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Maladaptive pattern of substance use leading to adverse consequences; continued use despite interpersonal problesm associated with the agent; symptoms not sufficient for substance dependence
- Substance Abuse- Psychological
- Substance Dependence- Physiological
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Increasing among high school students
Illicit drug use (alcohol and cigarettes are decreasing)
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Schedule: High abuse potential, No medical use
Schedule 1
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Schedule: High abuse potential, severe physical and psychological dependence possible, written order only, no refills
Schedule II (Morphine, PCP, cocaine, methamphetamine, methadone)
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Schedule: Some abuse potential, lesser dependence potential, telephone order OK, 5 refills/6 months
Schedule III (Steroids, codeine)
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Brain reward system for drugs of substance abuse
Dopaminergic mesocortico-limbic pathway
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Dopaminergic mesocortico-limbic pathway originates? Includes involvement of?
- Originates in VTA
- Critical involvement of Nucleus Accumbens (in prefrontal cortex)
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Most commonly used illicit drug among high school seniors
Marijuana
*50% of US population will use during lifetime
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Scientific name for cocaine
Cannabis sativa (Hashi)
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Active ingredients of cocaine
- Delta9-Tetrahydrocannabinol (psychoactive content)
- Cannabidiol
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Cannabinoid receptors
G protein-linked (CB1/CB2)- CB1 is very abundant in the brain
Delta9-THC is a partial agonist of CB1
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Endogenous ligands for CB1 come from
arachidonic acid
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Marijuana withdrawal
Nonexistent
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Therapeutic effects of Delta9-THC
- Reduced intraocular pressure
- Antiemetic effect
- Bronchodilation
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Dry mouth, nystagmus, tachycardia, hallucinations
9-THC adverse effects
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LSD (lysergic acid diethylamide): MoA, receptros
5-HT 1A and 1C agonist -> increased serotonin levels
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LSD results in
- Sympathetic activation
- Visual, temporal hallucinations
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LSD withdrawal
No withdrawal symptoms
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Datura stamonium hallucinogen
Anti-muscarine scopoloamine (witches)
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Highly selective for kappa opioid receptor
Salvia divinorum (Salvinoran A)
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Mitragyna speciosa
Kratom
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Kratom causes
Analgesia (Mitragyna speciosa)
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Name 5 amphetamines
- MDMA (ecstasy)
- MDA
- DOM
- 2C-B
- PMA
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Amphetamine Actions
- Hallucinations
- Euphoria, increased libido
- Hyperpyrexia
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Amphetamines: Toxicity
- Serotonergic Syndrome
- Hyperthermia
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Imaging shows a deficit in 5-HT transport
MDMA
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Legal Ecstasy
Piperazines (Schedule 1)
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Piperazines: MoA
- Serotonergic agonist
- Transport inhibitor
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Cocaine source
Erythoxylon coca
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Cocaine: MoA
Inhibits biogenic amine transport (SERT> DAT> NET)
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Cocaine adverse effects
- Excess CNS stimulation
- Pronounced circulatory stimulation
- Hyperpyrexia
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Bath Salts:
What are they?
MoA?
- Khat (Catha edulis)
- Methcathinone (epedrone)
- Mephedrone
VMAT inhibitors
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Stimulatory Anesthetics:
What are they?
Actions?
Adverse effects?
Ketamine, PCP
Actions: Hallucinations, dissociative anesthesia
- Adverse: Aggressive psychotic behavior
- Hyperpyrexia, rhabdomyolysis
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Legal derivative of synthetic ketamine
Methoxetamine
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Inhalants:
What are they?
Toxicities?
NO, chloroform, ether, amyl nitrite
- Toxicities: Cardiac arrhythmias, bone marrow depression, cerebral degeneration
- Liver, kidney, peripheral nerve damage
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Glue-sniffer's rash results from
Huffing
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FQ: 9-THC: receptor? effect?
- CB1 receptor
- Psychotomimetic effect
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Mixed direct/indirect sympathomimetic that can serve as a methamphetamine precursor
Ephedrine
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Primary brain system mediative positive reinforcement
Dopaminergic mesocorticolimibic pathway
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Vasoconstrictor, local anesthetic
Cocaine
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Hallucinogenic stimulant
MDMA (methylenedioxymethampehtamine)
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Soruce of antimuscarinic agent causing amnesia
Datura stramonium (scopolamine)
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Midazolam (Benzodiazepine) OD treated w/
Flumazenil
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Selective inhibition of membrane biogenic amine transporters mediates the action of
Cocaine
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Source of Mescaline
Peyote
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Drug w/ the lowest therapeutic ration(letal dose is closes to therapeutic dose)
Heroin
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NMDA receptor antagonist
Ketamine
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Causes serotonin neurotoxicity
Methylene Dioxymethamphetamine (MDMA)
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Sedative-Hypnotic Drugs
- Ethanol
- Barbituates
- Benzodiazepines
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Antidote for benzos
Flumazenil
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Date-rape drug; rapid-onset benzo w/ amnesic properties
Flunitrazepam
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Compuslive drug-using behavior in which the person uses the drug for personal satisfaction
Addiction
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A state characterized by signs and symptoms
Dependence
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OD Effects: Hyperthemia, HTN, Hallucinations, tachycardia, Delusions, Death
(HHHTDD)
Amphetamines, methylphenidate, cocaine
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Date-rape drug; uses GABAB receptors
GHB (gamma-Hydroxybutyrate)
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Amphetamies, Methylphenidate, Cocaine: OD symptoms
HTN, Hallucinations, Hyperthermia, Tachycardia, Delusions, Death
HHHTDD
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OD Effects: Slurred speech, drunked behavior, Dilated pupils, rapid pulse, clammy skin, shallow respiration, coma, death
Barbituates, Benzos, Ethanol, Scopolamine
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Barbituates, Benzos, Ethanol, Scopolamine: OD
Slurred speech, dilated pupils, weak and rapid pulse, drunken behavior, clammy skin, shallow respiration, coma, death
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OD effects: Constricted pupils, clammy skin, nausea, drowsiness, coma, death (rarely)
Heroin, other strong opioids
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Heroin, strong opioids: OD
Constricted pupil, respiratory depression, coma, death (rarely)
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Withdrawal:
1) Apathy, irritability, depression
2) Seizures, delirium, tremors, death
3) Lacrimation, rhinorrhea, yawning
- 1) Amphetamines, methylphenidate, cocaine (AMC)
- 2) Benzos, Barbituates, Ethanol, Scopolamine
- 3) Heroin, other strong opioids (codeine)
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PCP (angel dust) and Ketamine (special K): Receptor:
NMDA receptor
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OD results in horizontal and vertical nystagmus
PCP
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