PHAR 100 Module 3 Flashcards (Queen's University) 낱말 카드

Sedative-Hypnotics

CNS depressants that produce dose-dependent effects from anti-anxiety to anesthesia

GABA Inhibition

Sedatives enhance GABA signalling causing Cl- influx and reduced neuronal firing

Benzodiazepine Mechanism

Increase frequency of chloride channel opening

Barbiturate Mechanism

Increase duration of chloride channel opening

Benzodiazepine Therapeutic Uses

Anti-anxiety, sedation, muscle relaxant, anticonvulsant, insomnia

Barbiturate Therapeutic Uses

Anesthesia induction and antiepileptic therapy

Flumazenil

Benzodiazepine receptor antagonist used as overdose antidote

Benzodiazepine Short-Term Effects

Drowsiness, lethargy, impaired thinking, respiratory depression (IV)

Benzodiazepine Long-Term Effects

Variable cognitive effects, some impairment in coordination and memory

Benzodiazepine Special Populations

Pregnant and breastfeeding exposure crosses placenta and enters milk

Benzodiazepines in Older Adults

Slower metabolism, higher risk of oversedation, falls, cognitive issues

Benzodiazepine Misuse Potential

Low misuse liability with low inherent harmfulness at therapeutic doses

Benzodiazepine Tolerance

Tolerance develops to sedation and coordination impairment

Benzodiazepine Withdrawal

Anxiety, headache, insomnia; severe withdrawal after chronic use

Benzodiazepine Addiction

Possible but lower than barbiturates or opioids

Barbiturate Lethality

Low therapeutic index with frequent respiratory depression and high overdose risk

Barbiturate Short-Term Effects

Euphoria, motor impairment, intoxication, cardiovascular depression at high doses

Barbiturate Long-Term Effects

Chronic inebriation, memory and judgement impairment, mood changes

Barbiturate Misuse Potential

High misuse liability equal to or greater than alcohol

Barbiturate Withdrawal

Seizures, hallucinations, delirium, high body temperature; must taper slowly

Barbiturate Addiction

Compulsive craving regardless of dose

Zopiclone

Benzodiazepine-like drug used as hypnotic with minimal REM disturbance

Zolpidem

Benzodiazepine-like hypnotic with minimal REM disturbance

Buspirone

Non-sedating anxiolytic acting on serotonin receptors, used when additive CNS depression is a concern

Alcohol Classification

General CNS depressant with dose-dependent impairment

Alcohol Absorption

20% absorbed in stomach and 80% in small intestine

Alcohol Distribution

Distributes into total body water, brain, and crosses placenta

Alcohol Metabolism Rate

Metabolized at a constant rate ~120 mg/kg/hr due to ADH saturation

Alcohol Metabolism Pathway

Ethanol → acetaldehyde (ADH) → acetate (ALDH) → CO₂ + H₂O

MEOS Pathway

Minor metabolic route induced at high alcohol levels

Genetic ADH Variation

Faster ADH activity increases acetaldehyde causing flushing and unpleasant effects

Alcohol Excretion

95% liver metabolism; 5% excreted in breath, urine, sweat

Breathalyzer

Measures ethanol excretion in breath for intoxication estimation

Alcohol Mechanism

Enhances GABA-mediated Cl- channel inhibition and depresses neuronal firing

Low Dose Alcohol Effects

Relaxation, disinhibition, vasodilation, gastric secretion

High Dose Alcohol Effects

Motor impairment, respiratory depression, coma, death

Alcohol Memory Loss

Blackouts occur with short-term heavy drinking

Alcohol Psychiatric Effects

Depression, irritability, impulsivity, violence

Acute Alcohol Toxicity

Respiratory depression, aspiration, coma, death

Chronic Alcohol CNS Effects

Alcoholic dementia from neuronal axon damage and reduced connectivity

Chronic Alcohol Cardiovascular Effects

Alcoholic cardiomyopathy, hypertension, stroke

Chronic Alcohol Liver Effects

Alcoholic liver disease progressing from reversible to irreversible

Fetal Alcohol Effects

Fetal Alcohol Spectrum Disorder with permanent cognitive and developmental deficits

Alcohol Drug Interactions (Concurrent)

Ethanol + CNS depressants cause additive respiratory depression

Alcohol Drug Interactions (Chronic)

