Drugs and Individual Behavior Exam 1 Study Guide
Drugs and Individual Behavior Exam 1 Study Guide PSYCH 3102
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This 6 page Study Guide was uploaded by McKenna Keck on Friday September 9, 2016. The Study Guide belongs to PSYCH 3102 at University of Northern Iowa taught by Dr. Linda Walsh in Fall 2016. Since its upload, it has received 14 views. For similar materials see Drugs and Individual Behavior in Psychology at University of Northern Iowa.
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Date Created: 09/09/16
Exam 1 Study Guide Drug : “any chemical substance, natural or manmade (usually excluding nutrients, water, or oxygen), that – by its chemical nature – alters biological structure or functioning when administered & absorbed Pharmacology : is the discipline concerned w/ the uses, effects, & modes of drug action Psychoactive Drug : any drug that affects your feelings, perceptions, thought processes, &/or behavior. All psychoactive drugs exert their effects by altering the functioning of the nervous system. Psychopharmacology : the study of how drugs affect behavior & psychological processes Placebo & Placebo Effect : typically, an inert (chemically inactive) substance administered like a drug; any psychological or physiological effect or portion of an effect that is due to expectation/belief rather than to chemical action. Even some of the effect seen from taking a real drug might actually be attributed to placebo effect. Conscience Clause : A pharmacist can refuse to prescribe b/c it’s against their moral obligations. These laws vary from state to state. ● Right to Refuse v. Patients’ Rights Is it okay for pharmacists to not fill prescriptions (protect their rights), or do we protect the rights of the patient by requiring them to fill the prescription? Pharmacokinetics: Not about the movement of the drug, but about the interaction of the drug molecule & the cells of the body ● Administration: How a drug enters the body. ○ Oral (Pros & Cons): Pros: easy, convenient, socially acceptable, reversible for a while. Cons: subject to first pass metabolism, dose can’t be accurate b/c there are a lot of factors affecting absorption, can be hard to swallow large pills ■ First Pass Metabolism: Some of the drug absorbed from GI tract is immediately metabolized as it goes by enzymes in the liver before it even makes the 1st pass around the body to be absorbed. You wouldn’t get the effect of a substantial portion of the dose ■ Prodrugs: Something that will be turned into an active drug in your stomach but won’t be active otherwise. It’s not a drug until your stomach changes it into one ○ Inhalation (Pros & Cons): Pros: fastest route to the brain, fairly easy once learned. Cons: some drugs can’t be inhaled b/c the lungs are somewhat fragile, dose could be difficult to control b/c some will be left on tongue & it depends how deeply you inhale. ○ Rectal (Pros & Cons): Pros: can be administered when patient is vomiting, or can’t or isn't willing to swallow. Cons: sensitive tissues involved. ○ Injection (Pros & Cons): Pros: good control of dose, there aren’t any absorption obstacles b/c it goes directly into your blood. Cons: it’s not reversible, it’s the riskiest w/ the highest risk of infections, etc. ○ Topical (Pros & Cons): Pros: easy to apply/administer to the affected area. Cons: not good at distributing around the body. ○ Through Mucous Membranes (Pros & Cons): Pros: Fairly quick absorption. Cons: Not well distributed. ■ Sublingual: under the tongue ■ Buccal: held in cheek ■ Intranasal: sprays or snorting ● Absorption into Bloodstream & Factors Affecting It: The drug entering the bloodstream ○ FoodDrug Interactions Affecting Absorption: Sometimes the presence or lack of food in your body affects absorption. For some drugs, having food in your stomach will slow down absorption. For others, having food in your stomach will speed up absorption & prevent you from getting an upset stomach. There are some foods that interact w/ certain drugs. For example, grapefruit juice, diary affecting some antibiotics, etc. ○ The Grapefruit Juice Effect: Grapefruit juice increases absorption of antihistamines, codeine, tranquilizers, cardiovascular, AIDs drugs, & other drugs. More of the drug will get into your system, which could lead to accidental overdose. ● Distribution & Factors Affecting It: