Substance Abuse Class

1. At about what periods in history did cocaine reach its first and second peaks of popularity, and when was amphetamine’s popularity at its highest? Cocaine -late 19th century and early 20th amphetamine- 1960s (Hart & Ksir, p. 125)

2. How did Mariani, Freud Halsted popularize the use of cocaine? Psychiatric use (Hart & Ksir, p. 126)

3. How are coca paste, freebase, crack, and ice similar? Heated and they use home products

4. What similarities and what differences are there in the toxic effects of cocaine and amphetamine relate to the behavioral effects of the two drugs? Cocaine: CNS stimulations or convulsions and maybe cardiac arrest (acute) or full blow paranoid psychosis, increasing irritability, restlessness (chronic) Amphetamine: paranoia, increased feeling of power or capability (acute) and paranoia/sleep deprivation (chronic) (Hart & Ksir, p. 132,135)

5. How would medical practice be affected if both cocaine and amphetamine were placed on Schedule I? It can’t be prescribe ADHD meds. (Hart & Ksir, p. 141)

6. How does the chemical difference between methamphetamine and amphetamine relate to the behavioral effects of the two drugs? Methyl group added, makes molecule across blood-brain barrier more readily and increase CNS potency (Hart & Ksir, p. 138-139)

7. Compare the dependence potential of cocaine with that of amphetamine. Both potential reinforcers and habit forming psychological dependence (Hart & Ksir, p. 140) 8. Describe the effects of amphetamines on mental performance. Example would be Adderall, “smart pill”. It is said to make you more concentrated, but it can actually disrupt your performance. (Hart & Ksir, p. 141)

Chapter 1

1. What was the foul-smelling drug that o widely used in mental hospitals before the 1950’s? Paraldehyde (Hart & Ksir, p. 148)

2. A prescription of 30 mg of phenobarbital would probably have been for which type of use? To keep a person calm and relaxed. (Hart & Ksir, p. 149)

3. What is the relationship between psychological and the time course of a drug’s action? Psychological dependence develops more rapidly when the drug hits the brain more quickly. (Hart & Ksir, p. 152)

4. The barbiturates and benzodiazepines act at which neurotransmitter receptor? GABA (Hart & Ksir, p. 153)

5. Why should hypnotic drugs usually be prescribed only for a few nights at a time? Because of concerns of tolerance, rebound insomnia, dependence, and “hangover” effects. (Hart & Ksir, p. 155)

6. What is zolpidem (Ambien)? Zolpidem is a non benzodiazepin hypnotic. (Hart & Ksir, p. 156)

7. What are the characteristics of the sedative hypnotic withdrawn syndrome? increased anxiety, insomnia, tremors, weakness, nausea , vomiting, can lead to seizures (Hart & Ksir, p. 153)

8. What happens to a person who takes an overdose of a sedative-hypnotic? Impaired judgment and incoordination, depressed respiration, and, with large enough doses, death. (Hart & Ksir, p. 152 )

9. How are the effects of the nitrites different from the effects of inhaled solvent fumes? Nitrites used for cyanide poisioning, which is to be used as poppers to relieve chest pain, increases in blood flow and lowers blood pressure, increased warmth. Solvent fumes causes the effects to be similar to being drunk. (Hart & Ksir, p. 161)

10. What are the effects of combing GHB with alcohol? Profound intoxication, which caused people to become highly suggestible and unable to remember what happened. (Hart & Ksir, p. 162)

Chapter 2

1. Give two examples of anxiety disorder. Panic disorder specific phobia social phobia OCD PTSD Generalized anxiety disorder. (Hart & Ksir, p. 166)

2. Is schizophrenia a functional or an organic psychosis? Functional (Hart & Ksir, p. 168)

3. Besides sadness, what are some other indicators of a major depressive episode? Diminished interest or pleasure in most activities, change in body weight or appetite, insomnia or hyper-insomnia, fatigue or loss of energy, feelings of worthlessness, diminished ability to think or concentrate, thoughts of death or suicide. (Hart & Ksir, p. 170)

4. What type of drug is chlorpromazine, and where was it first tested on patients? Antipsychotic, A new phenothiazine drug, chlorpromazine, was synthesized in France in 1950 and was tested on such patients. In 1952, two French psychiatrists, Delay and Deniker, announced that the drug exerted a specific effect in diminishing the symptoms and signs of psychosis in patients with severe mental illnesses. (Hart & Ksir, p. 171)

5. What is tardive dyskinesia, and how does it respond to a reduction in the dose of an antipsychotic drug? Rhythmic, repetitive sucking and smacking of the lips and thrusting of the tongue in and out; movement of arms, fingers and toes, reversal is possible if lower dose is given immediately. (Hart & Ksir, p. 173)

