Mer Scott
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(Psychiatry) PHCY320 Test sobre PSY12 Addiction, creado por Mer Scott el 14/10/2019.

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PSY12 Addiction

Pregunta 1 de 15

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Assessable Tasks
By the end of this lecture you will be able to:
• Describe the epidemiology and differences between recreational drug use and the diagnosis of addiction
• Describe the underlying mechanisms and site of action for commonly used recreational drugs
• Identify their main wanted/unwanted effects

Arrastra y suelta para completar el texto.

    OK

Explicación

Pregunta 2 de 15

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Drugs ordered by overall harm scores and weights after normalisation (0–100) (Lancet, 2010)
1. - 72/100
2. - 55/100
3. (smoked) - 54/100
4. - 33/100
5. Cocaine - 27/100
6. Tobacco - 26/100

also cannabis - /100, benzodiazepiones - /100, methadone - /100

Arrastra y suelta para completar el texto.

    Alcohol
    Heroin
    Crack Cocaine
    Meth
    20
    15
    14

Explicación

Pregunta 3 de 15

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DSM-5 Criteria for Substance Use Disorders:
The 11 criteria for substance use disorder are divided into four categories of behaviour related to the substance use:
1. impaired
2. impairment
3. use
4. pharmacological indicators ().
The severity of the substance use disorder is determined by the number of criteria the person meets:
Mild - criteria
Moderate: criteria
Severe: or more criteria
Within the last 12-month period,

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    control
    social
    risky
    tolerance and withdrawal
    2 or 3
    4 or 5
    6

Explicación

Pregunta 4 de 15

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Probability of dependence when you have tried a drug once
- 32%
- 23%
- 17%
- 15%
Stimulants - 11%
Anxiolytics and Cannabis - 9%
- 8%

Arrastra y suelta para completar el texto.

    Tobacco
    Heroin
    Cocaine
    Alcohol
    Analgesics

Explicación

Pregunta 5 de 15

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Speed of drug entry into brain dictates the intensity of the ‘high’.

Selecciona uno de los siguientes:

  • VERDADERO
  • FALSO

Explicación

Pregunta 6 de 15

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Tolerance
• Can and often occurs in the absence of – reduced response after repeated administration
• Usually due to receptor/ desensitization and -regulation
– repeated use of a drug in a given category confers tolerance to the drug being used AND others within the same pharmacological category.
• Metabolic or - increased metabolism requires increasing doses to produce the same pharmacological effect.
– increasing doses required to produce the same effect (learned behaviour)

Arrastra y suelta para completar el texto.

    dependence
    second messenger
    down
    Cross-tolerance
    pharmacokinetic tolerance
    Pharmacodynamic tolerance

Explicación

Pregunta 7 de 15

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Neurocircuitry of impulsive-compulsive behaviuor:
• Associated with associated with drug, noy reward of drug
• Impulsivity and compulsivity are hypothetically drives that are “-up,” ie controlled by suppression of higher drives.
1 - impulsivity comes from the (NAc)
2 - compulsivity comes from the
3 - different areas of act “-down” to suppress these drives.

Arrastra y suelta para completar el texto.

    anticipation of the reward
    bottom
    top
    ventral striatum
    dorsal striatum
    prefrontal cortex

Explicación

Pregunta 8 de 15

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Addiction - shifts from drive, that comes with migration from to circuitry. With chronic drug use, compulsivity develops, as the drive changes from (impulsive) to seeking r (compulsory) and anticipation of obtaining/consuming the drug.

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    impulsive to a compulsive
    ventral
    dorsal
    seeking pleasure
    elief from the withdrawal symptoms

Explicación

Pregunta 9 de 15

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Choose the incorrect statement.

Selecciona una de las siguientes respuestas posibles:

  • Psychotropics bypass neurotransmitters and directly stimulate receptors causing DA release and the high.

  • Withdrawal of CNS depressants usually involves neuronal hypo-excitability with varying degrees of severity – anxiety, possible hallucinations, seizures etc.

