Psych 4321 Behavioral Action of Drugs Exam 4

Paul/Saul has cancer and has been going through chemotherapy for the past two months. The chemotherapy has caused severe nausea with vomiting. Which of the following drugs is/are FDA-approved to treat his nausea and vomiting?

B and C (dronabinol (marinol), nabilone (cesamet))

Strong drug seeking behavior and planning to get more PCP is mediated by ___.

increased dopamine in the dorsolateral prefrontal and anterior cingulate cortexes

PCP inhibits certain p450 enzymes, especially certain enzymes of the 2C family. Marijuana is primarily metabolized by the 2C family of p450 enzymes. If a person smoked marijuana with PCP (often called a "sherm stick"), what is likely to happen to the marijuana's bioavailability (ex., Amount of cannabinoids in the system)?

There will be more cannabinoids in the system because there will be decreased metabolism of the marijuana.

Smoking marijuana can cause downregulation and decreased sensitivity of receptors, which is most pronounced in the hippocampus. What is the result of this hippocampus downregulation?

Impaired long-term memory

Which of the following seems to have the lowest potential to cause physical dependency?

Dimethyltryptamine

People tend to build a rapid tolerance to LSD primarily because of downregulation of which receptor?

5HT-2A

Which of the following is considered an opioid but not an opiate?

Methadone

Lemuel is found stumbling around his neighborhood naked and sweating. He seems "out of it" as he punches a guy walking a dog. He then runs onto the railroad tracks in front of a train, shouting that he is invincible. What drug did he most likely just take?

PCP

Which of the following neurotransmitters often exerts its effects through retrograde transmission and is so lipid soluble that it would seep through any vesicles trying to carry it, which is why neurons make it as needed rather than storing it?

Anandamide

Herschel likes to enjoy psychedelic mushroom tea every afternoon when he gets off work. He uses relatively low doses, so he primarily experiences vivid colors and afterimages, with only a few visual hallucinations, like seeing oddly shaped butterflies flitting around his backyard. What is the primary psychoactive drug in the mushroom tea he ingested?

Psilocybin

Manfred has been suffering from pain due to MS. Unfortunately, he has no health insurance and can't get any medication for his pain other than ibuprofen and other over-the-counter (OTC) medications. But those OTC medications don't help his pain at all. However, he has a friend who can get him "non-prescription" drugs. Which of the following would be best for Manfred to help with his pain?

Marijuana

Nancy smokes K2 on a weekly basis. K2 and other synthetic marijuana can cause similar effects to natural marijuana, such as relaxation and elevated mood. However, synthetic marijuana, including the K2 Nancy is using, was banned in the U.S. because it can also cause vomiting, seizures, paranoia, and hallucinations. How does it cause these more severe side effects?

OR.

Synthetic marijuana, such as K2 and spice, can cause similar effects to natural marijuana, such as relaxation and elevated moods. However, synthetic marijuana was banned in the US because it can also cause vomiting, seizures, paranoia, and hallucinations. How does it cause these more severe side effects?

Although marijuana can cause similar side effects at very high doses, synthetic marijuana is more likely to cause severe side effects because it binds more strongly for a longer period of time to receptors and is much more potent so it is easier to overdose

The manufacturers of Delysid encouraged psychiatrists to use Delysid themselves in order to better understand hallucinations in schizophrenia. Delysid was the trade name for which of the following drugs?

LSD

Ben belongs to a Native American religious group that uses peyote in its religious rituals. When using peyote, Ben experiences visions and describes having a mystical experience where he feels open and loving to all people. What is the primary psychoactive drug in the peyote Ben uses?

Mescaline

Carolyn and Kevin pick up some heroin from Kevin's dealer on the way to a party. They get to the party a little later than planned because Carolyn was busy preparing the heroin so people could take it any way they want. Larry, who is hosting the party, appreciates that Carolyn has been so nice to prepare the heroin so that people can use it in the manner they like best, but he insists they need to get high ASAP. How do they need to use it to get high as quickly as possible?

