Alcohol
Another term for alcohol.
Ethanol or Ethyl Alcohol
Chemical primary active ingredient in tobacco.
Nicotine.
What is primary ingredient in Cannabis? What is full name to really impress?
Delta-9-Tetrahydrocannabinol.
women have 50% less gastric metabolism of alcohol due lower levels of _____________.
GAD (gastric alcohol dehydrogenase).
Name three medications FDA approved for alcohol over use/dependence and mechanism of action.
1. Naltrexone-endogenous opiod antagonist-reduce consumption. 2. Acamprosate (Campral), NMDA & GABA receptor modulator-reduces craving. 3. Disulfiram- (Anabuse) inhibits aldehyde dehydrogenous to allow Acetaldehyde accumulation-creates unpleasant reaction when drinking. Aversive tx.
Term to denote amount of alcohol concentrated in blood: What value constitutes driving impaired.
BAC of 0.05 to 0.08
Nicotine rapidly metabolized by CYP enzymes. Inducing or inhibiting? & Primary metabolite is..................
Induces liver function.
Metabolite is Cotinine
excreted by Kidneys.
Where are Cannabinoid (CB1) receptors found in highest concentration in the body? CB2 receptors?
CB1 throughout the body, highest in CNS, Hypothalamus, Amygdala; CB2 PNS & Immune System, Bones, Liver, Pancreas, Skin, Spleen.
Caffeine blocks Adenosine receptors which modulates the
release of what three neurotransmitters?
DA, AChe, Glutamate.
Miriam reports heightened anxiety, agitation, insomnia, mood changes, tachycardia, high blood pressure, hypertension, GI distress. No mental health disorder. What is she dealing with ? (HINT: she has stock in Starbucks)
Caffeinism.
Define Rapid Gastric Emptying & Relationship to ADH (Enzyme) and BAC
Rapid gastric emptying-drinking on an empty stomach reduces time alcohol exposed to ADH. Raises BAC.
Nicotine causes release of what hormone causing
_____________________?
Antidiuretic hormone (ADH) causing fluid retention.
What neurotransmitter is associated with the Endocannabinoid System?
Anandamide.
Cocaine blocks reuptake of what neurotransmitter? What effect?
DA. Responsible for reinforcement.
Jose comes to you with a panic disorder, acute anxiety, over drinks coffee. What antidepressant might she need to be informed about related to her coffee overuse and why?
SSRI antidepressants such as fluoxetine and fluvoxamine are potent inhibitors of CYP-1A2, and people taking these antidepressants can exhibit unexpected toxicity or intolerance to caffeine as plasma levels of caffeine rise, including Caffeinism with severe anxiety.
Four neurotransmitters involved psychodynamically with alcohol & effects.
Glutamate (excitatory) suppressed by alcohol, enhances GABA, body upregulates glutamate, no alcohol----seizures. Affects Opiods-modulates Dopamine, reinforcement, Serotonin, inhibits DA.
What neurotransmitters are affected by Nicotine? What is effect?
Facilitates release of DA (reinforcement), AChe (increase memory function), Glutamate.
THC is almost completely metabolized by CYP enzymes into? How long present in urine for infrequent smokers? Regular smokers?
Carboxy-THC Infrequent smokers 1-3 days. Regular smokers 7-21 days.
THC is converted into inactive metabolite
_____________________.
Carboxy-THC.
Melania is a 42 year old, with a dual diagnosis for Alcohol use disorder, severe, and Bipolar I. Her psychiatrist puts her on Anabuse. Explain its therapeutic action.
Disulfiram- (Anabuse) inhibits aldehyde dehydrogenous to allow Acetaldehyde accumulation-creates unpleasant reaction when drinking. Aversive tx.
Name Four Pharmacotherapies for Alcohol Overuse/Abuse/Dependence.
1. Treat & prevent withdrawal symptoms. 2. Reduce relapse in drinking behaviors. 3. Treat complications in alcohol dependence for those decreasing or discontinuing alcohol. 4. Reduce Glutamate release, glutamine receptor upregulation, neuronal damage.
What in Nicotine is metabolized and is carcinogenic?
BPDE which damages a cancer suppressing gene affecting lung tissue.
Name one pharmacologic effect of cannabis usage for respiratory system, respiratory, immune, & reproductive.
Cardiovascular: blood pressure, stroke. Respiration: bronchial irritation. Immune: immunosuppression. Reproductive: low T, menses changes, fertility.
Explain what is unique about the mechanism of action of the Endocannabinoids (eCBs): Hint: Two Things!
AEA & 2-AG are not produced ahead of time nor stored in neuronal terminals, rather, synthesized on demand, and retrograde direction.
Juan is a 45 year old veteran, with pain issues, arthritis, fibromyalgia, sleeping issues, PTSD features. Explain how medical cannabis may be an option as a medication regiment. How isit superior to what traditional conventional medication regiments?
Cannabis working on the endocannabinoid system, has analgesic benefits, mitigating effects of PTSD, anxiety, and working as a sleep aide. Opiates affect gastric motility and causes constipation, effects calcium and causes dental decay, affects the thalamus and disrupts pain regulation. Benzodiazepines are addictive, foment depression, affect cognition, disrupt sleep architecture.