  • Withdrawal of CNS depressants causes significant activation of the autonomic nervous system: sweats, tremors, GI disturbances

  • Inhibition of the mesolimbic DA release commonly occurs in withdrawal

Explicación

Pregunta 10 de 15

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Which of these is not a CNS stimulant/depressant?

Selecciona una de las siguientes respuestas posibles:

  • Nicotine

  • Methamphetamine

  • Cocaine

  • Caffeine

  • Alcohol

  • Benzos

  • Opioids

  • Cannabis

  • Heroin

Explicación

Pregunta 11 de 15

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Effects of Alcohol on reward:
Alcohol either acts directly upon µ or releases endogenous opiates such as .
It causes increased release in . Reinforcing effects also theoretically mediated by enhancing inhibition and reducing excitation.

Factors Associated With Alcoholism
• Environmental Factors
1. family or peer behavior
2. availability of other reinforcers (e.g. recreational resources)
3. job/educational opportunities
4. conditioned stimuli ( paired with drug use)
5. of alcohol
• Host Factors - Genes:
1. + and - for alcohol (reduced gene expression for alcohol dehydrogenase reduced
sensitivity to alcohol phenotype in alcoholics);
2. Antisocial or traits; risk-taking
3. Prior experience/expectations

Tx: Naltrexone on the reduces reward.
Naltrexone - µ : blocks effects of alcohol, decreases cravings. used to mediate ‘withdrawal’ over a few weeks to prevent symptoms like life threatening seizures.

Arrastra y suelta para completar el texto.

    receptors
    encephalin and endocannabinoids
    DA
    NAc
    GABA
    GLU
    group
    environmental cues
    Cost/ease of availability
    anxious
    VTA
    opiate antagonist
    pleasurable
    Long acting benzodiazepines

Explicación

Pregunta 12 de 15

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Cannabis - THC and cannabidiol
• ‘normal’ dose - sense of well-being, relaxation, friendliness, loss of awareness, slows processes, impairs -term memory
• ‘high’ doses - can induce and rarely
• “” in frequent/heavy users characterized by the emergence of decreased drive and ambition, thus “amotivational.”
Cannabidiol = negative modulator of , potentially used to treat addiction, anxiety, psychosis and epilepsy

Arrastra y suelta para completar el texto.

    temporal
    thought
    short
    panic, toxic delirium
    psychosis
    amotivational syndrome
    allosteric
    CB1 and CB2

Explicación

Pregunta 13 de 15

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Cannabinoids in the mesolimbic pathway:
interneuron feedback projections provide tonic of neurons
receptors mediate marijuana’s reinforcing properties

Opioids in the mesolimbic pathway:
Act on which arise in the and project to the . Opioids bypass the enkephalins and stimulate receptors causing release = high.

Nicotine & dopamine release:
Nicotine - full agonist at α4,β2 receptors on – cause prolonged channel until desensitization → prolonged burst of action potentials and consequently

Arrastra y suelta para completar el texto.

    GABAergic
    inhibition
    VTA dopaminergic
    CB1
    opioid neurons
    arcuate nucleus
    VTA and NAc
    directly
    DA
    nicotinic
    DA neurons in the VTA
    opening
    prolonged DA release

Explicación

Pregunta 14 de 15

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The ‘amphetamines’
• Increase conc. of DA, by"
• inducing release of newly synthesized
• and inhibiting NA, 5-HT and DA and VMAT
is an uptake inhibitor only
• Methamphetamine - similar to cocaine but lasting effects with less euphoria, associated with -like psychosis
• Ecstasy - , dependence rare/debatable

Arrastra y suelta para completar el texto.

    synaptic
    stores of intraneuronal DA
    reuptake transporters
    Methylphenidate
    longer
    schizophrenia
    serotonergic

Explicación

Pregunta 15 de 15

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The amphetamines ‘undesirable effects’
- change in of the human brain
- ability to cause infarcts ( tissue from oxygen deprivation)

Overdose treatment is with non-selective or or ß-blockers, for seizures

Arrastra y suelta para completar el texto.

    structure and function
    cerebral and/or myocardial
    dead
    diazepam
    Ca2+

Explicación