Smoking

Celeste dropped acid (i.e., she took LSD) and experienced synesthesia. Which of the following would be an example of synesthesia?

Seeing colors when music is played

Most of the hallucinogens (ex., psilocybin) seem to have cortical to cortical effects as opposed to limbic to cortical effects, such as seen in hallucinations with schizophrenia, which are mediated by the mesolimbic system. As a result, there seems to be different neurotransmitter systems involved in the hallucinations produced by the hallucinogens as compared to those in schizophrenia. What is the primary neurotransmitter system that is implicated with the hallucinogens, such as psilocybin and mescaline?

Serotonin

Which of the following has been shown to be helpful in reducing psychotic symptoms, decreasing seizures in some forms of epilepsy, and relieving anxiety?

Cannabidiol

___ is 50 times more potent than heroin and 100 times more potent than morphine. Medically, it is typically used as a transdermal patch, which is often cut into smaller patches and sold out on the street as "chicklets".

Fentanyl

Which of the following is a Schedule III/3 drug that is less potent than phencyclidine and is used as an anesthetic, especially in children?

Ketamine

Fanin started using IV heroin about three years ago. She decided to stop taking heroin and enrolled in a detox program to help manage her withdrawal symptoms and maintain heroin abstinence. She was given this drug, which is also a partial opioid receptor agonist but has much milder withdrawal symptoms than heroin and reduces cravings.

Buprenorphine

First used by indigenous people of South America, ayahuasca is a reddish-brown hallucinogenic drink made from brewing certain plants. What is the primary psychoactive drug in ayahuasca?

Dimethyltryptamine (DMT)

PCP and ketamine work differently from the other hallucinogens we studied. What is the mechanism of action for these two drugs?

All of the above (NDMA receptor antagonism, dopamine reuptake inhibition, nicotinic receptor antagonism)

Ophelia/Willow read about the Aztec god Xochipilli (aka Prince of Flowers) and decided she needed to try the hallucinatory drugs he was most closely associated with. She ate some and boiled some to make a weak "tea" that she drank. She started feeling like the world was moving in waves, and then she began seeing visions dancing around her. What did she just use?

Mushrooms

Cyril is in a lot of pain. However, he does not want to take any opioids. Which of the following is a non-opioid pain reliever?

Celecoxib (celebrex)

Drug screening can detect the presence of morphine a few hours after someone has eaten poppy seeds, such as a poppy seed bagel (or two), because poppy seeds, like other opiate-containing substances, are metabolized into morphine. The amount of morphine is typically too small to affect behavior (unless you ate a lot of poppy seeds). As a result, people are sometimes concerned they may be accused of using heroin when they have just eaten poppy seeds. However, when detecting heroin use, the presence of ___ would show the person used heroin and not poppy seeds.

6-monoacetylmorphine

Dr. Timothy Leary, famed Harvard psychologist, started the psychedelic drug research program at Harvard with Richard Alpert after travelling to Mexico and using ___ with the indigenous people.

mushrooms

Aldous Huxley, Allen Ginsberg, and Ken Kesey all produced famous works of literature while using ___.

peyote

Which of the following drugs is currently the cause of the most drug overdose deaths in the U.S?

Fentanyl

Ronald/Marcus enrolled in a drug trial for the treatment of opioid addiction. He will be randomly assigned to either the treatment group or the placebo group. He is informed that if he is in the treatment group, he will be given a drug that is not yet FDA-approved but may help his opioid addiction. He is warned that this drug, which is derived from a plant with naturally occurring psychedelic alkaloids, can cause dissociation, ataxia, ity, and prolonged lapse between ventricular heartbeats. Which of the following drugs is being given in the treatment group?

Ibogaine

Which of the following is an accurate statement regarding tolerance to opioids?

