Cocaine

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Where is Cocaine derived from?
The leaves of the shrub Erythatoxylon coca which is indigenous to northern and central Andes Mountains of South America
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What is the structure of cocaine HCL?
Cocaine HCL is readily water soluble and thus can be taken orally, intranasally or by HIV injection
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What is one disadvantage of Cocaine HCL?
Its vulunerability to heat induced breakdown, thereby preventing it from being smoked
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What can hydrochloride salt be?
Transformed back into cocaine freebase by mixing it with baking soda, heating the mixture and then drying it
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What are the chunks of dried, hardened mixture known as?
Crack
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What is the best and worst way of taking cocaine?
Intravenous is the best way and smoked is the worst way
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What does cocaine do the several neurotransmitter system?
Most of the behavioural and physiological action of cocaines can be explained by its ability to block the reuptake of three monamine neurotransmitters: dopamine, norephinerphrine and serotonin
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What happens to the neurotransmitters?
They are cleared from the synaptic cleft by the membrane proteins called transporters
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What does cocaine do?
Inhibits the transporters function
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What does inhibition lead to?
An increased neurotransmitter levels in the synaptic cleft and a corresponding increase in transmission at the affected synapses
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What did Yorgason report?
Intravenously administered cocaine in rats begins to block DA uptake within 5 seconds with peak inhibition occuring approximately 30 second post injection
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What did Ritz et al suggest?
Drugs in the treatments of depression block the 5HT, followed by the DA transporte and then the NE transporter
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What does cocaine additionally inhibit?
Voltage-gated sodiu channels in nerve cell axons. As these channels are necessary for neurons to generate action potentials, this actions of cocaine causes a block of nerve conductions
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What happens when cocaine is applied locally to a tissue?
It acts as a local anesthetic by preventing the transmission of nerve signals along sensory nerves
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What is made from cocaine?
Two synthetic local anesthetics that are widely used in medical and dental practice, procaine and lidocaine were developed from the structure of cocaine
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What are acute effects of cocaine?
The pleasurable feelings associated with the high serve as a reinforcer causing many users to use the drug repeatedly
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What are typical aspects of cocaine?
'high' are feelings of exhilaration and euphoria, a sense of wellbeing, enhance alertness, heightened energy and diminished fatigue and great self confidence
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How is it taken?
Taken by IV injection or by smoking, cocaine also produces a brief 'rush' described by some users as involving a sense of great pleasure and power and by others as being an intense organsm
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What happens at low and moderate doses?
Cocaine often increases sociability and talkativeness
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What can cocaine do?
Increase sexual interest, performance, aggression
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What are aversive effects?
Irritability
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What is cocaine considered as?
Sympathomitmetic drug
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What does it produce?
Symptoms of sympathetic nervous system activation
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What are the phsyiological consequences of acute cocaine administraton?
increased heart rate, vasoconstriction and hypertension, hyperthermia
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what happens at low doses?
Physiological changes are usually not harmful to the individual
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What are the risks of heavy cocaine use?
Seizures, heart failure, stroke, intracranial hemorrhage
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What can cocaine do?
Interrput blood flow to the brain and this phenomenon is exacerbated with repeated drug dosing
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what can experimental cocaine do?
Escalate over time to a pattern of cocaine abuse and dependence
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What do some individuals report?
Some individuals report strong anxiety response as their initial reaction to cocaine and are thereby dissuaded from further experimentation
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What do other factors mitigate against the development of a long term abuse pattern?
The unavailability of the drug, the cost of maintaining a steady supply, the social and legal consequence of using illicit drugs, very real fear of losing control over ones drug taking behaviour
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How many already meet criteria for cocaine dependence within 24 months after first use?
5%
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What can occur?
Cocaine binges can occur, episodic bouts of repeated use lasting from hours to days with little or no sleep. during these periods, nothing is important to the user except maintaining the high and all available supplies of cocaine are taken
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What are the three stages?
Crash, withdrawal, extinciton
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What is the crash phase?
Depressive episode
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What is the withdrawal phase?
Adhendonia (cant feel normal experiences), anergia (lack of energy), anxiety and growing craving for cocaine
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What is the incubation for cocaine us?
Cocaine craving and relapse to cocaine use actually increases over time following withdrawal from drug use
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What did Beveridge et al find?
Effects on the prefrontal cortex with repeated cocaine exposure
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What do Animal models have?
Supported the hypothesis that both sensation seeking and impulsivity are traits that contribute to the development of compulsive cocaine us
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What can Chronic exposure to cocaine lead to?
Tolerance or senstization. Changes in drug responsiveness depend on the pattern of the drug exposure the outcome measure and the time since the last dose
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What have animal studies done?
Implicated increased dopaminergic activity in the VTA and increased nucleus accumbens DA release as being important for locomotor sensitixation to pyschostimulants
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In contrast?
human cocaine dependent subjects show reduced DA release in the striatum compared to control subjects
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However, what is this consistent with?
Evidence for tolerance to the drugs euphric effects over time, thus leading to increased drug taking behaviour by these individuals
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What has much effort in the area of treating cocaine abuse has been focused on the development of medications?
Might reduce craving and promote abstinence among users
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What do these medications act on?
DA system
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Where as other do what?
target serotonin, glutamate and GABA systems
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What are two current drugs of interest?
Modafinil and disulfiram.
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What are under experimental and clinical development?
Anticocaine vaccines
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What can also be offered for cocaine addiction?
CBT, relapse preventation 12 step programs like narcotics anonymous and cocaine anonymous and contingency management programs based on a combination of vouchers and community reinforcement
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What can these help reverse?
Devastating effects of cocaine on our society
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Card 2

Front

What is the structure of cocaine HCL?

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Cocaine HCL is readily water soluble and thus can be taken orally, intranasally or by HIV injection

Card 3

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What is one disadvantage of Cocaine HCL?

Back

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Card 4

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What can hydrochloride salt be?

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Card 5

Front

What are the chunks of dried, hardened mixture known as?

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