EXAM 1 QUIZ QUESTIONS
Describe the mechanism of action of opiates
Opiates bind to either a mu, kappa, or delta receptor, causing a cascade of effects inside the cell that results in either analgesia, cough suppression, or reduction in smooth muscle activity.
When should you choose a typical first generation antipsychotic medication?
When a patient has majority positive symptoms (hallucinations, voices, etc). They are more effective at reducing the positive symptoms of schizophrenia and relatively ineffective on the negative symptoms.
cross tolerance
a condition in which the development of tolerance for one drug causes an individual to develop tolerance for another drug ONLY within the same drug class. ex.heroin and methadone
acetaldehyde
an intermediate in alcohol metabolism - buildup causes asian flush, because people in this descent lack enough ALDH to fully metabolize alcohol.
inverse agonist
chemical substance that produces effects opposite those of a particular neurotransmitter.
terpenes
class of organic compounds found in many plants that exist as oils and provide classic aroma and flavors of marijuana.
What might explain the long-acting side effects or undesired consequences of using too much MDMA over a 1-2 year period?
A prolonged loss of serotonin that depletes the brain's "reserve" for when low or depressed moods occur.
Buspirone (Buspar)
A serotonergic antidepressent - cannabis use disorder - nicotine - helps cessation by reducing withdrawal
Health consequences of alcohol
impacts every cell in the body. Reduction in grey matter replenished by CSF Korsakoff Syndrome Fetal Alcohol Syndrome Wasting Syndrome
Cannabinol (CBN)
metabolite of THC and weak agonist at CB receptor. Has minimal CB1 activity so only has mild psychoactive effects. MAY have potential immunosuppressive and anti-inflammatory properties.
the process of releasing neurotransmitters into the ________ is called _______
synapse; exocytosis
Wellbutrin
(Bupropion) dopaminergic Antidepressant Used: - Cannabis Use Disorder - Nicotine addiction - encouraging initial studies
Alcohol pharmacokinetics
- Alcohol is a small, non-ionized molecule that diffuses across membranes (yet dissolves in H2O) Higher concentrations or amounts - more rapid absorption - Mostly (90%) absorbed in small intestine (large surface area) - distributes throughout the body and released into the breath, sweat, and urine. PRIMARILY metabolized in the slomax anc liver by Alcohol Dehydrogenase ethanol --> acetaldehyde --> acetate - Perturbs the membrane lipids of CNS neurons. - - Enhances the movement of Cl- ions (GABAergic process), reduces anxiety, impairs motor control. - - Alcohol inhibits glutamate receptors, slowing transmission. - increases 5-HT activity (serotonin) - transient release of dopamine and inhibits its reuptake.
When should you select a second generation atypical antipsychotic medication over a first-gen typical antipsychotic?
1. when there are concerns over extrapyramidal side effects. 2. when the patient is experiencing his/her first episode of schizophrenia 3. When the patient is elderly. 4. When there is concern that neuroleptic malignant syndrome (NMS) might occur. DO NOT PICK 2ND GEN OVER FIRST IF: - the patient has insulin resistance, diabetes, and is overweight.
Ms. Jones has been evaluated for psychiatric disorders and the SCID reveals that she has first episode schizophrenia. The attending physician is asking your opinion about which medication she should receive. You ask to read the full report and notice that there is something missing. What additional information should you have in order to help you decide on medication recommendations?
A PANSS assessment should be conducted.
the Audit
An online questionnaire that help identify alcohol use disorder. An intervention strategy! Low score = fewer problems High score = warrant professional help
Naltrexone (ReVia)
Antagonist that blocks euphoric effects of opioids. Used to treat both Alcohol use disorder (AUD) and Opioid use disorder (OUD). Rapidly precipitates withdrawal. NOT an analgesic as it is a receptor antagonist, so no pain relief.
Valium and Xanax
Benzodiazepines, most widely abused due to short half life, rapid onset of action, rapid development of tolerance, and often prescribed to treat a medical condition with many refills (iatrogenic addiction).
The primary mechanism of action of the TYPICAL, first generation antipsychotics is:
Blockade of D2 receptors.
Which of the following has NOT contributed to the opiate overdose crisis in the world? A. Fentanyl has been added to batches of heroin. B. Physicians have been over prescribing prescription pain killers that contain opiates. C. Marihuana use via vaping has increased in popularity. D. People keep the unused tablets from their legitimate opiate prescriptions in their medicine cabinets after they no longer need them. E. Physicians are giving many refills of prescription opiates.
C. Marijuana use via vaping has increased in popularity. Does not contribute to the opiate overdose crisis, as marijuana is not an opiate.
Which ONE of the following options for a person who uses heroin on a daily basis is likely to have the most positive long-term benefits, reduce drug use and improved overall health problems? A. Send him/her to jail to reduce criminal activity first before treatment can really work. B. Enroll the person in Narcotics Anonymous with no other treatment. C. Enroll him/her in a 3-day inpatient detoxification treatment unit and then release. D. Enroll the person in a buprenorphine maintenance program with his/her primary care physician. E. Enroll them in a progressive inpatient program where physicians administer heroin on a regular basis in order to cleanse them of the adulterants found in street heroin.