The blood being moved around the body by the blood. ○ Membrane Barriers ■ BloodBrain Barrier: Excludes or slows entry of many drugs into the brain. It’s the single most effective limitation to the distribution of drugs in the body. Drugs that are fatsoluble are able to pass through (so psychoactive drugs make it through). ■ Placental Barrier: Excludes some large molecule chemicals but does NOT exclude psychoactive drugs. Generally speaking, whatever the drug level is in the mother will be the same or similar in the baby. Drug Action (See Neurotransmitter Section) = Pharmacodynamics ● Metabolism ○ By Liver: Drug may be “biotransformed” or metabolized by the liver, & then excreted by the kidney. This is the most common reason a drug effect comes to an end. The liver turns it into a form that your kidneys can filter out of your blood & send it out in your urine. ○ CYP P450 Enzymes & Why They’re Important to Know About: Families of enzymes found in the liver & GI tract lining. They metabolize (break down) lots of chemicals. Different subfamilies handle different drugs. Affecting these enzymes will affect drug metabolism. Some drugs increase these enzymes so drugs get metabolized faster or slower. You may never get the therapeutic benefit you need, b/c of absorbing too much or too little of the drug. CYP effects cause lots of drugdrug interactions & some interactions may be serious or even fatal. The more we learn about the CYP enzymes, the more we can avoid these potentially dangerous changes in metabolism of drugs. ○ At the Site of Drug Action: Sometimes the chemical is broken down at the site of drug action, before it can be eliminated by anything. ● Elimination ○ By Kidney: Drug may be “biotransformed” or metabolized by the liver, & then excreted by the kidney. This is the most common reason a drug effect comes to an end. The liver turns it into a form that your kidneys can filter out of your blood & send it out in your urine (above). ○ Other Routes of Elimination: Sweat, breath, feces, breast milk, etc. Drug HalfLife & How to Calculate How Much Drug is Left in Body at Different Times: The time it takes for ½ of the available drug to be eliminated from the body, as measured by a 50% drop in blood levels. Usually after about 6 halflives, the drug is basically out of your system. Alcohol is the exception to this rule, which is metabolized at a steady rate regardless of the concentration. DoseResponse Relationship & the Ways It’s Graphed: Graphic representation relating the amount of drug administered to the response produced. It’s for one particular drug effect (all drugs have multiple effects). The further apart the 2 curves are (one for therapeutic effect & one for lethal dosage), the safer the drug is. Threshold Dose: the lowest possible dose of a drug necessary to elicit a measurable effect Maximum Effect Peak or Plateau: the maximum effect of a drug. Administering more drug will not make you feel any more of an effect. Potency: related to the dose of drug required to produce a particular effect Efficacy or Effectiveness: related to the maximum possible effect obtainable from a particular drug. Effectiveness is far more important than potency in most cases. Drug companies will often try to impress you w/ the term “potency.” Median Effect Dose (ED50): The amount of drug necessary for 50% of the population to receive the desired effect. Lethal Dose (LD50): The amount of drug necessary for 50% of the population to die as a consequence of taking that dose. Safety Margin (LD1/ED99): LD1, being the smallest amount of the drug known to kill a person, & ED 99 being the dose that is shown to be effective for 99% of people. The higher LD1 is than ED99 the safer the drug, b/c you will not have to get near the lowest known lethal dose in order to achieve a therapeutic effect. Things that Can Change the DoseResponse Relationship ● DrugDrug Interactions: Having more than 1 drug in your system can change the experienced effects ○ Additive Interactions: (1+1=2) Effects of 2 analgesics in Excedrin add together. Like ibuprofen & aspirin together ○ Potentiating Interactions: (0+1=2) Tagamet, Zantac, birth control pills, or erythromycin can potentiate (strengthen) sedative effects of benzodiazepines like Xanax. You might not expect it, b/c they’re such different kinds of drugs, but it happens. ○ Synergistic Interactions: (1+1=3) Taking alcohol & another