Psychoactive Drugs: Intoxication & Withdrawal

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Questions and Answers

What is the primary distinction between addiction and dependence?

Dependence leads to compulsive drug seeking behavior.

Addiction is losing control over drug use, while dependence is about the body adapting to a drug. (correct)

Dependence results from psychological cravings.

Addiction mainly involves physical cravings.

How do most addictive drugs affect dopamine levels in the brain?

They decrease dopamine levels, causing sadness.

They block dopamine receptors, reducing pleasure.

They increase dopamine levels, producing feelings of happiness or reward. (correct)

They have no effect on dopamine levels.

What happens to calmodulin-related genes with drug use?

They become overactive, improving drug metabolism.

They decrease in activity, impacting normal cellular functions. (correct)

They become dormant, having no effect on the cells.

Their activity increases, enhancing cellular processes.

What role do glutamate and GABA receptors play in the brain?

They act as the on/off switches, regulating brain communication. Signup and view all the answers

What is the typical outcome related to tolerance when using addictive drugs over time?

The brain becomes less sensitive and requires more of the drug to feel similar effects. Signup and view all the answers

What is a common effect of alcohol intoxication?

Emotional lability Signup and view all the answers

What is a common symptom of stimulant intoxication?

Mood elevation Signup and view all the answers

What is the primary treatment for barbiturate intoxication?

Symptom management Signup and view all the answers

What is the mechanism of action of caffeine?

Acts as an adenosine receptor antagonist Signup and view all the answers

What does severe opioid withdrawal commonly include?

Dilated pupils Signup and view all the answers

Which treatment is indicated for severe cocaine intoxication?

Benzodiazepines for agitation Signup and view all the answers

Which psychoactive substance is most likely to cause respiratory depression during intoxication?

Alcohol Signup and view all the answers

What withdrawal symptom is commonly associated with benzodiazepines?

Seizures Signup and view all the answers

What symptom indicates withdrawal from nicotine?

Restlessness Signup and view all the answers

What is the mechanism of action of opioids?

Mu, Kappa, and Delta-Opioid receptor agonists Signup and view all the answers

Which of the following is a common effect of amphetamine intoxication?

Mydriasis Signup and view all the answers

How does inhalant intoxication commonly present?

Perinasal rash Signup and view all the answers

What is a significant risk associated with chronic cocaine use?

Perforated nasal septum Signup and view all the answers

Which treatment is commonly used for opioid overdose?

Naloxone Signup and view all the answers

Which is the recommended treatment for caffeine withdrawal?

Hydration and rest Signup and view all the answers

What indicates intoxication with methamphetamine?

Tactile hallucinations Signup and view all the answers

What symptoms are typically associated with cannabis intoxication?

Disinhibition, increased thirst, impaired judgment Signup and view all the answers

What is a key difference between dependence and addiction?

Dependence is a physical reaction, while addiction is a psychological one Signup and view all the answers

Which of the following substances is known to cause nystagmus as a symptom of intoxication?

PCP Signup and view all the answers

What is the mechanism of action (MOA) of MDMA?

Inhibition of monoamine reuptake Signup and view all the answers

What are common withdrawal symptoms from cannabis?

Irritability, insomnia, depression Signup and view all the answers

Which substance is characterized by causing life-threatening effects such as hypertension and serotonin syndrome?

MDMA Signup and view all the answers

What does mydriasis refer to in the context of drug intoxication?

Dilation of the pupils Signup and view all the answers

Which substance is known for causing a distorted perception of time?

Cannabis Signup and view all the answers

Study Notes

Psychoactive Drug Intoxication and Withdrawal

Depressants:
- Intoxication: Mood elevation, decreased anxiety, sedation, behavioral disinhibition, respiratory depression
- Withdrawal: Anxiety, tremors, seizures, insomnia
Alcohol (Ethanol):
- MOA: GABA agonist, glutamate antagonist (GABA-A receptor positive allosteric modulator)
- Intoxication: Emotional lability, slurred speech, ataxia, coma, blackouts, disinhibition, increased AST (2x ALT)
- Treatment: Supportive care (fluids, antiemetics)
Medication for Alcohol Withdrawal:
- Disulfiram:
  - MOA: Inhibits ALDH, increasing acetaldehyde after drinking, reinforcing abstinence
  - Usual Dose: 250 mg/day (range 125-500 mg/day)
- Naltrexone:
  - MOA: μ-opioid receptor antagonist, reduces feelings of reward and craving
  - Usual Dose: 50 mg/day
- Acamprosate:
  - MOA: Unknown mechanism, may block hyperglutamatergic state, mild protracted abstinence syndromes with feelings of "need" for alcohol
  - Usual Dose: 666 mg three times daily