D. Enroll the person in a buprenorphine maintenance program with his or her pcp.
Benzodiazapines
Diazepam, lorazepam, tirazolam, temazepam, oxazepam, midazolam, chloridiazepoxide, alprazolam MOA: facilitate GABA action by increasing frequency of Cl- channel opening. Decrease REM sleep. ATOM: alprazolam, traizolam, oxazepam, and midazolam have short half-lives and thus high addictive potential. Use: anxiety, spastiticty, status epilepticus, detoxification (alcohol withdrawal), night terrors, sleep walking, gneral anesthetic, hypnotic (insomnia) Tox: dependence, additive CNS depression with alcohol. Propensity for abuse in anxious individuals who will find the effects more rewarding.
.Long-term treatment with any of the typical first-generation antipsychotics produces: a. Tolerance to the antipsychotic effects. b. Physical dependence c. Drug-seeking behavior d. Significant increase in IQ e. None of the answers are correct
E. None of the answers are correct.
Which of the following statements is CORRECT in regards to the abuse of methamphetamine (ICE)? a. It is only administered intravenously and cannot be smoked. b. It has a very short duration of action, which is why it must be used multiple times a day. c. Methamphetamine abuse is treatable using a number of different FDA approved dopamine receptor antagonists. d. Its side effect profile is limited to only effects on the brain like anxiety and psychosis. e. Smoking ICE delivers the active drug very quickly to the brain, where it produces an immediate, intense euphoria, that fades over a few hours causing the user to engage in a new craving pattern.
E. Smoking ICE delivers the active drug very quickly to the brain, where it produces an immediate, intense euphoria, that fades over a few hours causing the user to engage in a new craving pattern. ICE is extremely addictive.
The Endocannabinoid System
Endogenous cannabinoids, their receptors and enzymes responsible for biosynthesis and degradation of endocannabinoids. Affects many systems, very widespread. CB1 and CB2 are most common in the CNS. These are g-coupled receptors that are found throughout the body in the brain, organs, connective tissues, etc. G-coupled signaling involves inhibition of ATP. They are the most prevalent receptors in the brain! CB1 = highly expressed by axons in the presynaptic termini of amygdala, hippocampus, etc. Strong associated with GABAergic (inhibitory) and glutamergic (excitatory) neurons, where they mediate inhibition.
True or false: It has been scientifically demonstrated that the long-term use of drugs like LSD and MDMA can cause schizophrenia and psychosis in individuals who have no family history or prior bouts with mental illness.
FALSE
True or False: Date rape drugs like flunitrazepam (Rohypnol™) and etizolam (Etizest-1™) only cause blackouts and place people in dangerous situations when combined with alcohol.
FALSE.
If a person is tolerant to morphine, then they are also cross tolerant to alcohol because both drugs cause people to be very relaxed and calm, even under stress. True or false?
False.
Crack Cocaine
Freebase, easier and less dangerous to make. Marketed as single doses, which made it more available to poor people. Blocks Dopamine transporter (reuptake pump), blocks sodium ion channels (local anesthetic action).
What is one effective method to ensure that patients who have schizophrenia take their medication on a regular basis?
Give the patient a long acting injectable medication.
Why is ketamine a unique analgesic?
It can produce analgesia without making the person unconscious or respiratory depression - actually stimulates respiration.
What is the one BIGGEST danger that flunitraxepam (Rohypnol) poses to the US public?
It causes rapid muscle relaxation and amnesia, making it an ideal drug to "slip" to someone in their drink in order to commit a crime and/or sexual assault.
Possible treatments for cocaine addiction
NONE FDA APPROVED. some people use: Topiramate (Topamax) Disufiram (antabuse)
Treating Alcohol Use Disorder
Naltrexone = alters the high of drinking, the drive to drink is reduces (opiate receptor antagonist) Acamprosate (Campral) - similar to glutamate, anticraving drug. Disulfiram (Antabuse) = irreversible inhibitor of ALDH, causes a violent reaction after one drink - people can die on this.
Cannabidiol (CBD)
Not psychoactive but may be medicinally relevant Anti-anxiety, anti-inflammatory, & anti-nausea effects Some CBD medications approved for childhood seizure disorders (Charlotte's Web, Dravat Syndrome)
How is patient controlled analgesia (PCA) associated to lowered opiate usage?
Patients take LESS opiates over a 24 hr period when using PCA, because they're able to control the pain at a lower level, before it reaches a 10.
Typical first-generation antipsychotic medications like chlorpromazine (Thorazine®) and haloperidol (Haldol®) are effective in treating schizophrenia, but what is important in considering administration and dosage?
