Drugs & Individual Behavior Class Notes - Week 6
Drugs & Individual Behavior Class Notes - Week 6 PSYCH 3102
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This 6 page Class Notes was uploaded by McKenna Keck on Thursday September 29, 2016. The Class Notes belongs to PSYCH 3102 at University of Northern Iowa taught by Dr. Linda Walsh in Fall 2016. Since its upload, it has received 25 views. For similar materials see Drugs and Individual Behavior in Psychology at University of Northern Iowa.
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Date Created: 09/29/16
Drugs & Individual Behavior Week 6 Tuesday September 27, 2016 Continued discussion on alcohol… Watched videos about effects of alcohol on the body, specifically on driving. ○ Loss of Judgment & Self Control ■ Cognitive inhibition & disinhibition of behavioral/emotional control is a dangerous combo ■ Alcohol is involved in: ● 50% of police arrests ● 5060% of murders ● 40% males committing sexual assault ● 6070% males committing domestic abuse ● 60% of child molestation & abuse ● 35% of suicides ○ Metabolism ■ In males, about 15% of alcohol can be metabolized in stomach before it’s even absorbed; women may have half as much metabolized here. ● There are other things besides gender that play a role, for example, ethnicity can. ■ The rest is metabolized in liver about 1 standard drink/hr by a healthy liver ● Alcohol dehydrogenase (enzyme in liver) converts alcohol into acetaldehyde, a rather nasty byproduct (toxic substance that our liver must also metabolize. Contributes to hangover symptoms). ■ Aldehyde dehydrogenase breaks down acetaldehyde into acetic acid ■ Acetic acid is oxidized into oxygen, carbon dioxide, & calories ■ Why Do We Experience Hangovers? ● Miniwithdrawal from alcohol (rebound hyperexcitability) ○ Like the shakes, being easily overwhelmed by light, etc). ● Toxic reaction to congeners (a slew of different chemicals that are a byproduct of the way the alcoholic beverage was produced. For the most part, they’re naturally occurring, but they could be synthetic) ○ Other alcohols, oils, & organic substances added or formed during the production of an alcoholic beverage ○ Congeners give these beverages their distinctive color, odor & taste ○ Congeners are 1 of the factors influencing hangover ○ Highest in congeners: bourbon, scotch, brandy, tequila, red wine, dark beers. Lowest: vodka, gin, white wine. ● Toxic reaction to alcohol & its byproduct acetaldehyde ● Fatigue, dehydration, hypoglycemia, loss of vitamins, etc. due to partying ■ Nearly 31,000 Americans die each year from the adverse effects of alcohol on their health. Almost half of these deaths due to cirrhosis of liver. ○ Health Risks of Chronic Heavy Drinking ■ Nervous system dysfunction & brain damage affecting memory, motor function; alcoholic dementia ■ Fatty liver; alcoholic hepatitis; cirrhosis ■ Impaired reproductive functioning (alcoholic impotence, suppression of ovulation, etc.) ■ Gastritis pancreatitis ■ CoCarcinogen increasing risk of oral, throat, stomach, intestinal, liver & possibly breast cancers. Increases cancer risks of smoking. ■ Impaired immune function. ■ Fetal Alcohol Spectrum Disorders ● 2,600,000 alcoholexposed US babies/year! ● May be subtle or severe depending on degree & timing of exposure ● 3rd most common cause of birth defects, retardation & learning disabilities (and the most preventable) ● Seen in 3050% babies born to alcoholic mothers, but symptoms may also be seen w/ as little as 2 drinks twice a week. ● Binge drinking particularly damaging ● Partial symptoms = FAE or ARND ○ Babies are usually smaller than usual (less than 5lb) ○ Smaller heads, smaller brains ○ The brains are typically very abnormally developed ○ Nervous system affected ○ Sometimes facial structure changed… still cute, but very consistent ■ Alcohol Poisoning/Overdose ● Symptoms: ○ Stuporous or unconscious; can’t be roused ○ Cool or damp skin; pale or bluish skin ○ Shallow slow or irregular breathing <8/min ○ Vomiting while unconscious ○ Weak rapid pulse ● Can be fatal or cause brain damage call 911 ● 30,000 college students/yr treated for alcohol overdose untreated, many die ● On average 6 deaths/day in US due to alcohol poisoning ■ You don’t have to “look” like an alcoholic to be at risk for these health consequences. Men who drink 15 or more drinks a week , & women who drink 8 or more drinks a week are susceptible. ○ Alcohol Withdrawal ■ Without the depressant you are overstimulated by the “hyperexcitability rebound” ● Tremors ● Agitation, anxiety ● Insomnia if you do sleep, vivid nightmares ● Sweating, nausea, vomiting ● Increased HR & BP ● Alcoholic hallucinosis ● Grand mal seizures