Increases liver enzyme activity leading to higher drug metabolism

Alcohol Misuse Potential

Moderate to high reinforcing properties with widespread availability

Alcohol Tolerance

Chronic exposure produces tolerance to impairment effects

Alcohol Cross-Tolerance

Alcohol causes cross-tolerance with sedatives and general anesthetics

Alcohol Withdrawal

CNS excitation, tremors, seizures, delirium tremens, risk of death

Alcohol Addiction

Strong compulsion to drink driven by reinforcement

Treatment of Alcohol Withdrawal

Diazepam suppresses withdrawal due to similar mechanism

Naltrexone

Opioid antagonist reducing reward effects and alcohol craving

Cannabis Definition

Drug-containing forms of Cannabis sativa

Cannabinoids

60 unique compounds in cannabis including THC

THC

Psychoactive cannabinoid producing most cannabis effects

CB1 Receptors

Located in brain; mediate euphoria, altered perception, memory impairment

CB2 Receptors

Located outside CNS; modulate inflammation and immune suppression

Cannabis Classification

CNS depressant, euphoriant, and hallucinogen at high doses

Cannabis Administration

Usually smoked or vaped; oils and edibles are ingested

THC Mechanism

THC binds CB1 receptors and inhibits release of excitatory neurotransmitters

Anandamide

Endogenous CB ligand acting as retrograde transmitter

THC Absorption Inhalation

Rapid onset, strong effects lasting 3-4 hours

THC Absorption Oral

Slow and incomplete, delayed onset (30-60 minutes) and weaker effects

THC Distribution

Highly lipid soluble; accumulates in fat and crosses placenta

THC Metabolism

Slow hepatic metabolism with long detection windows

THC Excretion

Half-life ~30 hours; elimination from fat stores is prolonged

Cannabis Short-Term CNS Effects

Relaxation, euphoria, impaired coordination, increased appetite

Cannabis Short-Term Cardiovascular Effects

Increased heart rate, increased extremity blood flow, postural hypotension

Cannabis Short-Term GI Effects

Increased appetite and dry mouth

Cannabis Short-Term Toxic Effects

Pseudo-hallucinations, impaired judgement, toxic psychosis at very high doses

Cannabis Driving Risk

Motor impairment increases accident risk

Cannabis Chronic CNS Effects

Loss of concentration, memory impairment, motivational syndrome

Cannabis Chronic Pulmonary Effects

Chronic bronchitis from smoking; cancer risk not fully established

Cannabis Reproductive Effects

THC decreases testosterone and sperm count; affects menstrual cycle

Cannabis Fetal Effects

If used during pregnancy, may alter fetal development

Cannabis Misuse Potential

Moderate reinforcing properties with widespread availability

Cannabis Tolerance

Tolerance develops with chronic use

Cannabis Withdrawal

Restlessness, anxiety, irritability, sleep issues

Cannabis Addiction

Possible with chronic heavy use but not universal

Opioids

Powerful analgesics with high misuse potential due to euphoria

Opioid Mechanism

Reduce neurotransmitter release and reduce postsynaptic activation to block pain signalling

Opioid Limbic Effect

Reduce emotional reaction to pain by modulating limbic system

Opioid Analgesia

Relieves severe pain

Opioid Sedation

Sedation and hypnosis are common opioid effects

Opioid Cough Suppression

All opioids are effective cough suppressants

Opioid Respiratory Depression

Major adverse effect responsible for overdose risk

Opioid Constipation

Very common opioid effect and tolerance does NOT develop

Opioid Miosis

Pinpoint pupil constriction is characteristic of opioids

Opioid Sex Hormone Effect

Reduces release of sex hormones

Opioid Therapeutic Uses

Pain relief and treatment of diarrhea

Naloxone

Opioid antagonist used for overdose reversal

Opioid Misuse Potential

Very high due to euphoric effects

Opioid Inherent Harmfulness

Low-moderate at normal doses but life-threatening at high doses

Injection Risks

Abscesses, infections, contaminated needles transmitting pathogens like HIV and hepatitis

Opioid Overdose

Profound respiratory depression requiring emergency treatment and naloxone

Opioid Use Disorder

Specific SUD that can occur after clinical or non-clinical opioid use

Opioid Tolerance

Tolerance develops to most effects except miosis and constipation; cross-tolerance among opioids

Opioid Withdrawal

Not life-threatening; causes restlessness, sweating, chills, vomiting, diarrhea, cramps

Opioid Addiction

Powerful craving due to euphoric reinforcement

Opioid Pregnancy Risk

Pregnancy increases risk of premature birth and low birth weight; newborn withdrawal may last weeks to months