HLSC 130

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NorCalTopaz
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212344
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HLSC 130
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2013-04-12 15:11:05
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ATOD HLSC class Sac State
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Test # 2, Prof Nozicka-Ferris
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  1. Morton's makes table salt, also known as sodium chloride.  What is the chemical name, what is the generic name, and what is the brand name?
    • Chemical name: Sodium chloride
    • generic name: table salt
    • brand name: Morton's
  2. Into which major category does each of these drugs fall: heroin, cocaine, alcohol, LSD, Prozac?
    • Heroin - opioids, analgesics
    • Cocaine-stimulants
    • Alcohol-depressant
    • LSD-hallucinogens
    • Prozac-Antidepressant
  3. What are non-specific drug effects?
    Non-specific drug effects derive from the user's unique background and particular perception of the world.
  4. What are specific drug effects?
    Specific drug effects depend on the presence of the chemical at certain concentrations in the target tissue.
  5. What is the dose-response relationship?
    Dose-response relationship is the correlation between the response and the quantity of drug administered.
  6. What is an effective dose of a drug?
    The dose of a drug that produces a meaningful effect in some percentage of test subjects
  7. What is the lethal dose of a drug?
    the dose of a drug that has a lethal effect in some percentage of test subjects
  8. What is the potency of a drug?
    measured by the amount of a drug required to produce a given effect
  9. What is a double-blind procedure?
    Neither patient nor researcher know (about whether drug or placebo administered), but collect data on therapeutic and side effects.
  10. What is a drug threshold?
    The level at which an effect is first observed
  11. What is the time-course (time-dependent) factor?
    • Drugs vary in the timing of the onset, duration and termination of effects
    • -how the drug is administered
    • -how rapidly is it absorbed 
    • -how it is eliminated from the body
  12. Which of the three routes of drug administration is the fastest?  Slowest?
    -inhalation
    -ingestion
    -injection
    • Fastest-inhalation
    • Faster-injection
    • Slowest-ingestion
  13. What are the advantages/disadvantages of inhalation drug administration?
    • Advantages:
    • From the lungs
    • Through capillary walls 
    • Into the bloodstream 
    • To the brain 
    • Rapid effects in 5 to 8 seconds
    • liver metabolism avoided

    • Disadvantages:
    • increased risk for direct adverse effects
    • potential for lung toxicity
  14. What are the advantages/disadvantages of injection drug administration?
    • Advantages:
    • Rapid effects
    • High concentrations 
    • Subcutaneous-slow and sustained drug effect
    • Intramuscular-more rapid than subcutaneous

    • Disadvantages:
    • Irritating material 
    • Can damage veins 
    • Infections
    • necrosis
    • Drug absorption unpredictable/unusual in very obese/emaciated individuals

    Fastest-arm, medium-thigh, slowest-butt
  15. What are the advantages/disadvantages of insufflation (snorting) drug administration?
    • Advantages:
    • Liver metabolism avoided
    • rapid drug effects
    • reliable and convenient
    • faster absorption through mucous membranes

    • Disadvantages:
    • potential for nasal necrosis
  16. Why might nonspecific factors influence psychoactive drug effects more than the effect of an antibiotic?
    Nonspecific factors would influence a psychoactive vs. an antibiotic because one is not expecting a "high" from an antibiotic. 
  17. Why should the LD50 (lethal dose) always be greater than the ED50 (effective dose)?
    the LD50 (te lethal dose in 50% of animals) should be greater than the ED50 (effective dose in 50% of animals) because that is the level at which death occurs.
  18. What is pharmacodynamic tolerance?
    Tolerance caused by altered nervous system sensitivity (i.e. from overuse/abuse of psychoactive drugs)
  19. What is behavioral tolerance?
    Tolerance caused by learned adaptation to the drug.
  20. Why is it thought that LSD is one of the most potent psychoactive drugs?
    because of the low dosage necessary for the effects (50 micrograms) to begin
  21. What is the safety margin in psychoactive drugs?
    the dosage between an acceptable level of effectiveness and the lowest toxic dose.
  22. Which route of administration gets the drug to the brain quickest?
    inhalation
  23. If an elderly person has less protein in the blood than a younger person, how would you adjust the drug dosage that has a high protein binding?
  24. How might two drugs interact with each other through actions on the CYP450 enzyme system?
    CYP450 are liver enzymes which metabolize drugs; they wait in the liver to inactivate ingested chemicals. 