B and C (cross-tolerance to other opioids occurs for all opioids, tolerance can build up to such high levels that doses for chronic users could easily kill a non-addict)

Isaac/Johan is rushed to the hospital with what appears to be a drug overdose, though no one is sure what he took. His girlfriend, Griselda, has been trying to keep him awake on the drive to the hospital, but she found it difficult keeping him awake enough to answer her frantic questioning. At one point during the drive over, she was certain he had died because she couldn't see him breathing. She actually pulled the car over to the side of the road and put a mirror under his nose. She detected a slight fogging of the mirror, so she knew he was alive, but barely. At the hospital, the doctor noted that Isaac slurred his speech, couldn't stand on his own, was generally unresponsive, had very small pupils, and his skin was taking on a bluish hue. Which of the following did Isaac most likely overdose on?

Heroin

Although Phencyclidine (PCP) is an extremely dangerous drug, it is a Schedule II drug and can be prescribed in some situations. When is it usually prescribed?

For use as a veterinary tranquilizer

Which of the following people is most likely to suffer from cannabinoid Hyperemesis syndrome (CHS)?

Bill, a 25-year-old who smokes marijuana after work to relax

Which of the following is the correct order, from most to least, of THC in cannabis sativa?

Flowering tops > bracts > leaves > stems > roots > seeds

___ is low in psychoactive properties itself, can help treat symptoms of dravet syndrome, and may protect against development of psychotic symptoms in people with psychosis that can be caused or exacerbated by TCH. Interestingly, it may also increase other psychoactive properties of TCH by increasing cannabinoid receptors.

Cannabidiol

Lonny is using a type of hallucinogen that primarily affects k-opioid receptors and causes odd out-of-body experiences, such as being in two different houses at once or becoming a sofa. What hallucinogen is Lonny using?

Salvinorin A

Which of the following drugs causes withdrawal symptoms very similar to nicotine withdrawal, such as irritability, anxiety, depression, and decreased appetite, while also showing milder opioid-like withdrawal symptoms, such as shaking, difficulty with coordinated walking, and tremor?

Marijuana

Which of the following is the correct order from lowest to highest potential for physical dependency?

LSD - marijuana - alcohol - cocaine - heroin

There are six opium alkaloids. Which is the most abundant of these opioids found in opium (hint: it's often used in patient-controlled analgesia)?

Morphine

Although not fully accepted by neuroscientists as a true brain network, connections between these three brain areas have been shown to be active when resting. The network that includes these three brain areas is implicated in rumination or letting the mind wander and having internal monologues, which can cause people to be overly self-focused. Certain drugs, like those in ayahuasca and hallucinogenic mushrooms, inhibit these areas and reduce rigid thinking and negative introspection. What are these areas of the brain?

Medial prefrontal cortex, posterior cingulate cortex, angular gyrus

Cannabis has extremely high protein binding. Although most drugs with high protein binding can have significant drug-drug interactions because of competition for binding to blood proteins, thereby "knocking off" other protein-bound drugs and increasing their

blood levels, cannabis does not have as significant a drug-drug interaction as far as protein binding is concerned. Why not?

While most drugs bind to albumin, cannabis binds primarily to lipoproteins.

Ronald is smoking marijuana with his friends Mary, Francis, and Steve. Ronald has always smoked more than his friends; he usually smoked two or three joints a day every day for the past five years. Mary Frances and Steve smoke marijuana on a much more casual basis, perhaps one joint every week or two. Mary smokes the least of all of them, only the equivalent of 1 joint over an evening with her friends. Frances and Steve don't smoke as often as Ronald, but they enjoy competing against one another to see who can smoke an entire joint in one long puff. Regarding the bioavailability of THC for each of these friends, which of the following statements is correct?

A and C are correct (Ronald's bioavailability of THC is probably higher than Mary's because bioavailability is higher for heavy users than for occasional users, since they are all together smoking now, it is Francis and Steve who probably have the highest bioavailability of THC among the four friends because the each smoke an entire joint in one puff).

Xavier/Todd feels very relaxed, happy, and social. He says he is "in tune" with the smells and vibrant colors in his garden. As he noshes on a large bag of potato chips, he gets into a "deep" conversation with his neighbor and says he has a keen understanding of his neighbor's life struggles. What drug has Xavier been using?