in about 10%, usually 1248 hrs after last drink but may be sooner if susceptible ● For some, these early symptoms worsen ■ Pharmacological Aids to the Treatment of Alcohol Abuse ● During Detox: ○ Use of another depressant (a benzo like Librium, Ativan, or Valium or another anticonvulsant) to gradually withdraw individual & to try to avoid seizures (gradual is easier than cold turkey) ● After Detox ○ AntiRelapse: ■ AlcoholSensitizer Antabuse (disulfiram) (Ethanol is metabolized into acetaldehyde, but not into acetate) ■ Various anticravings Drugs ● Narcoti c antagonists: Revia (naltrexone) blocks opiate receptors, so if you did drink, you wouldn’t get the pleasurable effects due to the release of endorphins both oral & extended release injection available ● Campr al (acamprosate) helps restore GABA balance & blocks glutamate ● Antide pressants (most of the SSRIs) antidepressant, antianxiety effects ● Antico nvulsant mood stabilizers (topiramate, valproate, gabapentin) are looking promising ○ These should be combined w/ meetings and/or psych interventions Thursday, September 29, 2016 Stimulants ● Stimulants: Drugs which stimulate brain, body, & behavior ○ BUT: Don’t all act by a common chemical mechanism. NOT a pharmacological family like depressants. ● Psychostimulants or Monoamine Stimulants or Controlled Stimulants ○ These on the Schedule of Controlled Substances ○ Amphetamines ■ History ● Developed as a synthetic substitute for ephedrine (1927) ● Was sold as OTC asthma inhaler Benzedrine ● Pep pills used worldwide during WWII; still used by armed forces today ● Became a prescription drug in 1965 because of growing abuse, then a “Controlled Substance” in 1971; new wave of meth popularity began in 1990s ■ Basic Amphetamines ● Molecules come in right (dextro or d) & left (levo or l) handed varieties or isomers ○ Right handed one fits our brain better ● Benzedrine was a mix (d, l amphetamine) (550 mg); today’s Adderal is also such a mix ● Dexedrine is damphetamine & is more potent (220 mg) ● Methamphetamine crosses BBB even better ○ Adding the methyl causes it to cross the blood brain barrier even faster. ● “Freebased” dextromethamphetamine (ice or crystal) is smokeable crystals like crack, but much longer acting. ■ Amphetamine’s Action ● Amphetamines make DA & NE more available at synapses by triggering their release & decreasing reuptake. ■ Medical Uses for Amphetamine & AmphetamineLike Drugs ● Treatment of ADHD & its variations, including in adults ○ The stimulant causes in increase in cortical activation, which allows the individual to better use their frontal lobe to control their behavior.] ○ Improve behavior in 7080% of those correctly diagnosed; one of the most welldocumented pharmacotherapies more effective than intensive behavioral therapy, but not a “cure” ■ First Generation Drugs ● Ritalin methylphenidate (halflife 24 hrs) ○ T echnically not an amphetamine, but very similar. ● Addera l a mix of d & l amphetamine salts ● Dexedr ine damphetamine ● Must be taken more than once a day for sustained effect. Kids had to take a 2nd dose at school. ■ New LongActing Varieties With a Variety of TimeCourse Profiles ● Long list, we don’t need to know. ● Started with pill, a transdermal patch, & a liquid form. ○ ADHD Treatment Risks ■ Stomach ache, headache, jitters, dizziness, especially at first ■ Appetitesuppression; delayed sleep onset ■ Growth reduction possible; motor tics in 1% ■ Rare heart attacks, strokes, sudden death in some ■ Kids may not receive adequate assessment & followup, but data suggest under prescription more common than overprescription ■ Nonamphetamine alternative treatments. Thought to be safer, but data suggests they aren’t as effective. ● Stratter a (atomoxetine) ● Antide pressants (less effective than stimulants) ● Etc. ● Treatment of Narcolepsy, ShiftWork Sleep Disorder, Daytime Sleepiness of Sleep Apnea ○ Amphetamines have been used to maintain wakefulness ○ Newer nonamphetamine psychostimulant available: ■ Provigil… Doesn’t seem to have the same risk of being abused ■ Nuvigil just the “righthanded” form of modafinil rather than a mix of R & L ● Controversial Use ○ Shortterm adjunct to weightloss programs multiple drawbacks means it should only be considered for obese facing serious health risks. ■ Health risks, tolerance, potential dependence & rebound weight gain limit usefulness ○ Prescription amphetaminelike appetite suppressants (they keep getting removed from the market because of health risks) *Some lines of notes copied directly from slides in order to maintain testing accuracy. Most is of the lecture & discussion, not found on slides.
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