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122 Cards in this Set
- Front
- Back
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Psychostimulants augment _____ and decrease _____.
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Mood, euphoria, alertness, energy and task performance; appetite and boredom |
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Psychostimulants augment _____ and are behaviorally reinforcing.
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Synaptic DA
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Increasing psychostimulant dosage causes _____ and increases chances of _____.
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Anxiety, irritability and sleep problems; Psychosis
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Cocaine and AMPH similarities |
Lipid soluble, well absorbed, vasodilation, tolerance to increased heart rate and euphoric fatigue reducing effects
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Cocaine and AMPH differences |
AMPH has longer duration effect because of longer half-life than cocaine
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Fetal effects while on psychostimulants
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Lower birth weight and placental abruption
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Psychostimulants and Psychosis
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Indistinguishable from paranoid schizophrenia, AVH with delusions, formication (bugs crawling) - effects more likely with AMPH than Cocaine
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Psychostimulant overdose |
Seen even at low doses (30 minutes for effects); initial excitement, severe headache, nausea, vomiting, unconsciousness, convulsions, cardiac failure then death - Cocaine poses greater risk
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Psychostimulants and overdose tx |
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Cocaethylene is _____.
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An active metabolite of cocaine when combined with alcohol (longer lasting and more toxic) |
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Cocaethylene acts as a _____.
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DA agonist of cocaine
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Alcohol increases blood cocaine levels by inhibiting _____ which results in the production of _____. |
Cocaine metabolism (liver); cocaethylene
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AMPH modifies _____ and _____ activity.
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DA (dopamine); NE (norepinephrine) |
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AMPH increases synaptic DA in 3 ways: |
2. Synaptic vesicle interaction releases free DA into nerve terminal 3. Reverse DA uptake |
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CNS toxicity in Meth users causes _____ and _____. |
Persisting psychosis (15%) and reduction in frontal/basal ganglia neuron density (6 - 8%) - associated with aggression and impulsivity after cessation
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Cocaine modifies _____ , _____ , and _____. |
CNS DA, NAc, Caudate |
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Cocaine prevents _____ leaving _____ in the synapse.
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Presynaptic DA uptake; DA
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Cocaine activates the _____.
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Mesolimbic DA pathway associated with euphoria |
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Cannabis reaches brain in about _____ and peaks in _____.
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30 seconds; 30 to 60 minutes |
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Cannabis has a _____ hour effect.
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3 to 4 |
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Cannabis distribution |
THC moves into fatty tissue (25 - 30% for a week) but continuous doses aggregate taking weeks to clear |
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THC crosses the _____ barrier. |
Placental
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Cannabis metabolism is mainly _____ with variable half-life (20 - 60 hours).
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Hepatic |
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Cannabis excretion _____ in feces and urine. |
40 to 65% |
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Pulmonary effects of cannabis includes _____ and _____.
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Bronchial dilation then constriction; impairs lung function if smoked
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Cardiovascular effects of cannabis include _____ and _____.
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Dilation of small blood vessels (red eyes); increase of blood pressure and heart rate with tolerance but decreases intraocular pressure (protects against ischemic damage - glaucoma) |
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Respiratory effects of cannabis includes _____.
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No respiratory depression seen so no OD risk
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Sleep and cannabis effects include _____. |
Suppression of REM sleep and increase of slow-wave sleep (increases drowsiness at small doses, decreases at large doses) |
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Cannabis effects on nausea _____. |
Antiemetic (inhalation better than oral) - good for chemo patients
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Cannabis effects on appetite and motor function includes _____ and _____. |
Increased appetite; Ataxia, muscle weakness, tremors |
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Cannabis effects on perception includes _____. |
Poorer peripheral vision, pain and time perception
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Cannabis withdrawal syndrome includes _____.
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Anxiety, irritability, stomach pain, reduced appetite (remember - withdrawal symptoms often opposite of drug effects) |
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Cannabis may induce _____ symptoms.
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Depressive |
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There are 4 main receptor types for cannabis:
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2. Cerebellum - motor performance 3. Hippocampus - memory 4. Prefrontal cortex - attention, memory, concentration |
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Cannabis has little _____ and thus no risk for OD. |
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Cannabinoid receptors and endocannabinoids are usually _____. |
Presynaptic |
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Cannabinoid receptors _____. |
Inhibits Ca and facilitates K flux and inhibits release of other transmitters
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Endocannabinoids are _____ that bind to the receptors.
