PHAR 100 > Module 2 > Flashcards

Module 2 Flashcards

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1
Q

What brought to light the impact and prevalence of substance abuse disorders?

A

THe opioid crisis

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2
Q

How many Canadians died of apparent opioid overdose between January 2016 ro September of 2020?

A

19355

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3
Q

What is SUD?

A

Substance Use disorder

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4
Q

How is an SUD defined and diagnosed?

A

by a number of criteria. Once a person reaches 2 then they have a mild SUD. The more criteria they meet the more severe the SUD.

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5
Q

What are the subgroups of criteria for an SUD?

A

social impairments, risky use, impaired control, tolerance, and withdrawal

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6
Q

What are social impairments?

A

When the invididual fails to fulfill a major roll and/or has persistent social or interpersonal problems. Additionally, social, occupational, or recreational activities bay be given up or reduced

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7
Q

What is risky use?

A

The individual may use the substance in physically hazardous situations or use the substance despite physiological or physcholoifical problems. cause by the use

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8
Q

What is impaired control?

A

the individual may have persisted craving for the substance

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9
Q

What is withdrawal?

A

THe individual may experience withdrawal syndrome after stopping use of the substance

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10
Q

What is tolerance?

A

The individual may develop tolerance to the substance

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11
Q

What is addiction?

A

impaired control associated ewith an SUD. Manifests as emotional or mental preoccupation with the drugs effects and by a persistent craving for the drug regardless of the consequences

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12
Q

What is the dopamine hypothesis?

A

The predominant hypothesis to explain addiction

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13
Q

What does the dopamine hypothesis suggest?

A

That commonly misused drugs increase dopamine in the reward system of the brain. Other neurotransmitters are involved but this is key to the reward pathway. Dopaminergic systems are also responsible for natural rewards such as food and sex as well

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14
Q

What are the three categories of addictive drugs?

A

increase dopamine, produce novelty, and reduce anxiety

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15
Q

What drugs increase cdopamine and are CNS stimulants?

A

cocaine, amphetamines, nicotine, and caffeine

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16
Q

What drugs increase dopamine and are opioids or others?

A

alcohol cannabis, morphine, heroin, and oxycodone

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17
Q

What drugs produce novelty?

A

LSD, and MDMA

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18
Q

What drugs reduce anxiety?

A

benzodiazepine, barbiturates

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19
Q

What is drug withdrawal?

A

An abnormal physiological state produces by repeated administration of a drug that leads to the appearance of a withdrawal syndrome when drug administration is discontinued or dose is dereased

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20
Q

How does the severity of withdrawal syndrome change?

A

Increases with the sp[eed of the drug withdrawal

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21
Q

How do withdrawal symptoms usually relate to the effect of the drug?

A

They are usually opposite to its effect

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22
Q

What are the withdrawal effects of stimulants such as cocaine and amphetamines?

A

sleepiness, muscle pain, anxiety, tremors, low mood, suicidual ideation, and cardiovascular problem

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23
Q

What are the common withdrawal symptoms of opioids such as heroin, morphine and prescription pain medication such as oxycodone

A

sweating, muscle aches, agitation, diarrhoea, abdominal cramping, vomiting

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24
Q

What is drug tolerance described as with reference tot eh dose-response graph?

A

shortened duration with decreased magnitude of effect.