Marijuana

From which naturally occurring opiate alkaloid are drugs such as oxycodone and naltrexone synthesized?

Thebain

Which of the following is the correct sequence for the synthesis of heroin?

Opium, morphine, heroin

Which of the following drugs was synthesized from ergot (toxins from a fungus) when a chemist was searching for respiratory and circulatory stimulants?

LSD

Gino/Vince smashed his finger with a hammer while roofing his house. He screamed in pain and almost fell off the roof. Which nerve fiber(s) carried the information that he just smashed his finger?

A: Delta

Chad used to smoke marijuana, snort cocaine, and drink alcohol. He quit all three drugs a few months ago but has decided to start smoking a joint every once in a while, because he likes the effects of marijuana. Which of the following is most accurate about what is likely to happen when he starts smoking marijuana again?

When he smokes marijuana, the stimulation of cannabinoid receptors will cause him to crave cocaine and alcohol.

George has been suffering from seizures due to epilepsy for many years. Unfortunately, he has no health insurance and can't get medication for it. However, he has a friend who can get him non-prescription drugs. Which of the following would be best for George to help with his seizures?

Marijuana

Cannabis has extremely high protein binding. Although most drugs with high protein binding can have significant drug-drug interactions because of competition for binding to blood proteins, thereby knocking off other protein-bound drugs and increasing their blood levels, cannabis does not have significant drug-drug interactions as far as protein binding is concerned. Why not?

While most drugs bind to albumin cannabis binds primarily to lipoproteins.

As opposed to most hallucinogens,_____ primarily affects K opioid receptors and causes odd out-of-body experiences, such as being in two different houses at once or becoming a chair

Salvinorin A

Which of the following is a prodrug?

Heroin

Synesthesia is a common effect of LSD. Which of the following would be an example of synesthesia?

Seeing colors when music is played.

The primary active drug in hallucinogenic mushrooms is?

Psilocybin

All opiates/opioids are transformed chemically at some point in the body into...?

Morphine

Marijuana can reduce pain. Cannabinoids appear to affect endogenous opioids, which is what causes the pain reduction. Which opioid receptor appears to be most involved in this pain reduction effect of marijuana?

Mu

There has been a large increase in heroin deaths over the past 16-17 years. What has been the percentage increase in heroin deaths?

300%

What is the primary active drug in peyote?

Mescaline

Which opioid receptor is/are considered the most important for the opioids used in pain reduction and addiction?

A and B: Mu and Delta

Protein binding for methamphetamine is around 20%. What does this mean?

It is minimally bound to blood proteins so that most of it is active.

Craig can't seem to drink enough water as he is constantly thirsty. When he reaches for a glass of water, his hands start shaking so that he ends up spilling much of the water before he gets it to his mouth. Complicating this shaking is his rigid, ratchet-like movement of his arm as he bends his elbow to raise his water glass. He also feels constantly fatigued and drowsy. He has reached a toxic dose of which of the following drugs?

Lithium

Petunia has suffered from depression for many years. Unfortunately, she is not responding well to any antidepressant. As best, she shows slight improvement on Sertraline (Zoloft), but she still has difficulty in daily functioning due to her depression. You decide to try the novel antidepressant esketamine (Spravato). Which of the following is the correct procedure to administer esketamine (Spravato)?

Keep her on Sertaline, give her esketamine while in the office, and observe her or have her participate in psychotherapy for at least two hours before leaving.

Edwina had a big night out for her birthday. She got drunk but decided to drive home anyway. She was stopped by the police. Her blood alcohol level was 0.15. which meant she was legally drunk. The officer took her to jail. Two hours later, her friend bailed her out. What would be her blood alcohol level when he friend bailed her out of jail?

0.12

According to the results of the largest study ever done on the efficacy of antidepressants, the sequenced treatment alternatives to relieve depression (STAR*D), which of the following antidepressants showed the greatest efficacy in treating depression?

None of the above

Smoking 1 minute heroin is the strongest, IV is also strong

IM and snorting are on the longer end