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Theme 3 (Addictive drugs (Depressants (Sedatives (Glutamate: excitation of…

- - - - Opioids
        
        Morphine
        
        mu, delta and kappa receptors
        
        agonists
        
        naloxone is the antagonist
        
        highly lipophilic
        
        Endogenous opiods
        
        Alr in the body thats why there are receptors
        
        Effects
        
        Analgesia (no pain)
        
        Respiratory depression = death
        
        depression of cough reflex
        
        Sedation
        
        Euphoria or dysphoria
        
        Constipation
        
        Histamine from mast cells
        
        small pupils
        
        Heroin
        
        converted to morphine
        
        Thru 6-AM
        
        Overdose
        
        Respiratory depression
        
        Loss of protective airway reflex (hypoxic)
        
        Opioid induced ventilatory impairment
        
        secondary complications: vomiting etc,
        airway occlusion, hypoxic brain injury
        
        Fentanyl
        
        Higher potency than morphine
        
        Naloxone
        
        High affinity, no efficacy
    - - Glutamate: excitation of cells
        GABA: inhibition of cells
        
        Barbiturates when bound
        = helps
      - Ketamine
        
        inhibits glutamate receptor
      - GHB
        
        breakdown product of GABA
        
        liquid ecstasy
        
        overdose: vomiting, delirium, agitation
      - Alcohol
        Treatments:
        
        Antidepressants
        
        Opioid antagonist
  - - - Effects
        
        alerting
        
        increase mental performance
        
        strong psychological, little physical (no defining withdrawal effect)
        
        strong DA release (cravings)
      - Mechanisms
        
        mesocortical/mesolimbic
        dopamine pathway (appetite)
        
        nigrostriatal dopamine pathway (motor)
      - Cocaine
        
        blocks DAT receptors
        
        dopamine in the synapse
      - Amphetamine
        
        SNS-like effects (over activity = seizures)
        
        Pushes dopamine out
  - - - Reward everytime
        
        positive reenforcement
        
        Dopamine pathway
        
        Nucleus accumbens = pleasure = pos. reenforcement
    - - negative reenforcement
        
        avoiding withdrawl symptoms
        
        Tolerance
        
        The more u take the more u need
        
        Pharmacokinetic tolerance
        
        more barbituate = fast metabolism in liver
        
        Pharmacodynamic tolerance
        
        Morphine inhibits activity of enzyme
        
        As dose increases, same dose is less effective
        
        Body has own homeostatic enzyme = morphine becomes less effective