depressant can lead to more than the sum of their effects (synergism). Like alcohol & sleeping pills together ○ Antagonistic Interactions: 1 drug canceling out the effectiveness of another drug. Smoking (tobacco or cannabis) can decrease the effectiveness of a wide range of medications b/c the liver is working harder. There’s an antidote drug you can give for someone who overdosed on a pain medication. This interaction can be live saving. ○ Alteration of Side Effects: Basically, you might get different side effects b/c of more than one drug being in your system. Like taking alcohol & aspirin increases stomach upset. ● DrugFood Interactions: Discussed above, the most wellknown being grapefruit juice. ● Tolerance: Progressively decreasing drug effects due to regular, repeated administration. ○ Metabolic Tolerance: Liver actually increases the amount of enzymes that metabolize that particular chemical b/c it’s coming in contact w/ it so much. ○ CellularAdaptive or Pharmacodynamic or Tissue Tolerance: The cells at the drug’s site of action adapt to the presence of the drug. ○ Behavioral or Conditioned Tolerance: Learning/conditioning leads to decreased drug effects. ○ CrossTolerance: Becoming tolerant to one drug may make you tolerant to other chemically related drugs ○ Tolerance v. Dependence ■ Physical Dependence: Body physically adapts to, & (to a certain extent) compensates for the regular presence of the drug. Your body & brain try to keep you normal. ● Abstinence or W/drawal Symptoms: Evidence that there is dependence is that the user experiences withdrawal symptoms or “abstinence syndrome” if drug is not administered. Most withdrawal symptoms are the opposite of the drug effect, b/c the drug isn’t there to bring them back to “normal.” ● CrossDependence: If you are dependent on one drug, a chemically related drug may also satisfy cravings/diminish withdrawal symptoms. Desired Effect v. Side Effects Every drug has multiple effects, but we consider all effects but the desired effects side effects. ● Adverse Reactions: Potentially serious side effects. ○ Allergic Reactions/Hypersensitivity: An allergic response to a drug, usually (but not always) after the person has become sensitized to it. May cause rash, swelling, fever, or in the worst cases, anaphylactic shock. ■ Anaphylaxis: A potentially life threatening medical emergency. Symptoms include: tingling lips & mouth, flushing of face or body, itchy eyes, nose, face, hives, eyes & face swelling, wheezing, weakness or dizziness, throat swelling closed, low blood pressure, cardiac arrhythmia, loss of consciousness, & possible death. Epinephrine is the lifesaving medicine, delivered by an EpiPen. ● Idiosyncratic Response: Rare, unpredictable, highly individual response to a drug. The user may be at the extremes of the doseresponse curve or may exhibit unusual physiological or behavioral responses to the drug. Drug Names ● Chemical: Describes molecule. Usually super long. ● Generic: Official, nonproprietary. No one owns it. It’s what we call the chemical compound. ● Brand: Owned by a company. Might be the way you know the drug. ● Street/Popular: Users might use these names. Vary a lot from place to place, & time to time, & aren’t very constant. ● Generic v. Brand Name Equivalence ○ Chemical & Biological Equivalence: The active ingredient must be biologically & chemically equivalent. This doesn’t mean they’ll be clinically equivalent. It’s hard to tell if you’ll experience the same effect, especially considering placebo effect. Central Nervous System (CNS): The brain & spinal cord. Peripheral Nervous System (PNS): All the nerves that are outside the brain & spinal cord. Virtually every drug will have some kind of effect on the peripheral nervous system. ● Somatic Nervous System: Motor & sensory nerves (help us move & sense things). Not many drugs will affect those nerves, except cocaine being applied topically acts as an anesthetic. ● Autonomic Nervous System: Involuntary or unconscious nerves, to regulate the functioning of organs (like, you don’t have to think about your heart beating for it to beat). ○ Sympathetic Division: “Fight or Flight” Nerves that turn on a lot of arousing body reactions so you can fight or flee. Prepares you for any situation where your body will be more active. ○ Parasympathetic Division: Most active when you’re just chillin’. Digesting, keeping mouth