Patients' doses are slowly increased in order to minimize side effects while achieving the effective dose for that patient. Too fast of an increase is very dangerous in first generation antipsychotics.
MDMA (ecstasy) damages the nerve terminals of which neurotransmitter?
Serotonin
Nabilone (Cesamet)
Synthetic cannabinoid used to treat vomiting, also approved for wasting syndrome. May suppress activity in the vomit center in the medulla.
Buprenorphine
Taken as a replacement in the treatment of heroine and methadone dependence. Helps stabilize the lives of people dependent on heroin and other opioids, and to reduce harms related to drug use. can be used to: - help people withdraw from heroin and methadone - reduce the need to use heroin (maintenance) - treat severe pain.
A friend asks you for advice about her 93 year old father who is a patient on a terminal cancer inpatient unit of a major hospital. He has just had his 3rd surgery to remove the rest of his colon that was cancerous; he is in a great deal of pain. The doctor originally prescribed a 15 mg dose of morphine (i.m injection) every 6 hours for the past week for pain management. That seemed to be helping the pain, but now he is complaining that the pain has returned. What would you recommend?
The dose must be INCREASED to counter the effects of tolerance and tell her not to worry about her father becoming dependent on opiates -- that is of much less concern for him right now.
What accounts for the fewer number of "bad trips" on LSD in the past 15 years?
The doses that are used are much lower than in the 1970s.
A PANSS assessment has been conducted on a young female patient who has been diagnosed with her first episode schizophrenia. Her overall score is 145, but you ask for a breakdown of the subscale scores and you find the following: Positive symptoms 18 Negative symptoms 84 General Psychopathology 43 Which recommendation do you make?
The patient should be started on an atypical, second-generation antipsychotic.
What is it about oxycodone (Oxycontin) formulation that contributed to it becoming a drug that was widely abused?
The sustained release tablets were crushed up and injected resulting in taking a dose that was designed to last 24 hours in a few seconds.
Ecstacy (MDMA)
There is some evidence that it may be an effective adjunct therapy for PTSD. It produces an altered state of consciousness. It is very hard to identify real from fake MDMA because the tablets come in many shapes and sizes and is often adulterated. There is not evidence that it produces exclusively violent and aggressive reactions after even a single dose.
Hallucinogens as a class
They are not self administered on a regular basis, but instead are often used episodically. They're often used to expand the mind and seek unique experiences instead of just getting high. They are generally believed to be "safer" by the lay public as overdoses are uncommon. They can cause psychosis after only a few doses. They all have different pharmacologies, and are not all cross tolerant or cross dependent on each other.
The third generation atypical antipsychotic medications have many unique features to them; which is a KEY feature of this class of drugs?
They have partial D2 receptor agonist activity and bind to presynaptic receptors to reduce the synthesis of dopamine.
A patient arrives in the ER unresponsive, not breathing and turning blue. The ER physician administers a single dose of naloxone (Narcan™) and the patient begins to breathe again. After a few minutes The ER nurse has also taken a blood sample and sent it off to the lab for analysis—the report returns with a positive result for acetaminophen, naloxone, 6-monoacetylmorphine (6-MAM) and morphine. Also, the patient's blood alcohol concentration was 22 mg/dL. The doctor made special note that no heroin was found in the blood specimen. Did the patient overdose on heroin?
YES. The presence of 6-MAM is proof that heroin was taken as it is a metabolite that only heroin produces.
Methylphenidate (Ritalin, Concerta)
a non-amphetamine behavioral stimulant used primarily to treat ADHD. Blocks reuptake of dopamine, but comes on slowly. NOT a cognitive enhancer.
Nicotine
a stimulating and highly addictive psychoactive drug in tobacco. Can act as a stimulant and a depressant, and is rewarding regardless of which it does. Close to the reward system in the brain, and modulates release of dopamine and 5-HT serotonin. Nicotinic cholinergic receptors: Acetylcholine produces an influx of sodium INTO the cell, = incr firing rate of neurons. REINFORCING effect of nicotine.
Schizophrenia is frequently characterized by the presence of:
a. Significant risk of suicide b. Impaired perception of reality c. Disorganized thinking patterns e. Delusions and hallucinations
Rimonabant (Acomplia)
act to block receptors that normally detect neural signaling chemicals known as endacannabinoids, but also block the effects of THC. An inverse agonist selective to CB1. Appeared to balance the EC system. Was approved to treat obesity by reducing appetite in 56 countries. Was removed from the markets in 2009 due to adverse side effects (suicidal ideation).
Barbiturates
drugs that depress the activity of the central nervous system, reducing anxiety but impairing memory and judgment. Induce sleep, general anesthesia Low Therapeutic index (TI). Potentiate the effects of the neurotransmitter GABA, enhances binding sites for GABA, inhibits the release of glutamate (excitatory).
Speedball
injectable combination of heroin and cocaine "parachuting" down from the high. Heroin takes the edge off, so may use more, which can lead to an OD.