    However, once the liver recognizes a foreign substance (drugs), the CYP450 enzyme tries to return the body to homeostasis - possibly rendering one drug inactive but with another develops a tolerance (competing drugs for metabolism).
  25. Which type of tolerance is related to physical dependence, and why?
    this has to do with drug disposition tolerance, when increased CYP450 enzyme activity metabolizes the drug faster, requiring an increased dosage for the same effect.  But more drug activity causes increased metabolism...
  26. What is behavioral tolerance?
    the drug continues to have the same biochemical effect  but with a reduced effect on behavior (like someone who breaks their writing hand improves with the other)
  27. What is pharmacodynamic tolerance?
    A drug's reduced effectiveness and increased withdrawal reactions, most notably, the brain does not change, but neuron sensitivity to the drug does.
  28. Mandatory sentencing laws for crack vs. powder cocaine did what?
    Five grams of crack was a minimum of 5 years, the same in powder was a maximum of one year. 

    In addition, Blacks were disproportionately given harsher sentences, exaggerated crack's harmfulness (vs. "blow"), most often applied to low-level defenders, and quantity-based sentences overstated seriousness of crack

    Anti-Drug Abuse Acts of 1986 and 1988 Penalties for sale of crack cocaine significantly moresevere than penalties associated with powder cocaine

    Tougher penalties for first-time users of crack
  29. What neurotransmitters are affected by cocaine use?
    • dopamine
    • seratonin
    • GABA
    • glutamate
  30. What is the brain-chemical reaction of cocaine use?
    cocaine blocks the reuptake of dopamine, norepinephrine, and seratonin causing a prolonged effect on these neurotransmitters

    Cocaine blocks reuptake of dopamine, serotonin, andnorepinephrine
  31. Delivery routes of cocaine and its efficacy?
    Ingestion- (coca leaves) slow, steady and reduced absorption; release through mucous membranes

    Inhalation-rapidly absorbed, reaches brain quickly

    IV - very rapidly absorbed, rapid and brief effect

    Smoking- same as IV but less invasive

    Half life of one hour, drug screens half-life eight hours
  32. Acute vs. chronic toxicity of cocaine?
    Acute: small amounts not necessarily bad, but increased amounts causes CNS stimulation i.e. convulsions - respiratory or cardiac arrest.  Also, cocaine is "cut" with toxic substances, and combination with alcohol which can be more toxic.

    Chronic: (binge) irritability, restlessness and paranoia, also paranoid psychosis with auditory hallucinations
  33. Dependence potential of cocaine?
    causes largest proportion of admits into drug programs nationwide

    can cause anxiety, irritability, depression, increased appetite, exhaustion, cocaine craving upon withdrawal (but psychological pull is strong)
  34. Ephedra (ma huang) precursor to what?
    Ephedrine - causes bronchial dilation, stimulates sympathetic branch of ANS, including elevated blood pressure

    Patented into amphetamines, adderal is used to treat ADHD, and amphetamine for narcolepsy
  35. During the mid-1960's, how prevelant were amphetamines in the average American life?
    Prevalent, as they were prescribed by MD's for postponing sleep, weight control and depression
  36. What role did amphetamines play in hippie culture during the 60's?
    in Haight-Asbury, next to established IV heroin users who were doing "speedballs" to intensify their high.  the hippies started doing that as well.
  37. How did the movement against methamphetamines come about in the 1960s?
    As the use of amphetamines were recognized as abuse, they were prescribed less and tightly controlled
  38. How did America's amphetamine problem become a political issue?
    associated with hippies and heroin, overprescribing as well
  39. How did pharmaceutical companies react to the drug regulations of 1970?
    MDs prescribed less, manufactured less, cost went up, illicit manufacturing skyrocketed
  40. What is the amphetamine addiction situation in the US today?
    HI, CA and midwest all hubs of meth manufacture and use, subculture in gay communities in urban areas
  41. What neurotransmitters are affected by meth  use?
    Causes increased activity of monoamine neurotransmitters by stimulating their release;