Barbiturates

MOA: Increases duration of chloride channel opening (GABA-A receptor positive allosteric modulator)
Intoxication: Low safety margin, marked respiratory depression
Withdrawal: Delirium, life-threatening cardiovascular collapse
Treatment: Symptom management (assist respiration, increase blood pressure)

Benzodiazepines

MOA: Increases frequency of chloride channel opening (GABA-A receptor positive allosteric modulator)
Intoxication: Greater safety margin, ataxia, minor respiratory depression
Treatment: Flumazenil (benzodiazepine receptor antagonist)
Withdrawal: Seizures, sleep disturbance, depression

Opioids

MOA: Mu, Kappa, and Delta-Opioid receptor agonists (Opioid receptor modulator)
Intoxication: Pinpoint pupils, decreased GI motility, respiratory and CNS depression, euphoria, decreased gag reflex, seizures
Treatment: Naloxone (for overdose)
Withdrawal: Dilated pupils, diarrhea, flu-like symptoms, rhinorrhea, yawning, nausea, sweating, piloerection, lacrimation
Treatment: Symptom management, methadone, buprenorphine

Inhalants

MOA: Enhanced GABA signaling
Intoxication: Disinhibition, euphoria, slurred speech, ataxia, disorientation, drowsiness, perinasal/perioral rash
Withdrawal: Irritability, dysphoria, sleep disturbance, headache

Stimulants

Intoxication (nonspecific): Mood elevation, decreased appetite, psychomotor agitation, insomnia, cardiac arrhythmias, tachycardia, anxiety
Withdrawal (nonspecific): Irritability, dysphoria, sleep disturbance, headache

Amphetamines

MOA: Induces reversal of monoamine transporters (VMAT, DAT, SERT, NET), increases neurotransmitter release
Intoxication: Euphoria, grandiosity, mydriasis, prolonged wakefulness, hyperalertness, hypertension, paranoia, fever, skin excoriations (meth), severe: cardiac arrest, seizures
Treatment: Benzodiazepines (for agitation and seizures)
Withdrawal: "Meth mites"

Methamphetamine

MOA: Enhances release of monoamines (5HT, NE, DA)
Intoxication: Pupil dilation, agitation, euphoria, tactile hallucinations, alertness, arousal, wakefulness
Withdrawal: Sleepiness, hunger, depression

Caffeine

MOA: Adenosine receptor antagonist
Intoxication: Palpitations, agitation, tremors, insomnia
Withdrawal: Headache, difficulty concentrating, flu-like symptoms

Cocaine

MOA: Blocks reuptake of monoamines (5HT, NE, DA) or blocks dopamine (DAT), serotonin (SERT), norepinephrine (NET) transporters
Intoxication: Impaired judgment, pupillary dilation, diaphoresis, hallucinations, paranoia, angina, sudden cardiac death
Treatment: Benzodiazepines (diazepam), phentolamine for cardiovascular management, nitroglycerin for refractory hypertension or non-selective beta-blockers
Withdrawal: Restlessness, hunger, severe depression, sleep disturbance

Nicotine

MOA: Stimulates central nicotinic acetylcholine receptors
Intoxication: Restlessness
Withdrawal: Irritability, anxiety, restlessness, decreased concentration, increased appetite/weight
Treatment: Nicotine replacement therapy (patch, gum, lozenge), bupropion, varenicline

Hallucinogens (LSD)

MOA: 5-HT2A receptor agonist (increases serotonin activity)
Intoxication: Perceptual distortion (visual, auditory), depersonalization, anxiety, paranoia, psychosis, flashbacks
Withdrawal: None

MDMA (Ecstasy)

MOA: Blocks reuptake of 5HT and DA, or induces reversal of transporters for monoamines (SERT > DAT, NET), increasing neurotransmitter release.
Intoxication: Euphoria, hallucinations, disinhibition, hyperactivity, thirst increase, bruxism, distorted sensory and time perception, mydriasis (pupil dilation)
Withdrawal: Depression, fatigue, change in appetite, difficulty concentrating, anxiety

Phencyclidine (PCP)

MOA: NMDA receptor antagonist
Intoxication: Violence, nystagmus, impulsivity, psychomotor agitation, tachycardia, hypertension, analgesia, psychosis, delirium, seizures
Withdrawal: Recurrence of intoxication symptoms (GI tract reabsorption), sudden onset of severe violence.

Dependence vs. Addiction

Dependence: Body's adaptation to a drug; reaction when drug is stopped
Addiction: Loss of control and compulsive drug use; includes psychological cravings.

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Description

Explore the effects and treatment options for psychoactive drug intoxication and withdrawal, with a focus on depressants and alcohol. Learn about the mechanisms of action for various medications used in managing alcohol withdrawal and their typical dosages. This quiz will test your knowledge on these critical topics in substance use and mental health.