Pharmacology of Substances Flashcards

MDMA (ecstasy) primarily exerts its psychoactive effects by causing massive release and reuptake inhibition of:

Answer: Serotonin primarily, with dopamine and norepinephrine also affected

MDMA primarily causes a massive release of serotonin (5-HT), along with dopamine and norepinephrine, which accounts for its empathogenic, stimulant, and hallucinogenic properties.

A client reports using inhalants regularly. The counselor should be most concerned about which acute life-threatening complication?

Answer: Sudden Sniffing Death Syndrome due to cardiac arrhythmia

Sudden Sniffing Death Syndrome can occur even on a first use of inhalants, when catecholamine surge sensitizes the heart to arrhythmias, leading to sudden cardiac death.

Tolerance to opioids develops MOST rapidly with which effect?

Answer: Analgesia and euphoria

Tolerance develops rapidly to opioid analgesia and euphoria, while constipation and miosis show minimal tolerance—explaining why long-term users remain constipated.

Which statement BEST describes the pharmacokinetic difference between crack cocaine and powder cocaine?

Answer: Crack cocaine is smoked, reaching the brain faster and producing a more intense but shorter high

Smoking crack cocaine delivers the drug to the brain in seconds via pulmonary absorption, creating a rapid, intense rush that dissipates quickly, reinforcing compulsive redosing.

A client prescribed buprenorphine reports precipitated withdrawal after their first dose. This MOST likely occurred because:

Answer: The client used a long-acting opioid and was not sufficiently withdrawn before induction

Buprenorphine's high receptor affinity displaces full opioid agonists that still occupy receptors; if induction begins too early, this displacement precipitates acute withdrawal.

Gamma-hydroxybutyrate (GHB) is endogenously produced in the brain and acts primarily on:

Answer: GABA-B receptors and GHB-specific receptors

GHB acts on GABA-B receptors and specific GHB receptors, producing CNS depression; its narrow therapeutic window makes overdose particularly dangerous.

The concept of 'reverse tolerance' or sensitization is MOST associated with which substance and effect?

Answer: Cocaine and psychosis/seizure susceptibility with repeated use

With repeated cocaine use, sensitization (reverse tolerance) can develop for psychotic symptoms and seizures, meaning smaller doses can trigger these effects over time.