    Chemical structure is similar to the catecholamine neurotransmitters

    Methamphetamine structure allows it to moreeasily cross the blood-brain barrier
  42. Meth absorption, elimination and tolerance?
    • Peak effects 
    • 1.5 hours after oral ingestion 
    • 5-20 min after intranasal administration 
    • 5-10 min following IV injection or smoking 

    Half-life  5-12 hours

    Rapid tolerance (tachyphylaxis) can occurafter high doses
  43. Acute toxicity from meth?
    • Acute behavioral toxicity:
    • Increases in feelings of power, suspicion,paranoia

    Potential risk of violent behavior 

    Very high doses may destroycatecholamine neurons

    Contaminants formed during the manufacture of illicit methamphetamine may have toxic effects on brain cells
  44. Chronic toxicity from meth?
    Paranoid psychosis

    Two possible reasons for the psychosis  1. Heavy methamphetamine users have schizoid personalities. 2. Caused by sleep deprivation. 

    Higher risk among those who inject the drug
  45. Dependence potential from meth?
    • Often no obvious withdrawal symptoms Produce psychological dependence 
    • Capable of producing dependence as defined by DSM criteria
    • A potent reinforcer
  46. Describe the effects of meth on mental/physical performance
    at low dosages, can improve mental acuity and physical performance (because of disruption of sleep), simple tasks only
  47. Crack
    • Miami, FL is America’s "Cocaine Capital"
    •  Two main forms of cocaine made is powder and crack cocaine
    •  Crack cocaine is the cheaper alternative but more potent alternative to powder cocaine.
    •  1984-crack cocaine first emerged in the US; 5.8 million crack cocaine users are addicted within the first year
  48. Cocaine dealer
    • Powder cocaine is the preferred in London
    •  1990’s use of cocaine sky rockets
    •  42 tons of cocaine is used in the UK each year
    •  Britain consumes more cocaine than any other nation in Europe.
  49. Trafficker"
    •  2 million cocaine dealers around the world  1,000 tons of cocaine is manufactured/produced yearly
    •  Fishing boats were used to smuggle drugs into the US through San Diego.
    •  "Eddie" made $40,000 per month in trafficking cocaine from Mexico to New York.  Get $13 million for trafficking to LA and $18 million to NY = $5 million to get cocaine from San Diego to New York
    •  Drivers had to pass a 30 second test, to determine if that person is worth interrogating when pulled over
    •  Traffickers can make 25% of the retail price of cocaine. A worldwide total of $50 billion/year
    •  "Blood in, blood out" means kill to get in and kill to get out.
    •  Drug wars cost the lives of 20,000 people