Amphetamines
longer lasting than cocaine, almost always orally ingested. Binds to dopamine transporter to block reuptake, blocks sodium ion channels, goes into axon terminal to induce release of more dopamine.
Anandamide and 2-AG
two brain chemicals that bind to cannabinoid receptors. Anandamide = short lived, fast effect, and metabolized. Once anandamide is transported into the cell, it is metabolized by Fatty Acid Amide Hydrolase (FAAH). FAAH inhibiting drugs can increase the concentration of anandamide and 2-AC and thus could be a therapeutic agent for disorders that involve the endocannabinoid system.
Ambien
zolpidem - most commonly used benzodiazapine to treat insomnia. Most useful when used to INITIATE sleep. Highly misused and combined with other drugs.
Identify one statement that is FALSE about alcohol induced tolerance? a. Tolerance only occurs after someone has been drinking for 15 years. b. Tolerance can occur at the cellular level and affect neurotransmitters. c. Metabolic tolerance occurs due to an increase in the activity of alcohol dehydrogenase in the liver. d. Behavioral tolerance can occur to frequently performed, overlearned activities even with a high BAC. e. Typically develops at a different rate to different effects.
A. Tolerance only occurs after someone has been drinking for 15 years, is FALSE.
Pharmacodynamics Steps
ADME Absorption - into the blood stream Distribution - moves from blood stream to target organ Metabolism - usually inactivates a drug, but sometimes makes it more active Elimination - remaining drug or metabolites exit via urine, feces, sweat, breath, and saliva.
Caffeine mimics which of the following neurotransmitters and binds to its receptor?
Adenosine! Adenosine is the neurotransmitter that induces sleepiness. As an agonist, caffeine blocks out the adenosine, thus preventing the sleepiness setting in.
What is the name for a chemical that binds to a receptor but produces NO effect?
Antagonist Very high affinity for a receptor but has no efficacy.
When a person who has been drinking 6-8 cups of brewed coffee per day decides to go "cold turkey" and stop all caffeine intake, the ensuing withdrawal symptoms...
Are totally dependent on the individual! Some people have terrible headaches, while others may have very few symptoms.
Alcohol's mechanism of action is complex, but is most likely related to what?
Attenuation glutamate activity and enhancement of GABA activity. Alcohol is a tiny molecule and does not "bind" to receptors.
What is crack cocaine?
It blocks the reuptake of dopamine from the synapse, causing an excessive amount to bind to the dopamine receptor. It was the center of attention during the 1980s as the cause of birth defects in mothers who use it while pregnant. It is cocaine hydrochloride that has been converted to free base so that it can be smoked: the primary preferred route of administration is smoking.
True or false: Kombucha is generally safe, but because there is a lot of alcohol in this beverage, you could easily get a DUI if you drink kombucha and drive.
False
True or false: One of the most important things you can do for a person who is very intoxicated on alcohol is to get them to drink 2-3 cups of coffee in order to sober them up.
False
Type 2 error
False negative- An error that occurs when a researcher concludes that the independent variable does not have an effect on the dependent variable when it does.
Acetylcholine (ACh)
First identified in the peripheral nervous system, prominent in memory function. Blocking ACh receptors can induce psychotic reactions and amnesia; deficiencies in these neurons are related to dysfunctions seen in Alzheimer's disease. Inactivated by acetylcholinesterase (AChE) located in post synaptic sites. Irreversible AChE inhibitors are toxic and fatal (Sarin).
A young man is pulled over for suspected driving his automobile while intoxicated. The laboratory report comes back positive for cocaine and cocaethylene. The lab report for alcohol has not yet been received and looks like it is going to be delayed. You are reviewing the case and are asked by the judge to provide an opinion. The verdict?
He definitely drank alcohol.
What is the most important factor to consider when a person drinks A LOT of coffee?
If the person is also a tobacco smoker and decides to quit smoking "cold turkey," that they should cut back on their coffee intake first. Nicotine speeds up the metabolism. ***ADD
E cigarettes are:
Often thought to be safer than smoking, but recent evidence suggests that they have potentially serious effects that are different from smoking.
Which route of administration is MOST affected by the First Pass Effect?
Oral
Dopamine
Pathways originate in the brainstem and define 3 Major Circuits: 1. hypothalamus to pituitary (hormonal response) 2. substantia nigra to basal ganglia (Parkinson's) 3. midbrain to frontal correct (medial forebrain bundle, reward and schizophrenia).
Absorption occurs when a drug that is taken by any route enters:
the bloodstream
Tolerance
the diminishing effect with regular use of the same dose of a drug, requiring the user to take larger and larger doses before experiencing the drug's effect. The body doesn't gain tolerance to ALL effects, though. ex. Opiates - large side effect is constipation BAD tolerance -- more pain -- more opiates -- less pain -- more constipation
potency
the dose of drug required to produce a specific effect of given intensity as compared to a standard reference considers both affinity and efficacy.