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Natural substances (similar effects as THC) |
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Cannabis therapeutic uses includes _____. |
Nausea and vomiting, analgesia (two major uses for cancer patients), glaucoma, appetite stimulant, spasticity |
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Sativex is used as an _____. |
Oral spray (not as effective as smoked marijuana - available in Canada) |
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Cannabinoid antagonists (block cannabinoid receptors) may be useful for _____. |
Reducing craving and acute effects (may be helpful for other areas such as OD and opioid dependence)
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Hallucinogens are _____. |
Biogenic amines |
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Hallucinogens can be _____ and _____. |
Serotinergic and Catecholinergic (adrenergic); Anticholinergic and Glutaminergic |
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LSD has rapid _____ absorption (under 60 minutes) and peaks at around _____.
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Oral; 3 hours |
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LSD is very potent, with only _____ entering brain! |
1% of the drug
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LSD has a _____ half-life. |
Long
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LSD is metabolized in the _____. |
Liver |
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LSD effects occur through the _____ agonism. |
5-HT_2A |
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LSD physical effects include _____. |
Increase in temperature, pupil dilation, heart rate, blood pressure, blood glucose, dizziness, drowsiness, nausea |
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LSD effects on perception include _____.
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Colored lights, distorted vivid images and may induce panic due to overwhelming visual/emotional effect |
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A common long term effect with LSD use are _____. |
Flashbacks |
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LSD has NO _____. |
Physical withdrawal symptoms |
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LSD has _____ toxicity. |
Low |
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Most deaths associated with LSD are _____, _____, and _____.
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Accidents, homicide, suicide |
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Anticholinergic psychedelics: |
Scopolamine
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Catecholamine psychedelics: |
Mescaline, DOM, MDA, MDMA (ecstasy), DMA, TME, MDE |
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Serotonin psychedelics: |
LSD, DMT, psilocybin, bufotenine (glands from toads), harmine
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Psychedelic anesthetics: |
Phencyclidine (PCP) |
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Catecholamine psychedelics adds _____ to stimulants.
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Hallucinogenic properties (ex: slight chemical alterations to AMPH or Ritalin)
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Mescaline comes from _____.
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Peyote cactus |
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Mescaline is chewed with onset in _____ and duration of about _____. |
30 to 90 minutes; 10 hours |
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Mescaline causes _____. |
Visual hallucinations (anxiety, tremors, sympathetic effects [Fight or Flight], hyperreflexia) |
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Synthetic Amphetamines are structurally related to _____ and _____ and produces a mix of effects.
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Mescaline; AMPH |
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Synthetic Amphetamines: |
DOM, MDA, DMA, MDE, TMA, MDMA |
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Synthetic Amphetamines are _____ stimulants that _____ LSD-like effects as doses increase. |
Behavioral; increase
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Synthetic Amphetamines are more toxic and potent than _____. |
Mescaline |
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MDMA can produce irreversible _____. |
5-HT damage (damages 5-HT transporter) |
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MDMA can also cause _____ and _____!
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Severe toxicities; death (malignant hyperthermia)
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Serotonin Psychedelic (LSD, psilocybin, bufotenine, DMT) can cause _____ and _____ greater than somatic effects.
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Visual distortions; psychological effects
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Psilocybin can be found in certain _____. |
Mushrooms
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Psilocybin causes _____ and _____ that resemble those produced by LSD. |
Hallucinations; sensory distortions |
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Phencyclidine is considered an (three A's) _____, _____, and _____. |
Anesthetic, analgesic, amnestic |
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_____ can cause bizarre and serious psychotic reactions (agitation, excitement, delirium, out-of-body experiences, paranoia) |
Phencyclidine
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Phencyclidine resembles _____ state.
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Schizophrenic
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Phencyclidine antagonizes _____ receptors. |
NMDA |
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A side effect of phencyclidine include _____.
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Lack of pain |
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Overdose and violent behavior is often associated with _____.
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Phencyclidine |
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Salvia Divinorum is usually destroyed by the _____ acid (no taken orally). |
Stomach |
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Salvia is the most _____ naturally-occurring hallucinogen yet identified.
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Potent |
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Pain is a response when _____ are stimulated through mechanical, thermal and chemical injury.
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Nociceptors (pain-sensitive neurons) |
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Nociception is the perceived sensation of _____. |
Pain
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Nociceptor cell bodies are located in the _____.