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25
Does tolerance develop for all aspects of a drug?
No. For example tolerance is developed to the euphoria of morphine but not its constipating effects
26
What is cross tolerance?
resistance or tolerance to one drug because of resistance or tolerance to a pharmacologically similar drug. Ex. alcohol creates a tolerance to benzodiazepines
27
How can environment affect SUD?
can increase the likelihood of misuse
28
What factors can influence SUD?
genetics, pre-existing disorders, environmental factors, and developmental disorders
29
What genetic factors affect SUD?
things such as genetic mutation in dopaminergic pathways in the brain can increase the risk of addiction
30
How can pre-existing disorders affect SUD?
individuals with a major affective disorder, anxiety disorder, or schizophrenia, are at higher risk for SUD than the general population
31
How can environmental factors influence SUD?
exposure to environments that promote drug use, family dynamics, trauma, and social/work groups can alter SUD
32
How can developmental factors affect SUD?
individuals are more vulnerable during certain developmental timeframes such as adolescence and early adulthood. Ex. smoking begins before 18, 80% of alcohol abusers began before 30, and illicit drug use begins between 15 and 18 years of age
33
How have people with SUD been stigmatized?
by the general public, medical professionals, etc
34
What can stigmatization lead to in SUD?
a consequence of this is isolation and low self esteem along with individuals not receiving the medical or social help that they need
35
What is one way that stigma can be reduced?
By changing the language that you useq
36
What should be said instead of abuse, addict, druggie or junkie?
person with SUD
37
What should be said instead of abuse?
use/misuse
38
What should be said instead of clean?
in recovery/not currently using
39
What is harm reduction?
An approach that seeks to reduce/prevent the negative consequences of substance use and to improve health without judgment, discrimination or coercion along with not requiring the person to stop using the substance
40
What are health harms in harm reduction?
Decrease morbidity (transmission of blood born disease) and mortality
41
What are societal harms in harm reduction
decrease lost productivity, apprehension of children and criminal activity
42
Can SUD occur with medications used as prescribed?
yesW
43
What is misuse?
using the drug in ways or amounts other than what was prescribed or against societal norms
44
What is misuse potential?
The tendency of the drug to be misused. This varies drug to drug as well as between individuals/ DEtermnind by 5 factoes
45
What are the 5 factors that determine potential for misuse?
nature of the drug, route of administration, amount/frequency of use, availability. and inherent harmfullness
46
What is nature of the drug in potential for misuse?
most drugs are natural reinforcers like food or sex. The pleasurable effects of a drug increase the probability of misuse
47
How does route of administration relate tot potential for misue
dress that can be administered in ways with rapid absorption giving rapid effect have a greater potential for misuse than drugs which product the effects slowly
48
How does amount/frequency of misuse affect the potential for misuse of a drug?
THe greater dose/frequenct of use. the greater potential for tolerance, withdraw and addiction development
49
How doers availability relate to potential for misuse
the more widespread, the more likely for misuse. Ex alcohol is only moderately intrinsically misused. but is the most misused in society due to availability
50
How does inherent harmfulness relate to misuse potential?
the more inherently harmful the less likely for misuse. Ex. methanol causes similar effect to ethanol but causes blindness so it is not widely misused
51
Can opioids cause tolerance withdrawal and addiction?
tolerance: yes withdrawal: yes addiction: yes
52
Can CNS depressants cause tolerance withdrawal and addiction?
tolerance: yes withdrawal: yes addiction: yes
53
Can CNS stimulants cause tolerance withdrawal and addiction?
tolerance: yes withdrawal: yes addiction: yes
54
Can hallucinogens cause tolerance withdrawal and addiction?
tolerance: yes withdrawal: no addiction: yes
55
Can cannabis cause tolerance withdrawal and addiction?
tolerance: yes withdrawal: yes addiction: yes
56
What are amphetamines and cocaine?
two classes of CNS stimulant drugs that have a history of being misused.
57
What does the amphetamine drug class include?
amphetamine, dextroamphetamine, and methamphetamine
58
What are related compounds to amphetamines?