Which of the following dopamine pathways is the most important in regulating REWARD
the midbrain to the frontal cortex (medial forebrain bundle)
Acute administration of THC produces which set of effects?
Increased heart rate and impaired time perception.
Which route of administration is the fastest way to get a drug into the brain?
Inhalation
Which route of administration gets nicotine to the brain QUICKEST?
Inhalation.
What is the most likely mechanism of action of nicotine?
It binds to nicotinic cholinergic receptors that are on presynaptic sites of dopamine and serotonin, causing their release.
What are some hallmarks of nicotine withdrawal?
There is a tendency to gain weight. Sleep disturbances (mostly insomnia) occur soon after they stop smoking. Complaints include headaches, restlessness, tingling of fingers. Wide range of mood swings from anxiety to anger to depression can occur.
Compare amphetamine and cocaine:
They both produce stimulation, euphoria, and insomnia, but the duration of amphetamine is longer than cocaine. Amphetamines are primarily obtained from diverted prescriptions. They both bind to the dopamine transporter and prevent its reuptake into the axon terminal.
True or False: Pure TCH in the form dronabinol (Marinol) can be prescribed by physicians in the US to trade wasting syndrome secondary to AIDS.
True!
True or False: THC is metabolized to both active and inactive metabolites that are targets for urine drug screens.
True.
Which of the following statements is TRUE about vaping a cannabis product?
Vaping involves heating a cannabis product to a high temperature so that cannabinoids are released as a vapor.
What was the chemical compound that caused popcorn lung in E-cigarette marijuana users?
Vitamin E Acetate, when inhaled, can cause lung damage known as popcorn lung.
Marijuana and the endocannabinoid system
Weak agonist: Binds to cannabinoid receptors (CB) in the brain. Naturally occurring substance, anandamide occurs and binds to the same receptors. modulates the activity of other nts, induces a sense of well-being, high, euphoria. Has a low inherent acute toxicity, and tolerance/dependence develops with chronic use. Dronabinol - FDA approved medicinal THC, used for wasting syndrome in AIDS and nausea during chemotherapy. THC IS 4,000 TIMES MORE POTENT THAN ETHANOL IN REDUCING PERFORMANCE DRIVING. Enhances other drugs (2x cocaine [] due to vasodilating)
What is the major CONCERN about E-Cigarettes?
While advertised as a way to stop smoking, many smokers revert back to tobacco or continue to use both.
Who generally metabolize caffeine the slowest?
Women taking oral contraceptives.
Agonist
a molecule that, by binding to a receptor site, stimulates a response
Routes of administration
oral - easy, generally slow (first pass effect) inhalation - quickest, easiest absorption parental (iv) - fast to slow buccal/sublingual - cheek pouch/under tongue intrathecal - just outside the spinal cord (epidural) rectal - generally slow topical - slow and erratic
Limbic system
neural system located below the cerebral hemispheres; associated with emotions and drives. Essential in addiction disorders.
the naturally occurring chemicals that bind to receptors are called
neurotransmitters
reuptake
neurotransmitters that can't find an area across the synapse to attach will be reabsorbed by the sending neuron and metabolized by enzymes. Deactivates neurotransmission.
How would a dose response graph show a desirable vs a risky drug?
A very desirable drug would deliver 100% efficacy at a lower dosage than do side effects appear. The side effect curve would be far beyond that of the desired effects curve. If the side effect curve and desired effects curve are close together, the drug is risky. ex. cancer drugs - the 100% effective dose is very close if not overlapping with the dose in which side effects appear. A very dangerous drug has side effects appear before the desired effects (ex. LSD).
At what blood alcohol concentration does a non-tolerant individual BEGIN to have impaired judgement?
0.05% (50 mg/dL)
GABA
A major inhibitory neurotransmitter. Undersupply linked to seizures, tremors, and insomnia. Causes more electronegativity in the neuron, slows neural processes. The "break," compared to a car. High concentrations in the brain and spinal cord. GABAa = fast receptors, open chloride channels GABAb = slow response of G protein coupled type.
Which of the following is TRUE about the practice of consuming alcohol along with an energy drink? a. Vodka and Coca-cola is the most popular combination. b. Caffeine can mask the depressant effects of alcohol. c. They are consumed together because caffeine interferes with alcohol metabolism and makes the alcohol effects last much longer--thus can save money on a bar tab. d. The mixture of an energy drink plus a clear alcohol (like gin or vodka) are heated up together and the fumes are inhaled in order to achieve a more intense effect. e. Putting gummy bears in a glass with both an energy drink and vodka will soak up the alcohol and prevent you from getting drunk, even if you eat the gummy bear afterwards.