6. Which type of drug was discovered while testing an antituberculosis? MAO monoamine oxidase inhibitors (Hart & Ksir, p. 174)
7. How do the selective reuptake inhibitors differ from the older tricyclics in terms of their action in the brain? Reuptake inhibitors serotonin and norepinephrine, but are more selective, have fewer other actions than the tricyclics (Hart & Ksir, p. 176)

8. What were two of the three reasons it took so long for lithium to be available for use in the United States? Lithium was originally used as a salt substitute and because its use was not controlled there were several deaths. 2.) Mania was not seen as a major problem in the United States. (Hart & Ksir, p. 179)

9. If clozapine is dangerous, why is it prescribed to all? Lowers white blood count, but it produced much less pseudo parkinsonism than the other drugs, some patients who have failed to improve with the other antipsychotics showed improvement. (Hart & Ksir, p. 172)

10. Why was Prozac the most widely prescribed antidepressant drug ever marketed? Because it was safer than the other tricyclics, less likely to lead to overdose deaths (Hart & Ksir, p. 176)

Chapter 3

1. What is the maximum percentage of alcohol obtainable through fermentation alone? What would that be in proof? Up to 15% is theoretically possible, in practice the standard alcohol content for wine is about 12%, 15% = 30 proof 12% = 24 proof (Hart & Ksir, p. 187)

2. Did Prohibition reduce alcohol abuse? Yes! Though rates of alcohol dependence and alcohol related deaths began to increase by the end of prohibition, they were still lower than before prohibition. (Hart & Ksir, p. 189)

3. In about what year did apparent consumption of alcohol reach its peak in the United States? 1981 (Hart & Ksir, p. 197)

4. About how much more likely are men than women to engage in frequent heavy drinking? A little over half (Hart & Ksir, p. 198)

5. About how many standard drinks are required can typical human metabolize each hour? One-half of one standard drink (Hart & Ksir, p. 187)

6. For your own gender and weight, about how many standard drinks are required for you to reach the legal BAC limit for driving under the influence? 0.57 puts me “possibly impaired” in 1 hour, drinking 3 beers according to the state of Oklahoma. (Hart & Ksir, p. 200)

7. Alcohol enhances the action of which neurotransmitter at its receptors? GABA at the GABA-A receptor (Hart & Ksir, p. 203)

8. What is the typical behavior of a person with a BAC of 0.20? Marked depression in sensory and motor capability, intoxication. (Hart & Ksir, p. 205)

9. Describe the four groups in the balanced placebo design. Half of the study participants are given mixed drinks that contain alcohol, while the other half get similar-tasting drinks without alcohol. Each of these groups is divided in half with some being told they’re getting alcohol (whether they are or not) and others being told they’re testing a non-alcoholic drink (Hart & Ksir, p.205 )

10. What term id used to describe the fact that drinkers tend to focus on the “here and now”? “Time Out” (Hart & Ksir, p. 205)

11. About what proportion of U.S. traffic fatalities are considered to be alcohol related? Less than 40% (Hart & Ksir, p. 206)

12. What is the role of expectancy in males’ increased interest in sex after drinking? Men who had stronger expectancies that alcohol would enhance sexuality reported experiencing more arousal after being given a placebo – belief that alcohol enhances sexuality (Hart & Ksir, p. 207)

13. If alcohol did not actually increase violent tendencies, how might we explain the statistical correlation between alcohol and such things as assault and homicide? Unfortunately, it has proven difficult to perform controlled experimental studies on these complex problems, so the answers remain unclear (Hart & Ksir, p.209)

14. Why is it dangerous to drink alcohol to “stay warm” in the winter? Alcohol has an effect on the CNS that causes the dilation of the peripheral blood vessels. This increases heat loss from the body, but makes the drinker feel warm. The heat loss and cooling of the interior of the body are enough to cause a slowdown in some biochemical processes (Hart & Ksir, p. 210)

15. If someone you know has drunk enough alcohol to pass out, what are two things you can do to prevent a lethal outcome? 1) Place them on their side so that any vomit is less likely to be aspirated and someone sober needs to monitor the person’ breathing until they can be aroused and begin to move 2) If this isn’t possible, the person needs to be taken to the ER or call 911 (Hart & Ksir, p. 211)

16. Can brain damage be reversed if someone has been drinking heavily for many years? Not fully, No. (Hart & Ksir, p. 213)

17. About what percentage of the heaviest drinking women will have children diagnosed with FAS? 23-29 per 1,000 births (Hart & Ksir, p. 215)

18. What is the most dangerous withdrawal symptom from alcohol? Seizure activity (Stage 4) (Hart & Ksir, p. 217)

19. Did the early founders of AA view alcohol dependence as a disease? YES! (Hart & Ksir, p. 219)

20. If one identical twin is diagnosed with alcohol dependence, what is the likelihood that the other twin will also receive the diagnosis? In some studies, as high as 50% So inheritance plays a strong role, but is far from a complete determinant of alcohol dependence. (Hart & Ksir, p.220)