wet, mostly pretty calm maintenance functions. Keeps you sitting upright in your chair. Calming as opposed to arousing. Brain Areas to be Familiar W/ to Understand Drug Effects: ● Medulla: Lifesustaining & lifeprotecting reflexes. Overdose death usually due to drug action in the medulla, interfering w/ regulation of breathing or cardiovascular function. ● Reticular Formation or Reticular Activating System: Arouses brain for normal waking & consciousness. Sometimes called reticular activating system. Sends messages to the upper parts of the brain. ● Cerebellum: Motor coordination & balance. Drug action on cerebellum may cause slurring, stumbling, loss of balance. ● Hypothalamus: Drug action in hypothalamus affects appetite, hormone levels, sexual function, autonomic & instinctive emotional responses. ● Limbic System: Emotional Control System. Recognizing emotions, showing emotions, feeling emotions, & has an effect on memory. ○ Reward/Pleasure System: Bundle of dopamine (DA) neurons from midbrain through hypothalamus & nucleus accumbens, then on to cortex & limbic system. It’s active when you do something “good for your survival.” ○ Nucleus Accumbens: One of the key hubs of this system. ● Basal Ganglia: Initiating voluntary movements & keeping undesired movements in check. Involved in initiating voluntary action & controlling unwanted movements that might interfere w/ what we want to do. ● Cortex: The site of all of our higher functions. Drug action here affects judgment & reasoning, selfcontrol, sensation/perception, contact w/ reality. Neuron or Nerve Cell ● Dendrites: Message receiving part of a neuron. ● Cell Body or Soma: Integrates all those individual messages coming into dendrites. Sometimes called soma. ● Axon: Single outgoing branch. Message sending part. ○ Axon Terminals: The end of the axon branches where the neurotransmitters are actually sent out. ● Synapse ○ Synaptic Vesicles: The neurotransmitters must be stored here in order to protect them. ○ Synaptic Gap: The gap between terminal buttons & the next dendrites. ○ Neurotransmitters: The chemical used to send the message. ○ Receptors: The structures on the receiving neuron that neurotransmitters attach to. ○ Presynaptic Membrane (axon): Where the neurotransmitters are sent out. ○ Postsynaptic Membrane (dendrite): Where the neurotransmitters are picked up. Ways of Clearing Up Released Neurotransmitters ● Reuptake: like recycling. Some of the molecules of the neurotransmitters that weren’t used are saved for later use. They’re taken back to the axon ending. ● Enzymatic Breakdown: Enzymes break down the remaining chemicals. Best Known Transmitters & Their Best Known Locations/Functions ● Acetylcholine (ACh): Neurons using ACh = cholinergic neurons. Found in nerves to skeletal muscles (you would be totally paralyzed without them), the parasympathetic NS, & learning & memory areas of brain. ● Norepinephrine (NE): Found in the sympathetic NS & brain areas involved in appetite, arousal, mood. Very close chemical relative to DA. ● Dopamine (DA): Involved in our reward & pleasure systems. ● Serotonin (5HT): Found in the sleep & pain suppression areas of brain, the limbic system (mood), & in sensory processing areas (vision, hearing, touch, etc). 5HT blockers are used to decrease nausea (like for chemo). ● GABA: Best known inhibitory transmitter (when it crosses the synapse, it tells the next neuron to stop firing, or to diminish firing). If you are born w/ not enough GABA, you may suffer from seizures, anxiety, etc. b/c of excessive neuronal activity. Widely known in the CNS. It’s an amino acid type transmitter. ● Glutamate: Amino acid which acts as an excitatory transmitter almost everywhere in the CNS (kind of like the opposite of GABA. It excites the next neuron instead of calming it down). ● Endorphins: Family of transmitters which decrease pain perception & elevate mood. Narcotic analgesic drugs (like our pain killers) act on endorphin receptors. Agonist Action: A drug that triggers or increases the usual synaptic effects of a transmitter. For example: a drug which fits postsynaptic receptor sites & MIMICS action of transmitter. Antagonist Action: A drug prevents or decreases the usual synaptic effects of a transmitter. For example: A drug which fits receptor site by doesn’t trigger a response. This drug is a blocker.
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