B. Caffeine can mask the depressant effects of alcohol, is TRUE!
Which of the following is the CORRECT statement about tolerance/dependence on central nervous stimulates? A. Tolerance does not develop to the euphoric effects so individuals can spend the same amount of money for cocaine or amphetamines over a long time period. B. The initial crash lasts 24-48 hours and can include fatigue, agitation and depressed mood. C. Withdrawal is characterized by arrhythmias and overstimulation that can lead to a heart attack. D. Tolerance does not occur and so individuals do not need to increase their dose to achieve the same effects. E. Withdrawal from CRACK cocaine is far worse than from cocaine and can be life threatening due to seizures and convulsions.
B. The initial crash lasts 24-48 hours and can include fatigue, agitation, and depressed mood.
Identify one statement that is FALSE about alcohol induced blackouts: a. They are more likely to occur in women. b. They only occur when drinking distilled spirits like whiskey, vodka or gin. c. A person can have sexual intercourse with someone and then have no recollection of it the next day. d. A person can have either complete or partial (fragmented) loss of memory. e. Combining a prescription benzodiazepine like diazepam (Valium®) or smoking marihuana increases the risk of having a blackout.
B. They can only occur when drinking distilled spirits like whiskey, vodka, or gin, is FALSE!
Which of the following is a medically accepted therapeutic use of amphetamine in common practice today? A. Treat insomnia. B. Treat ADHD. C. Provide weight control for 4-5 years. D. To treat severe depression. E. All are medically accepted uses.
B. To treat ADHD. Some students said E, but remember, "accepted" therapies. In some cases, it may be appropriate to take amphetamines for a very short-term management of weight, but long term is definitely not recommended.
Which drug will remain in the body for the longest period of time: a. A drug with a half-life of 5 hours b. A drug with a Cmax of 500 ng/mL c. A drug with a half-life of 10 hours d. A drug with a Tmax of 3 hours e. A drug that bypasses the blood brain barrier
C. A drug with a half life of 10 hours.
Which of the following statements is NOT true about the endocannabinoid system? a. Endocannabinoids bind to the CB1 receptor primarily located on presynaptic sites to modulate the activity of other transmitters. b. The ECS modulates a wide range of biological functions like memory, sleep and pain. c. Anandamide can be taken by mouth to mimic many of the same effects as THC but with fewer side effects. d. Once released into the synapse, endocannabinoids are metabolized by fatty acid amide hydrolase (FAAH) into inactive entities.
C. Anandamide can be taken by mouth to mimic many of the same effects as THC but with fewer side effects.
Select the CORRECT statement about binge drinking: a. Since a lot of alcohol is consumed quickly, you sober up sooner. b. Binging on an empty stomach will slow down the absorption and allow the effect of alcohol to last longer. c. It can easily lead to blackouts and nonconsensual sexual activity. d. It protects your liver from getting exposed to alcohol over a long period of time. e. You are less likely to use other drugs like marihuana or opiates so it is a much safer practice.
C. It can easily lead to blackouts and nonconsensual sexual activity.
Which of the following is the correct statement regarding the interaction between the two neurons: a. Neurons make physical contact with one another at the synapse b. Neurons only communicate with other neurons that have the same neurotransmitter in them c. Neurons initiate electrical signals that are converted to chemical signals that moves across the synapse to either excite or inhibit another neuron d. Neurons only connect to neurons that are on the same side of the brain
C. Neurons initiate electrical signals that are converted to chemical signals that move across the synapse to either excite or inhibit another neuron.
What is the CORRECT statement about "speedball"? A. It is a combination of cocaine and naloxone (Narcan®). B. The danger lies in the fact that the adverse side effects of cocaine and heroin are additive and so overdoses are more likely to occur. C. The opiate in the combination is short acting to match the short duration of action of cocaine. D. It is a combination of fentanyl and caffeine. E. It gets its name from the song "Pinball Wizard" performed by the Who.
CORRECT: The danger lies in the fact that the adverse effects of cocaine and heroin are addictive, and so overdoses are more likely to occur.
Which of the following best describes the mechanism of action of caffeine in maintaining wakefulness?
Caffeine competes with adenosine and blocks it from exerting its sedating effects.
The major non psychoactive chemical in cannabis is:
Cannabidiol (CBD)
At the cellular level, the major active chemicals in cannabis bind to:
Cannabinoid receptors
Which of the following statements is NOT correct about caffeinated beverages? a. Cold Brew coffee is more concentrated and so has more caffeine than brewed. b. Some of the solvents used decaffeinate coffee have been shown to be carcinogenic c. Decaffeinated coffee still contains a small amount of caffeine. d. A Grande cup of coffee (16 oz) contains more caffeine per ounce than Expresso (2 oz). e. Many caffeinated soft drinks contain significant amounts of caffeine and therefore can contribute to the development of tolerance.
D. A grande cup contains more caffeine per ounce than espresso. Espresso is very concentrated, and while a grande cup may have "more coffee," the caffeine is diluted.