methylphenidate (Ritalin) which is used to treat ADHD and MDMA which is a derivative of methamphetamine that is often misused. fosters feeling of intimacy and empathy while improving intellectual capacities. Neurotoxic causing neuronal damage and death
59
Describe the chemistry of chemistry?
Synthetic organic compounds that are structurally similar to neuroepinephrine and dopamine. Can be synthesized readily
60
What are the four main effects of amphetamines on the CNS?
decreased threshold for transmitting sensory input to the cerebral cortex leading to CNS excitation a feeling of euphoria and reward temperature regulation and feeding centre modifications leading to appetite suppression increased aggressive behaviour and mood swings
61
What will increased CNS excitation lead to?
alertness, a feeling of power, reduced fatigue, and increased responsiveness. increased BP and HR
62
What are the effects of short term use of amphetamines in non CNS tissue?
chest pain, cardiovascular collapse (high doses) and increased respiratory rate. overdose may result in a seizure, high fever, or stroke
63
What are the effects of long-term amphetamine use?
chronic sleeping problems, poor appetite, anxiety, repetitive behaviour psychosis, aggressive behaviour, elevated BP and abnormal cardiac rhythm
64
What are the effect of concurrent drug use with amphetamines?
other drugs may be sought to antagonize toxic effects of amphetamines. Ex. benzos for sleepingg problems. or drowsiness from opioids may want amphetamines
65
What are two disorders that can be treated by an amphetamine like drug?
narcolepsy (sleep disorder) and ADHD (hyperactivity impulsivity and difficulty controlling or refocusing attention. generally treated with ritalin
66
how are amphetamines most commonly taken?
orally, injection, smoked. also occaisoionalyl sniffed or snorted
67
What is the potential for misuse in amphetamines
Extremely high due o powerful euphoria. Soluble salt forms allow for large readily injectable doses. There is inherent harmfulness however this is not a deterrent
68
Describe the tolerance to amphetamines
develops to the euphoria and mood elevating effects, the cardiovascular and respiratory stimulating effects, and the lethal effects. no tolerance however to the therapeutic effect or drug induced psychosis
69
Describe the withdrawal effects of amphetamines?
stopping use results in mood depression, prolonged sleep, huge appetite, lack of energy, and fatigue
70
Descibe addiction in amphetamines
amphetamines are self-administered to produce euphoria and an abrupt awakening sensation. Act as rewards, resulting in intense craving and panic if it is not available
71
What is cocaine?
a local anesthetic and a CNS stimulant. considered a narcotic legally. almost indistinguishable from amphetamine in its acute effects and its pattern of toxicity
72
What is the duration of action of cocaine?
shorter duration of action (1h) compared to amphetamines (12h)
73
What are the routes of administration of cocaine?
commonly sniffed or smoked while amphetamines are commonly IV
74
What is the mechanism of action of cocaine
inhibits the active reuptake of dopamine and serotonin into the presynaptic neuron. increases dopamine concentration in the synaptic cleft and in turn increases the activation of the postsynaptic neurons receptors
75
What is the therapeutic use of cocaine?
as a local anesthetic for the mouth and the throat. rarely used as better anesthetics have been developed
76
What are the long term effects of cocaine use?
toxic psychosis hallucination or insect sensations impaired sexual function permanent brain damage and impairment of neuronal function may occur high BP and an irregular heart rhythm changes to nasal mucosa as the drug is sniffed
77
What are the effects of consuming alcohol and cocaine at the same time?
alcohol reacts with cocaine to form an active metabolite called cocaethylene which increase the euphoria experienced but also raises blood pressure, aggressive and violent thoughts, and poor judgement
78
How is cocaine taken?
usually sniffed or smoked but can also b injected
79
What is the potential for misuse of cocaine?
one of the highest misuse liabilities amongst all the drugs. Due to powerful euphoria. Inherent harmfulness due to physical and psychological deficits. These do not deter misuse
80
Describe tolerance towards cocaine?
develops toward the mood elevating effect but not to the drug induced psychotic effects. TOllerence does not develop as readily to the hallucinatory and behavioural effects of cocaine as compared to the amphetamines
81
Describe withdrawal with regards to cocaine?
Very similar to those associated with amphetamines
82
Describe additiction with regards to cocaine?
can occur. pleasurable and rewarding
83
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