     In 2006 Philippe Calderon is elected President of Mexico. The drug-related death rate went down and the cartel needed a new leader when the Mexican government took down the "Big Fish"/major
  50. The "Producer"
    •  Over half of the world’s cocaine comes from Columbia
    •  Cocaine farmers/growers make the least amount of money in the production chain, and traffickers make the most money.
    •  Cocaine paste sells for $750/kilo and yucca plant sells for 40 cents/kilo
    •  Coca paste is created from breaking down the coca leaves.
    •  Only ½ of 1% of coca leaf is cocaine
    •  Cement powder and liquid fertilizer are used to break down the leaves, then gas is used to extract the cocaine into a liquid cocaine, and then sodium crystals are added and the liquid is cooked off.
    •  "The Producer" (farmer) has no intention to make people addicted to cocaine so he can make money, he’d rather grow local crops such as yucca.
    •  Farmers make an average of $1 million pesos/$500 per year; 5 cents per gram.
  51. The "Crack Addict"
    •  Cocaine is snorted and smoked by 1.9 million Americans; 360,000 are hard core crack addicts
    •  Euphoria from the first hit of crack cocaine is the highest. Never get the same high again and always chase the first high.
    •  Crack cocaine is considered the "poor man’s drug".
    •  Generally rich people use more powder cocaine and poor people use more crack cocaine.
    •  Smoking crack cocaine is more addicting than snorting the powder form.
  52. The "Cocaine User"
    • 20 million cocaine users worldwide from United Nations World Drug Report; majority of the users snort
    •  Cocaine creates intense feels of pleasure without a loss of control, falling into a stooper, or hallucinations
    •  Dopamine is the neurotransmitter signaled in the brain when cocaine is snorted.
    •  Cocaine use changes the structures in the brain
  53. the "Scientist"
    • 25% of users will develop a problem-prison or addiction
    •  Animal research resulted in the animals compulsively taken cocaine and none survived, whereas the animals taking heroin were alive
    •  Researchers believe people can get addicted to the lifestyle (environment, friends, and situations) of cocaine.
    •  New research shows that cocaine can be so addictive that showing images of cocaine use can increase dopamine levels and lead a person into relapse. Relapse is due to effects on the memory system.
    •  Law enforcement treats cocaine users as criminals, rather than people suffering from a disease
    •  Over past 10 years government has repeated reduced funding for drug rehabilitation and increased funding for prisons. As a result, 1 million American are in prison in the US on drug related crimes costing tax payers $12.5 billion is spent on offenders in prison
    •  40% of coke and 77% of crack offenders, reoffend
  54. The "Eradicators"
    •  Cocaine eradication programs in Columbia have had an effect in the amount of cocaine produced in the country.
    •  The amount of cocaine manufactured in Columbia today remains the same as a decade ago.
  55. The "Agent"
    •  Austin, TX is the major "transit hub" for cocaine into the US
    •  1.8 million people arrested on drug charges last year, that is one every 20 seconds.
  56. Why are we losing the war on drugs?
    • Supply and demand,
    • addictive nature,
    • quick euphoric feeling,
    • and money made from distribution
  57. Alcohol pharmacology
    •  Absorption 
    • Some: stomach;
    • Most: small intestine 
    • Slower with food or water;
    • Faster if carbonated 

    • Distribution  Blood alcohol concentration (BAC)  expressed as a percentage in terms of grams per 100 ml 
    • Throughout body fluids 
    • Less distributed in fatty tissues 

    • Metabolism  Liver: about 0.25 oz of alcohol per hour 
    • If rate of intake = rate of metabolism, BAC is stable 
    • If rate of intake > rate of metabolism, BAC climbs
    • Metabolism Liver: about 0.25 oz of alcohol per hour
    • If rate of intake = rate of metabolism, BAC is stable
    • If rate of intake > rate of metabolism, BAC climbs
    • Blood Alcohol Concentration The relationship between blood alcohol concentration and alcohol intake
  58. Standard drink =
    • 0.5 ounce of pure alcohol
    • 12 ounces of beer 
    • 4 ounces of wine 
    • 1 ounce of 100-proof spirits
  59. Alcohol facts from Sac State Police
    ·“Buzzed driving is drunk driving”·        

    .08 for over 21 years old is drunk driving

    ·.01 or above for under 21 years old is drunk driving – Zero tolerance policy·   

          DUI’so   Infraction – fineo   Misdemeanor – fine plus possible jail timeo   Felony-  possible prisono   1st time DUI’s include fees and court costs ranging from $15,000 to $20,000 if plea bargained. Add attorney fees if taken to court. Plus court ordered classes.
  60. College aged drinking
    • ·        85-90 % of college rapes/sexual assaults involve alcohol (used by the victim, perpetrator, or both).·       
    • A hangover is the most common negative consequence students report as a result of drinking alcohol.·       
    • The prefrontal cortex does not fully develop until about age 24. Because of this, alcohol will affect cognition more in students under 24 when compared to those older than 24. (This was discussed within the context of impaired thinking the day after drinking.)·        Carbonated beverages mixed with alcohol speed up the absorption rate.·   
    •      Alcohol interferes with the REM stage of sleep.·       
    • High-risk drinking is defined as four drinks in one sitting for women, and five drinks in one sitting for men.·       
    • The presence of food in the stomach will slow down how fast alcohol is absorbed.

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