Which is a FALSE statement about alcohol? a. Men have higher levels of alcohol dehydrogenase than women in their stomachs b. Alcohol overdose (not leading to death) causes hypothermia. c. Women achieve higher blood alcohol concentrations than men when consuming the same amount on the basis of their weight. d. A strong cup of coffee can sober a person up so he/she can drive home e. Metabolic tolerance to alcohol causes alcohol's effects to be shorter.
D. A strong cup of coffee can sober a person up so he/she can drive home.
What is the correct statement regarding adulterants used to cut cocaine? A. Mannitol is one of the most popular, but is quite toxic. B. Lactose should be avoided by people who are lactose intolerant. C. Active adulterants are rarely used because they make it easier to detect the cocaine. D. An active adulterant could lead to a placebo response or the belief that the drug is more potent. E. Adulterants should never be used by happily married couples who share their cocaine—if they want to remain happily married that is.
D. An active adulterant could lead to a placebo response or the belief that the drug is more potent.
When comparing two drugs, which of the following properties belong to the MOST safe and thus more desirable MEDICATION? a. ED50 is much higher than the LD50 b. Has a half-life that is greater than 12 hours c. Side effects begin to appear at a dose that is 1.5 times higher than the desired effects d. ED50 is 5 times lower than the dose that produces side effects e. Cmax is 10 times lower than the other drug.
D. ED50 is 5 times lower than the dose that produces side effects. A safe drug will be one that exerts its effects after a very small dose relative to the dose that produces side effects. Answer C is definitely a safe drug but being only 1.5 times the dose between desired effects and side effects makes this much less safe than answer D in which the difference is 5-fold. Cmax has no direct bearing on safety—that is simply a fact about the drug's kinetics. The absolute amount of a drug is not as important as its efficacy.
Which is FALSE about methylphenidate? A. It is a mild psychostimulant and so its abuse liability is low compared to cocaine. B. Is used medically to treat ADHD. C. There are long acting formulations (Concerta™) that last for 24 hours. D. It helps maintain wakefulness, and has been shown scientifically to improve cognitive function, learning and memory in healthy adults. E. It is sometimes crushed up and snorted in order to increase the high.
D. It helps maintain wakefulness, and has been shown scientifically to improve cognitive function, learning, and memory in healthy adults. FALSE!
Which of the following is NOT an example of homeostasis? A. putting on a jacket when the outside air is cold b. increased production of receptors in response to excessive transmitter c. increased firing of GABA neurons in response to rapid firing of glutamate neurons d. loss of dopamine neurons during the normal aging process e. increased heart rate in response to low blood pressure
D. Loss of dopamine neurons during the normal aging process.
Which of the following is FALSE about physical dependence on alcohol? a. Withdrawal can be so severe that is could be fatal. b. Signs and symptoms begin to appear 8-12 hours after the last drink. c. The signs of withdrawal can be reversed by drinking more alcohol. d. The signs include severe sedation, lethargy and slipping into a coma. e. The acute withdrawal is typically treated with benzodiazepines.
D. The signs include severe sedation, lethargy, and slipping into a coma, is FALSE. Withdrawal signs are the opposite of what the drug does to the body.
Which of the following individuals is MOST LIKELY to develop the highest degree of tolerance and physical dependence on caffeine? a. Bob, who drinks three 8-ounce cups of regular brewed coffee each morning before he leaves for work b. Julie, who drinks one 1.9-ounce 5-hour Energy Extra Strength shot each day. c. Lois, who drinks three 8-ounce cups of regular brewed coffee (breakfast, lunch and dinner), and two 12-ounce cans (one before lunch and one at 7:30 pm) of sugar-free Pepsi-One cola each day. d. Helen who drinks six 8-ounce glasses of iced tea each day. e. George, who drinks two 12-ounce cans of regular Coca-Cola each day with lunch, but had a cold and was taking an OTC medication for 2 days to help him with his symptoms.
Definitely C, Lois.
What are some hallmarks of placebo response?
Delayed onset of action, lower maximal response, and shorter duration of action.
Which person (who has not eaten in 8 hours) is likely to have the lowest peak blood alcohol concentration? a. Drinks two 12 oz. cans of beer in 60 minutes. b. Drinks two 5 oz glasses of wine in 60 minutes. c. Drinks one novelty drink that includes 1.5 oz of Anise Liqueur and 1.5 oz of Brandy in 60 minutes. d. Drinks one 5 oz glass of champagne in 60 minutes. e. Drinks one 1.5 oz shot of vodka in 60 minutes.
E. Drinks one 1.5 oz shot of vodka in 60 min. It will produce the lowest BAC because they are "sipping" over 60 min. Taking your time to consume a drink will significantly reduce blood alcohol concentrations.
Which of the following ways is NOT a way that a neurotransmitter is altered in the synapse? a. Mimic the transmitter at the receptor b. Block the receptor c. Increase transmitter metabolism d. Prevent re-uptake back into the terminal. e. Increase blood flow to the synapse.
