Recreational Drug use- 216

mesolimbic system

reward pathway

main function of reward pathway

reinforces survival habits by releasing dopamine and creating pleasure

charecteristics of addictive substances psychological

- increase dopamine

- stimulate reward pathway

- downregulation

hippocampus and amygdala

areas of situational associations which enhance creavings

situational associations

environment

mood

people

addictive personalities have decreased activity in which area

ventromedial prefrontal cortex

addctivie personalities have decreased

impulse control

addiction is a

disease

clinical procedure of overdose

- alpha priortization

airway

patency

patency checked by

the state of being open

breathing

oxygenation and ventillation

circulation

organ perfusion

organ perfusion

CO, BP

disability

treat for dysfunction and treat as needed

examples of dysfunction

CNS

bradypnea

arrythmias

treatment of seizure

diazepam

treatment hypertension

nipride

treatment bradypnea

intubate

expsoure

identify drug/substance and initiate treatment

how to find exposure

toxidrome sand labs

labs

serum

urine

is narcan dangerous

no because it is an antagonist

type software recreational drugs

downers

mixed

uppers

downers

opiods

ketamine

PCP

mushrooms

benzodiazepines

Xanax, valium

benzodiazepines

mixed

alcohols

cannabinoids

nicotine

uppers

cocaine

amphetamines

LSD

ecstasy

euphoria can be

upper or downer

downers affect

relaxation (euphoria)

altered mood

uninhibited behaviour

what causes altered mood in downers

serotonin and dopamine

downers inhibit

excitatory neurotransmittesr

glutamate

substance P

Downers agonize

inhibitory neurotransmitters

GABA

with increasing dose of downers

depressed LOC and VS

opiods therapeutic use

substance P inhibition causing analgesia

opiod drugs

fentanyl

morphine

oxycodone

codeine

heroin

opium

buprenorphine

heroin addiction in north america

1/5 soilder in vietnam war addicted to Heroin and brought to north admerica

toxicity of opiods related to

potency

affinity dosage

neuromodulcation in opiods

lasting altreations in emotional and cogntive processes

lean

codeine and soda/heard candy

fentanyl potency

extremly potent

1 salt crystal of fent

overdose

routes of fentanyl

PO

snorted

IV

SL (blotter paper)

treatment of fentanyl OD

may need multiple doses of narcan and IV

longterm affect of fentanyl

vegetative state

heroin charecteristics

highly lipophillic

crosess BB rapidly

what is heroin metabolized into

morphine

routes of heroin

IV

inhaled

snorted

smoked

carfentanyl

7 poppy seeds can kill and crudely diluted so people don'tknow what they are consuming

nalaxone duration

30 minutes IV in hospital

addication treatment

weaning protocol

counselling

weaning protocol drugs

bupreorphine

methadone

natrexone

suboxane

buprenorphine

partial agonist

suboxone

buprenoprhine and nalazone

naltrexone

long acting nalaxone

methadone

long acting opiod

couselling

CBT

support group meetings

rehabilitation centres

withdrawl symptom management

withdrawl symptom management

benzodiazepines= anxiety

opiod receptors

mu, kappa, delta,

opiod side effects

decreased LOC

bradypnea/apnea

hypotension

pruritus

nausea

constipation

urinary retneion

what pregnancy category are opiods

category D

pregancy category D

show signs of risk , but benefits may outweight risk

hypotension and opiods

peripheral vasodilation

pruritus from opiods

mast cell stimulation and histamine release

nausea d/t opiods

sbustance P binding in CTZ

constipation d/t opiods

d/t mu receptor causing decreased peristalsis

treatment of constipation

laxatives

urinary retention from opiods

mu receptor agonism

ketamine classes

sedative hypnotic

dissociative anesthetic

higher doses of ketamine effects

sedation

amnesia

repiratory depression

PCP

phencyclidine

phencyclidine

relative of ketamine which higher doses trance state

mushrooms active ingredients

psyilocin

psyilocin prodrug

psyilocybin

mushrroms are

hallucinogenic

psychedelic

mushrooms addication risk

relatively low

desired effects of mixed drugs

- relaxation (euphoria)

- altered mood

- unihbited behaviour

dangers of mixed effect

- increased dopamine causing addiction and gateway drug

- neuromodulation

neuromodulation

lasting emotional and cogntive process alterations

risks specific to cannabinoids

risk of psychosis 2%

alcohol effect

excitatory- less

inhibitory- more

alcohol stimulates

endrophines increasing serotonin and stmulating dopamine , and increases GABA and decreases glutamate

alcohol and gaba

increases receptors causing tolerance

alcohol and sedation

higher doses

alcohol combined with other drugs

dangerous

metabolism of alcohol location

Liver and Gi

first enzyme of alcohol metabolism

alcohol dehydrogenase

after phase 1 metabolism of alcohol byproduct

acetyaldehyde

acetaldehyde

toxic

phase 2 metabolismm enzyme

acetyladehde dehydrogenase

last byproduct alcohol

acetate

alcohol inhibits

adrenal ADH

inhibition of adrenal ADH causes

diruetsis

dehydration

electrolyte imbalance

alcohol elimination

zero order kinetics

chronic alcohol use causes

tolerance

tolerance

GABA receptor numbers increase requiring more and more alcohol from same efffect

what is depleted in alcohol metabolism

vitamin B

metabolizing enzyme polymorphism

accumulation of acetaldehyde

symptoms of alcohol intolerance

cogntivie distrubances and brain fog

poor or decreased sleep

rashes/flushing

stomach ache

dizziness or sense of room psinning

mood disturbances such as depression, anxiety, irritability

asthma, wheezing

rapid heart beat

heart burn

headaches and muscle aches

alcohol poisioning emergency

slow irregular berathing

low body temperature

vomiting

seizures

unconsciousness and can't be women