PHRM 845: Therapeutics III > Svensons Sections > Flashcards

Svensons Sections Flashcards

(51 cards)

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1
Q

What are psychostimulants?

A
  • Activate the CNS resulting in alertness, excitation and elevated mood
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2
Q

What is the most used illegal drug in 2018?

A
  • Marijuana
  • Cocaine, ecstasy, meth, crack, herion
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3
Q

What are the roles within the Mesolimbic dopamine system?

A
  • Prefrontal Cortex [planning, judgement]
  • Hippocampus [Memory, Learning]
  • Amygdala [Fear, Emotion]
  • NUCLEUS ACCUMBENS [Reward]
  • VTA
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4
Q

What are some of the pathways that drugs can have abusive effects on the dopamine reward system?

A
  • Nicotine [VTA: DA, Opioid peptide +]
  • Opiates [VTA: GABA - & NAc -]
  • Stimulants [Release DA from VTA to NAc]
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5
Q

What is Nicotine MOA?`

A
  • Activates Acetylcholinergic receptor
  • Na enters; K exits = Action Potential
  • 12 units
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6
Q

What is the difference between Acetylcholine and Nicotine?

A
  • BOTH have charged groups and H-Bond groups
  • Nicotine can cross the membrane [weak base] & not degraded by ACHE
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7
Q

What is the partial agonist therapy for Nicotine?

A
  • Release of Dopamine
  • HIGHLY ADDICTIVE
  • Varenicline: Partial Agonist - low efficacy and binds tightly
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8
Q

What are some of the commonly abused psychostimulants?

A
  • MDMA [Ecstacy], Meth, Methylphenidate, Cocaine
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9
Q

Why is Pseudoephedrine kept behind the counter?

A
  • Being able to reduce the OH to H = Meth
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10
Q

What is the MOA for cocaine?

A
  • Antagonist of Amine Transporters [DAT, SERT, NERT]
  • DAT>SERT>NET
  • Increases DA concentration
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11
Q

What is the MOA for Methamphetamine, Ecstacy & Bath Salts?

A
  • Compete for reuptake
  • Block DA reuptake
  • PUSH OUT DA from vesicles
  • Activates TAAR1 - Reverse transport
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12
Q

What are some of the clinical effects of Methamphetamine abuse/

A
  • Neurologic: Delirium, tremor
  • Psych: Anxiety, Paranoia, Hallucination, Delusions
  • ENT: Profuse Dental decay [“Meth Mouth”]
  • Cardio: Tachycardia, Hypertension/Vasospams
  • Skin: Diaphoresis
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13
Q

What is important to know about the brain within a METH abuser??

A
  • Measures: [11C]d-thero-methylphenidate
  • DA receptors are down-regulated [might cause addictions]
  • Recovery of DA receptors means that homeostasis has returned
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14
Q

Can low dose psychostimulant improve performance?

A
  • Low Dose = cognitive enhancement
  • Higher Dose = Addiction and Cognitive Deficit
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15
Q

What are the Sympathomimetic Toxidrome?

A
  • MATHS
  • Mydriasis
  • Agitation, arrhythmia, angina
  • Tachycardia
  • Seizure, sweating
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16
Q

What is the key component that is found within Cannabis?

A
  • Delta 9 - TetraHydroCannabinol
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17
Q

What is the difference between Hemp and Marijuana?

A
  • Hemp: 0.3% or less of THC needed [groen for agricultural products
  • Marijuana: 15 - 20% of THC
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18
Q

What is important to know about the legalization of marijuana?

A
  • Still a Schedule I under Federal Controlled Substance Act
  • Farm Bill of 2018 is passed = legalizing hemp
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19
Q

What is important to know about Delta 8 - THC?

A
  • It has 25% of the psycostimulant of Delta 9 and is NOT illegal
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20
Q

What is Synthetic Marijuana?

A
  • Agents that are potent than THC - gets sprayed onto the drugs
  • “spice”
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21
Q

What are some of the signs and symptoms of Acute Cannabis Intoxication?

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A
  • Perceptual [Slowing, Illusions..]
  • Affective [Euphoria., Anxiety, Disinhibition]
  • Cognitive [Suspiciousness, Impaired Reaction time]
  • Physical [Tachycardia, Hypotension, Dry Mouth][
22
Q

What are the parts of the Endocannabinoids Systems [ECS]?

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A
  • Receptors [CB1 & CB2]
  • Ligands [Anandamide & 2-AG]
  • Transporter [EMT]
  • Enzymes [FAAH, MAGL, DAG]
23
Q

What do Endocannabinoids and phytocannabinoids do within the receptor?