E. Increase blood flow to the synapse
Which of the following is NOT a feature of a placebo medication? a. The onset of action is generally delayed b. They rely mostly on expected effects by the patient c. The duration of action is generally shorter d. The magnitude of the desired effect is generally low e. Placebos are of no benefit
E. Placebos are of no benefit. If it works, I don't care how. The experience is so subjective.
Serotonin
Essential in depression, based on tryptophan, similar to LSD. Plays a role in depression, active states, sleep, sex, temperature regulation. Its transporter is the target of SSRI medication.
Which of the following statements is FALSE? a. The average concentration of THC in cannabis products has increased significantly since the 1990's. b. Edibles are food or liquid products that have been infused with cannabinoids. c. It is very hard to die of an overdose from just THC alone. d. Combining alcohol with cannabis can increase the risk of a blackout. e. Products that contain very high concentrations of THC concentration can result in tachycardia that may precipitate a panic attack in some people. f. Vaping cannabis can be better controlled and so tolerance and dependence on THC is less likely.
F. Vaping cannabis can be better controlled and so tolerance and dependence on THC is less likely.
True or False: If a person is tolerant to cannabis, then they are also tolerant to alcohol because both drugs can cause people to be very relaxed and calm, even under stress.
FALSE
True or false: Neurotransmitters are very versatile chemical messengers. Thus, dopamine can bind to serotonin receptors and produce effects that are opposite of serotonin.
FALSE
True or false: You can easily "beat" a hair drug test simply by cutting 2" of the hair on your head because that is where the most recent drugs will be concentrated.
FALSE!
"Bob" (not his real name) smokes, on average, about 1 pack of tobacco cigarettes each day. He has smoked for the past 10 years with little change in his smoking patterns. His brand contains 1.0 mg nicotine and 10 mg of tar. Unknown to Bob, one of his friends, "Jane" (also not her real name) has substituted another type of cigarette (but the same brand), and over the next week Bob actually increases the number of cigarettes that he smokes to about 1.5 packs a day. What is the likely explanation for this change in his smoking behavior?
Jane has switched him to a cigarette that contains less nicotine (ex 0.75 mg).
What is the most likely cause of craving for a cigarette?
Low plasma nicotine concentrations.
Which of the following best describes the difference between cannabis in the 1970s and the cannabis today?
Smoke and vaped products are more concentrated and so the unit doses that are inhaled are much higher.
What is the leading case of preventable death in the world?
Smoking.
True or False: Cocaine metabolism begins the moment it enters the bloodstream.
TRUE!
Glutamate
The "gas pedal." The major excitatory neurotransmitter. Found on the surface of nearly all neurons. Plays critical role in cortical cognitive function, motor control, cerebellum, and sensory function. Regulate synaptic plasticity and involved in learning, memory, and cognitive function.
Affinity
The ability of a drug to bing to its receptor
Which cigarette during the day is considered to be the most rewarding?
The first one in the morning
Cytochrome p450
The general name for a large class of enzymes that play a significant role in drug metabolism and drug interactions. Located on hepatocytes, metabolize a wide range of things.
The primary organ that is responsible for metabolizing drugs in the body is
The liver
What is so unique about the nicotine patch that makes it a good candidate for treating nicotine dependence?
The patch releases nicotine slowly and results in a stable blood nicotine concentration over the course of a day.
What is exocytosis?
The process of releasing neurotransmitter into the synapse.
What are some strategies to treat cocaine and amphetamine dependence?
There are no FDA approved medications for treating stimulant use disorder.
mixed agonist/antagonist
acts as an agonist but blocks the effect of another agonist
behavioral tolerance
adjustment of behavior through experience in using a drug to compensate for its intoxicating effects. Ex. for most user that overdose, they reported that they used their usual dose, but injected it in an unusual or difference environment than they were used to. Behavioral cues have physiological effects.
dosage
administration of drug per unit time
partial agonist
display intermediate activity at the receptor ex. naloxone
indirect agonist
drug that does not bind to receptor but enhances the amount of endogenous ligands ex. cocaine
Kidney failure will have the greatest impact on which function?
excretion Some students thought "metabolism," but the liver has the greatest impact on that function. Drugs are first metabolized and then presented to the kidney for elimination (excretion)
Prodrugs
initially inactive drugs that exert no pharmacologic effects until they are metabolized. The metabolic transformation occurs in vivo.
Dose
quantity of drug given
efficacy
refers to the magnitude of the effect of a drug once it binds
Type 1 Error
rejecting the null hypothesis when it is true (false positive)
what is the fastest "natural" way that a neurotransmitter's effect is ended?
reuptake into the axon terminal
If a person has not smoked marijuana on a regular basis, and he smokes one join by himself, he probably should not drive his car for 18-24 hours afterwards, even though he feels fine - why?
the subjective high after the THC disappears within a few hours, but the effects on psychomotor function and fine motor skills persist for up to 24 hours.
Energy drinks are most dangerous when they are combines with alcohol because...
they mask the depressant effects of alcohol, causing the person to consume more alcohol.