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Dorsal Root Ganglia |
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Bidirectional axons relay information from the _____. |
Dorsal horn of the spinal cord
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Nociception may be influenced by cerebral mechanisms due to the conscious cognitive activation with a _____. |
Placebo response |
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The 3 main types of Analgesics:
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1. Opioid analgesics 2. Non-steroidal anti-inflammatory (NSAIDs) 3. Analgesic adjuvants (antidepressants, anticonvulsants, NMDA-antagonist, THC) |
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Only ____ and _____ deal with the physical as well as emotional aspects of pain. |
Opioids; THC |
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Opioid is a _____. |
Morphine-like agonist
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Opiate is a _____. |
Drug derived from opium poppy (codeine, morphine) |
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Narcotic is a _____. |
Sleep-inducing drug (poor term used for 'illegal drug') |
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Endorphins are _____.
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Endogenous compounds that exhibit properties like morphine |
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Opioid receptors are _____. |
Protein receptors in the body which morphine acts upon |
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The 3 types of opioid receptors:
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2. Kappa (k) 3. Delta (𝛿) |
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Mu is involved in _____.
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Respiratory depression (OD), sense of tranquility, reduced apprehension, cough suppression, pupil constriction, reduced GI motility, sedation
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Kappa is involved in _____.
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Spinal analgesic, dysphoria, psychotomimetic effects (psychosis-like/hallucinogenic), minimal respiratory depression (Salvinorin A - pure K agonist)
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Agonist is a _____.
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Drug with Mu affinity and morphine-like affinity and efficacy |
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Partial agonist is a ____. |
Drug with Mu affinity but only partial efficacy
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Mixed agonist-antagonist _____. |
Binds (esp. Kappa); analgesia if non-dependent but may start withdrawal in dependent persons |
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Pure antagonists have _____.
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Affinity (esp. Mu) without morphine action (Naltrexone)
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Which are the two sources of naturally occurring opioids? |
1. Opium poppy (morphine and codeine) 2. Endogenous transmitters (endorphins) |
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Opioid actions of analgesia comes primarily from the _____. |
Neuronal inhibition in the brain and/or spinal cord |
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BZD tolerance or barbiturate tolerance _____ impact opioid tolerance and vice versa. |
Does not
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Opioids are _____ in GABAergic withdrawal.
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Ineffective |
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Opioid use main concern is _____. |
Respiratory depression (OD) - decrease of brainstem sensitivity due to higher levels of CO2 in blood |
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Pure agonist, morphine, is often administered through _____ and slowly enters the brain. |
IV or smoked (bc poor oral absorption) |
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Morphine agonist acts _____ on glutamate neurons to inhibit release.
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Presynaptically (much like Cannabis; overlap between opioid and cannabinoid receptors) |
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Opioid withdrawal symptoms include _____. |
Restlessness, fever, chills, vomiting, cramping, diarrhea, intense pain (not life-threatening but difficult to tolerate) |
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Opioid withdrawal can _____ pain threshold, which causes more pain! |
Lower |
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Pure agonist, heroin, rapidly enters the brain when _____ or _____. |
Smoked; injected |
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Pure agonist, hydromorphone, is _____ more potent as morphine.
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10X |
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Balladone (?) is a _____ version used for elderly persons and end-of-life or cancer patients to make feel better.
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Control-release |
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Meperidine (Demerol) is _____ acting with _____ withdrawal.
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Shorter; rapid |
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Fentanyl comes in _____ patch, _____, and _____ form (high street value items). |
Transdermal; lollypop; dissolvable tablet
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Oxycontin is usually indicating for _____. |
Long-term constant analgesia |
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Oxycontin (Oxycodone CR) has an immense potential for _____ because it can be _____ and _____. |
Abuse; crushed; snorted |
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Buprenorphine (Buprenex) and Tramadol (Ultram) are _____.
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Partial Opioid Agonists (Mu receptors) - blocks 5-HT and NE reuptake so is antidepressant |
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Buprenex and Ultram have many side effects including _____. |
Drowsiness, dizziness, nausea and vomiting, constipation, headache (watch for serotonin syndrome if combined with an SSRI) |
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Nalbuphine (Nubain) and Pentazocine (Talwin) are analgesics via _____ agonism. |
Kappa (with weak or antagonistic action at Mu receptors) |
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Opioid antagonists are best used for _____. |
Opioid reversal especially for OD (sends straight to withdrawal)
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Buprenorphine (Buprenex) is a partial agonist on the _____. |
Mu receptor (utile as a replacement medication - can administer in office setting - high abuse potential/street value) |
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Suboxone attempts to prevent abuse potential, drug administered through _____. Taken appropriately it can lower drug seeking behaviors.
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IV
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Suboxone is a combination of _____ and _____. |
Buprenorphine; naloxone (a pure antagonist) |
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Buprenorphine tablets can be _____ and ____, thus leading to potential abuse.
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Crushed; injected |
