Pharmacology: Drugs of Abuse 2

  1. Triad of Symptoms:
    respiratory depression, miosis and coma
  2. How do you treat respiratory depression in opioid agonist toxicity?
    Give Naloxone = competitive opioid receptor antagonist
  3. Can Naloxone precipitate withdrawal?
    • Yes
    • Thus, careful titration of the dose to reverse respiratory depression will reduce the possibility of eliciting full-blown abstinence syndrome.
  4. How does the DOA of Naloxone compare to most opioid agonist?
    Naloxone’s DOA is shorter acting
  5. What are the psychostimulants?
    Cocaine, Methamphetamine, Methylphenidate
  6. What are the subjective-Behavioral Effects of Psychostimulants?
    • Very intense and reinforcing euphoria
    • Euphoria characterized by heightened awareness, arousal, elation, improved performance on tasks of vigilance and alertness, and greater self-esteem
    • Repeated dosing produces involuntary motor activity, stereotyped behavior and anxiety, which can progress into acute paranoid psychosis during extended, uninterrupted 'runs'
    • (Particularly with amphetamine-like drugs)
  7. Chronic use of psychostimulants can cause what?
    Nneurotoxicity, resulting in semi-permanent behavioral changes similar to schizophrenia, e.g. paranoid ideations, hallucinations, hostility, memory impairment and difficulty in concentrating.
  8. Doe psychostimulants have a fast or slow onset?
    Rapid onset with IV/Inhaled
  9. Why do pychostimulants have a high abuse potential?
    Intense and reinforcing euphoria, resulting in a very high abuse potential.
  10. Stimulants cause dose-dependent increases in what?
    HR and BP
  11. Because stimulants cause a dose dependant increase in HR and BP, what are SEs that can result?
    Arrhythmias, myocardial ischemia, coronary and cerebral vasospasm, hyperthermia and seizures
  12. Death from Stimulants is due to what?
    cardiovascular complications
  13. What type of treatment is available for stimulant induced Arrhythmias, myocardial ischemia, coronary and cerebral vasospasm, hyperthermia and seizures?
    Treatment is supportive
  14. What is the standard of care for treating high dose cocaine users?
    Antidepressants to reduce depression associated with abstinence
  15. Tolerance to stimulants develops rapidly to what effects?
    Behavioral effects
  16. What is the plasma half-life for cocaine?
    ~ 50 minutes
  17. About how much time elapses before an Intranasal/inhalation/I.V. cocaine user desires more?
    10-30 minutes
  18. What is characteristic use of methampetamines/cocaine?
    • A binge pattern of abuse develops characterized by dose escalation and uninterrupted use that continue for days until supply runs out
    • Called a Run
    • Food intake, sleep and social responsibilities are ignored
  19. Physical Dependence following a run with stimulants has what characteristics?
    • Withdrawal or 'crash' ensues characterized by 'craving', dysphoria, depression and sleepiness/fatigue
    • Can last from 1-3 weeks in highly dependent individuals
  20. What is the psychoactive chemical/reinforcing agen in Marijuana?
    • Delta- 9 -tetrahydrocannabinol (Delta9-THC)
    • A cannabinoid agonist
  21. Where are cannabinoid receptors located?
    High density in the cerebral cortex, hippocampus, striatum (same as nucleus accumbens) and cerebellum
  22. What is the endogenous ligand for cannabinoid receptors?
    Thought to be an arachidonic acid derivative called Anandamide
  23. What is the peak and DOA of marijuana when smoked?
    • Readily absorbed, resulting in rapid onset
    • Peak within 30 minutes
    • Last for several hours
  24. What are the reinforcing effect of marijuana?
    • Marijuana causes euphoria characterized by a sense of well-being and feelings of happiness that is followed by drowsiness
    • Perception of time is altered along with distortions in hearing and vision
  25. Why do subjective effects of marijuana vary among individuals?
    They are a function of dose, experience/expectations and setting
  26. Under what conditions are Anxiety/panic reactions are reported with marijuana use?
    In inexperienced users or following use of large quantities
  27. What are the Physical-Physiological Effects of using marijuana acutely?
    • Impairment of cognitive and motor skills needed to complete complex tasks
    • Tachycardia
    • Vasodilation (conjunctival reddening)
    • Xerostomia
    • Lowered intraocular pressure
    • Appetite stimulation
    • Anti-emesis
    • Orthostatic hypotension in large doses
  28. How many reports of lethal overdose for marijuana are made each eyar?
    No reports of fatal overdose with marijuana
  29. Chronic use of marijuana has what negative effects?
    Negatively affects short-term memory
  30. Under what conditions does tolerance develop to marijuana’s effects?
    After frequent use at high doses
  31. Physical Dependence to marijuana happens at what interval?
    Develops in subjects taking high doses for several weeks
  32. Abrupt cessation to marijuana use results in what effects?
    Mild abstinence syndrome characterized by insomnia, irritability, anorexia, increased sweating and mild nausea
  33. Does moderate use or marijuana cause physical dependence?
Card Set
Pharmacology: Drugs of Abuse 2
Pharmacology: Drugs of Abuse 2