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Cyproheptadine -ANSWER-5-HT2A receptor antagonist

Serotonin syndrome -ANSWER-Caused by excessive stimulation of 5- HT2A receptors and possibly 5-HT1A receptors

In patients withdrawing from both hypnotic - sedatives and CNS stimulants, which is treated first? -ANSWER-hypnotic - sedatives

For those patients on both opiates and sedative-hypnotics, which should be tapered first? -ANSWER-Taper the sedative-hypnotic first while keeping the opiate dose set at a stable level. Once off the sedative-hypnotic then taper the opiate

Codeine is metabolized into morphine by this enzyme: -ANSWER-

CYP2D6

Methadone is primarily metabolized by this enzyme: -ANSWER-

CYP3A4

These drugs inhibit CYP 3A4, and thereby slow the elimination of

methadone and increase the methadone level: -ANSWER-

Erythromycin, diltiazem, ketoconazole and sequinavir

These drugs induce CYP 3A4, and thereby speed up the elimination

of methadone and decrease the methadone level: -ANSWER-St.

John's wort, carbamazepine, phenobarbital, efavirenz

Cocaine induced psychosis versus acute schizophrenia: how do you

tell the two apart? -ANSWER-Tactile hallucinations, less negative symptoms, think cocaine induced psychosis; more bizarre thinking think acute schizophrenia

Pharmacodynamics -ANSWER-what the drug does to the body

Pharmacokinetics -ANSWER-what the body does to the drug

One standard alcoholic drink in the United States contains this amount

of alcohol: -ANSWER-0.6 oz (17 g)

What is an AWOL machine? -ANSWER-I device that allows you to inhale ethanol vapor (hence "Alcohol Without Liquid") to get a quicker response

Jejunum -ANSWER-Site where about 90% of alcohol is absorbed

Compare the difference in alcohol levels in men and women - ANSWER-A woman of the same weight as a man, both of whom consume the same amount of alcohol, because the rate of absorption in the stomach is higher in men than women (although most alcohol is absorbed in the jejunum), The woman will have a 20 to 25% higher blood alcohol level than the man

Describe how alcohol is broken down the liver -ANSWER-Alcohol is converted to acetaldehyde by ADH and CYP2E1, then acetaldehyde is converted to acetate by ALDH

How does alcohol affect the DA neuron firing in the VTA -ANSWER- Increases it

How does alcohol work in the body that is different from cocaine or amphetamine, or benzodiazepines, or opiates? -ANSWER-Alcohol works on a diverse assortment of ligand-gated and voltage-gated ion channels that regulate neuronal excitability, where's all the others act on specific protein receptors on brain neurons

Flumazenil (Romazicon) action is as: -ANSWER-a GABA-A receptor

antagonist without intrinsic activity

The rate of alcohol metabolism is proportional to bodyweight, and

probably liver weight, and is approximately, in the average adult: -

ANSWER-1 oz every 3 hours, or 28 g evry 3 hours, or 9.4 g/hr

Say some things about the amygdala -ANSWER-Processing emotionally-relevant stimuli

Ondansetron (Zofran) is -ANSWER-a 5-HT3 receptor antagonist

How do potassium channels affect glutamatergic activity? -ANSWER- Potassium channels act as a brake on excitatory glutaminergic activity by hyperpolarizing the membrane

Effects of acute and chronic alcohol consumption on GABA-A -

ANSWER-Acute: enhanced channel activity = sedation, anxiolysis;

Chronic: reduced function, altered subunit formation = withdrawal sxs,

increased anxiety

Effects of acute and chronic alcohol consumption on acetylcholine -

ANSWER-Acute: enhance/inhibit channel activity = reward, arousal;

Chronic: reduced receptor expression = maintain drinking, relapse

Effects of acute and chronic alcohol consumption on serotonin - ANSWER-Acute: enhance channel activity = reward; Chronic: variable effects on receptor expression = modulate drinking

Effects of acute and chronic alcohol consumption on

endocannabinoids -ANSWER-Acute: increase release = reward,

euphoria; Chronic: reduced receptor expression = cognitive effects

Effects of acute and chronic alcohol consumption on dopamine - ANSWER-Acute: increase release = reward, euphoria; Chronic: blunted responsiveness = anhedonia

Effects of acute and chronic alcohol consumption on glutamate -

ANSWER-Acute: inhibit channel activity = intoxication, anxiolysis;

Chronic: increased receptor expression and function = tolerance,

withdrawal excitability, seizures, craving, relapse

Effects of acute and chronic alcohol consumption on opioid peptides - ANSWER-Acute: increase release = reward (μ); Chronic: altered coupling and expression to signaling pathways = craving, relapse, dysphoria (κ)

Effects of acute and chronic alcohol consumption on CRF/NPY -

ANSWER-Acute: mixed = stress indicators, increased appetite;

Chronic: increase CRF/decrease NPY during withdrawal = increased

anxiety, craving, more drinking

Effects of alcohol on adenosine -ANSWER-Adenosine is a major inhibitory neurotransmitter and has antiepileptic effects. Alcohol increases the intracellular concentrations of adenosine