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A
  • Retrograde Regulators - inhibiting the release of GABA and Glutamine
  • THC = PARTIAL AGONIST
  • SYNTHETHIC = FULL AGONIST
24
Q

Where are CB1 expressed the most?

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A
  • In the brain
  • Low levels respiratory centers of the brainsteam = <respiratory depression; coma
25
Where are CB2 expressed the most?
- in the periphery - Help with immune regulation
26
What are some of the FDA approved cannabinoid drugs?
- Marinol [Synthetic Delta 9 - THC in sesame oil]; Counters loss of appetite - Nabilone [Anti-emetic in cancer patients]
27
What are the challenges with medical marijuana use?
- Lack of product quality control - Absence of adequate study for ADR - Highly politicized - Growing influcances
28
What is the Pharmacology and use for Cannabidiol [CBD]?
- Low affinity for CB receptors - Antagonize THC at CB1 - For Pain - not good data
29
What is Cannabidiol approved for?_
- Rare Seizure Disorder [Dravet Syndrome and Lennox-Gastust Syndrome]
30
What is Cannabinoid Hyperemesis Syndrome?
- Episodes of using cannabis causing nausea/vominting and stomach pain - Treatment: cannabis cessation, Benzo, Haloperidol, Capsaicin
31
What is the mechanism of action for capsaicin for cannabinoid hyperemesis syndrome?
- Substance P activates NK-1R = N/V - TRPV-1 [heat] decreases Substance P - Cannabis downregulates TRPV-1 = N/V - Capsaicin activates TRPV-1 = - N/V
32
What are Psychedelics?
- Agents that produce non-ordinary and variable forms of conscious experinces
33
What is a delusion?
- Fixed, False belief unresponsive to logic [Paranoia]
34
What is a hallucination?
- A false perception arising from internal stimuli [False Reality]
35
What is an illusion?
- A misperception of external stimuli [Distortion]
36
What are the two classes of Psychedelics?
- Classical & Dissociative
37
What are the Classical Psychedelic Drugs?
- Phenethylamine [Mescaline, MDA, MDMA, Psilocin] - Tryptamine [DMT, LSD, Ibogaine, 5-MeO-DiPT]
38
What is the mechanism of action of the classical psychedelic?
- Agonist of Serotonin receptor [Increasing Glutamate and BDNF] - Pretreatment with Serotonin antagonists BLOCKS effects
39
What are the adverse effects of the Psychedelic drugs used?
- Short Term: Tachycardia, Hypertension, Tremors, Dry Mouth, Nausea, Hyperthermia - Acute Reaction: Terrifying thoughts, Fear of ...] - Psychotic Reactions: Flashbacks, Psychosis
40
What is the Mechanism of Actions for Dissociative Psychedelics>
- Inhibition of GABA release - Disinhibition of Glutamate Release
41
What are the Prominent NMDA receptor antagonists>?
- Induces anesthesia AND analgesia - Ketamine and Dextromethorphan
42
What is important to know about Ketamine?
- "Special K" - S + is more active - Used in opioid tolerant patients for pain
43
What is important to know about Dextrimethorphan?
- Abused by 4% of high schoolers - Low dose = cough supporession; High Dose = "High"
44
What is the Pharmacology of Phencyclidine [PCP]?
- Mort potent than Ketemine [NMDA Antagonist] & Dopamine [D2 Agonist] - Cigarette dipped in liquid PCP to get high - Self Mutilation without recognition is a side effect
45
What is the Pharmacology of Muscimol?
- Agonist of GABAa that induces dissociative psychedelic effects - Gets decarboxylated to active form
46
What are the type of Psychoactive inhalants?
- Liquids [Paint Thinner, Gas, Glue, Markers] - Aerosols [Spray Paint, Deodorant, Hair Spray] - Gases [Chloroform, Nitrous Oxide, Butane] - Nitrites [Leather Cleaner, Room Deodorizer]
47
What are the ways that Inhalants can be misused?
- Sniffing, Huffing, Bagging, Dusting
48
What is the pharmacology of Alkyl Nitrites?
- "Poppers" - Cleaning solutions & Room Deodorizers - Abused among gay men [Relaxes Anal Sphincter, Enhanced Erection, Euphoria]
49
What is the pharmacology of Volatile Solvents?
- Liquids at Room Temp and vapor when exposed to air - Toluene, Acetone, Benzene, Butane
50
What are the clinical effects of volatile solvents?
- Acute effects: Locomotor, Euphoria - High Doses: CNS Depression, Slurred Speech, weakness, sedation
51
What is the risk of Inhalant abuse?
- Asphyxiation, Suffocation, Seizures, Coma, Choking, fatal Injury
PHRM 845: Therapeutics III
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