine (13% EtOH) 1.5oz liquor (40% EtOH) 1 standard drink = affects BAL 20mg/deciliter (18-20) of EtOH in 150lb person Process about 20mg of EtOH an hour (1 drink per hour) ZOK metabolism: about 1 drink/hour (Depends on amount of NAD) |
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How many drinks in first hour to get up to legal limit (0.08%)?
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5 drinks in first hour (4 x 0.02 raise + 1 processed in 1st hour)
Only 1 drink/hour after to maintain above limit |
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Legal Limit unit conversion
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Legal Limit: .08% BAC = .08g per 100g = 80mg/100ml = 80mg/dL
(100ml = 1dL; 1g = 1000mg) |
