Substance Abuse Disorders

Alcohol Dependence

binds with GABA, glutamate, and HT3 receptors to cause CNA depression

Alcohol contribute to the release

dopamine

alcohol and blood-braine barrier

crosses easily

alcohol metabolism

stomach and liver

alcohol effects

heart damage, impaired glucose metaolism, resp depression, liver damage, gastritis, pancreatitis, kidney damage, sex. dys., birth defects

BAL for CNS effects

0.05

alcoohol interactions

other CNA depressants, NSAIDS, acetaminophen, disulfiram, antihypetensive drugs

drug of choice for acute alcohol withdrawal

lorazepam (benzodiazepines)

other drugs for acute alcohol withdrawal

beta-blockers, antipileptic drugs, alpha adrenergic agonists

Abstinence Maintence drugs

Naltrexone (vivitrol) & disulfiram (Antabuse)

Naltrexone (vivotrol)

pure opiod antagonist, decreases cravings, blocks pleasurable effects

Naltrexone (vivotrol) adverse effects

HA, nausea, anxiety, sedation

Disulfiram (antabuse)

causes unpleasant effects with alcohol ingestion, disrupts metabolism

Nicotine receptors

autonomic ganglia, CNA, carotid body, aortic arch

Nicotine transfer

can cross placenta, and enters breast milk

nicotine heart effects

vasoconstriction, increased HR, increase BP

nicotine effects on GI

increases gastric acid secretion, increases GI motility, vomiting

nicotine effects on CNS

increases alertness, tremors, facilitates memory, improves cognition, reduces aggression, suppresses appetite

nicotine effects on prenatal

increases ectoptic pregnancy risk, low birth weight, parinatal mortality, SIDS, behavioral and emotional defecits

nicotine cessation techniques

pacthes, lozenges, gum, nasal spray, inhalers

Nicotine free drug

bupropion (antidepressant)

drugs used for long term optiod use management

methadone and buprenorphine

methadone dose

once a day

methadone function

high tolerance to methadone means taking street drugs will not produce desireable effects

Buprenorphine

agonist-anagonist opiod (patial mu agonist, full kappa antagonist)

buprenorphine function

facillitates detox and maintenance, alleviates cravings

Heroin

opiod

heroin routes

nasally, IV, smoking

heroin function

rapidly converted to morphine in brain

Cocaine

CNS stimulants that produces euphoria

cocaine route

nasally or smoking

severe cocaine OD

vent. dys., conculsions, hyperpyrexia (fever), stroke, MI, coronary vasospasm

Marijauna

THC, can increase HR and bronchodilation

cannabinoid hyperemesis syndrome (CHS)

with chronic use causes nauseu and vomiting

Methamphetamine

CNS stimulant, increases norepinephrine and dopamine

Methamphetamine routes

swallowed, smoked, injected IV, inhaled intranasally

Methamphetamine complication

psychotic state, cardiac complication, significant wt loss

Schedule I

other drugs prescribed not approved

Schedule II

prescriptions must be typed out in ink and signed by prescriber

Schedule III

may be oral, written, or electronic (buprenorphine)

Schedule IV

oral, written or electronic (lorazepam)

Schedule V

may be dispensed without presecription (pregabalin)