Name one kind of med to avoid in treating those w/ substance use disorders?
- Benzos in those using alcohol
- QTc-prolonging agents in those using stimulants
- TCAs (seizure risk)
- CYP450 1A2 metabolism in smokers
Source: Suave, 2012
200
Impulsivity is hypothesized to be related to the _____, while compulsivity is hypothesized to be related to the _____
What is: Ventral striatum, dorsal striatum
200
Name the three opioid receptor subtypes involved in opioid abuse
μ- opioid receptors: involved in reinforcement and drug dependence
κ-opioid receptors: induce dysphoria, counteract μ-opioid receptors
δ-opioid receptors: involved in emotional control
Stahl S.M, Grady M.M. (2012). Stahl's illustrated substance use and impulsive disorders. Cambridge: Cambridge University Press.
This substance abuse treatment for opiod dependence requires an induction phase, where the pt must abstain from opiods in order to experience mild withdrawal
What is Suboxone
Source: Bezchlibnyk-Butler et al., 2014
300
What is the brain's naturally occurring cannabinoid called?
Anandamide
300
What is the source of all natural opioids?
The poppy papaver somniferum
300
Regarding NRT, why is the nasal spray associated w/ more dependence risk than the oral inhaler?
The nicotine is actually absorbed in the mouth, not the lungs, with the inhaler
file:///Users/Alison/Downloads/Nicotine%20tx%20options.pdf
300
If you had a patient with dysphoric mood, nausea or vomiting, muscle aches, runny nose and eyes, dilated pupils, goose bumps, sweating, diarrhea, yawning, fever, and insomnia, what would you suspect is going on?
Opiod Withdrawal
300
This substance abuse treatment is helpful for your patient whose goal it is to achieve reduced-risk drinking
Naltrexone
Source: Stahl, 2011
400
ALL addictive drugs increase _ in the _/
dopamine; nucleus accumbens
400
Which neurotransmitters are affected by alcohol?
Increases GABA and decreases glutamate
400
Which nicotinic receptor is the primary target of nicotine in cigarettes?
α4β2
400
What makes heroin able to more quickly cross the BBB than other opiods, allowing it to reach high levels?
It is more lipid-soluble than other opiods
Source: Powell, 2014
400
This substance abuse med works to inhibit glutamate and enhance GABA in order to reduce alcohol cravings and prevent relapse
What is Campral (Acamprosate)
Source: Bezchlibnyk-Butler et al., 2014 & Stahl, 2013
500
What role does glutamate play in substance abuse disorders?
Glutamate modulates plasticity and learning associated with drug exposure through changes in the ratio of NMDA to AMPA receptors in the VTA
500
Which drug of abuse produces its effects through retrograde neurotransmission?
Marijuana;
Instead of going from pre- to postsynaptic neurons, endocannabinoids are synthesized in the postsynaptic neuron, released, and diffuse to presynaptic cannabinoid receptors such as the CB1 receptor, thus allowing postsynaptic neurons to communicate back to presynaptic neurons
Stahl, Stephen M.; Grady, Meghan M. (2012-10-04). Stahl's Illustrated Substance Use and Impulsive Disorders (Kindle Locations 1034-1037). Cambridge University Press. Kindle Edition.
500
These agents, particularly, _______, are the best studied for the pharmacological treatment of stimulant dependence.