Addiction
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What is the NT and function of the prefontal cortex?
glutamine • executive control over midbrain structures • judgement and cost benefit analysis
What is the function of the ventral tegmental area
location of dopamine cell bodies projects to nucleus accumbens - reward center projects to prefrontal cortex - executive control
What is the function of the nucleus accumbens
integrates VTA and PFC -reward center
What does the dorsal lateral prefrontal cortex do as a whole? how is it affected in addiction?
top down control - prioritizing -not functioning as well in addiction
What is the function of the ventral medial prefrontal cortex
assigns emotional valience • well thought out emotional decision • cooperates with amygdala which assigns an emotional value to something
what is the function of the orbital frontal cortex and how does it function in addiction?
prevents impulsive decisions hypofunctioning
what is the function of the anterior cingulates? how does it function in addiction?
vigilance hyperfunctioning - scheme to get more beer, more drugs
How are the functions of the D3 and D2 receptors different?
D3 - static levels of DA - energy D2 - pulsatile - reward
How does the limbic system and PFC circuits change in addiction?
increased limbic system circuitry decreased PFC circuitry
Is pharmacotherapy or counseling preferred for treatment for addicts?
combination of BOTH -addiction is not at a conscious level which would be targeted by counseling
What is the mechanism of benzos in the brain?
increase GABA receptors - allows for more hyperpolarization with chloride
What are the symptoms of alcohol intoxication?
anxiousness, disinhibition, slurred speech, ataxia, sedation, respiratory suppression, coma and death
When do withdrawal symptoms from benzos and alcohol appear and peak? what is the first symptom?
appear at 8 hours, peak at 24 first symptom is dry heaves
what are the symptoms of withdrawal from alcohol and benzos?
agitation, insomnia, tremor , GI upset inc pulse and HR, inc Bp seizures hallucinations, delirium and death
What is the treatment for intoxication with benzos and alcohol?
support, restraint, protect airway, ventilate benzos: reversal with flumazenil
what is the treatment for withdrawal from benzos and alcohol
benzos until symptoms normalize -usually lorazepam
What are the symptoms of stimulant intoxication?
inc mood and irritability, insomnia, appetite loss dilated pupils, inc HR, BP, Temp vasospasm, hyperreflexia, psychosis, cardiac arrest
What is the treatment for stimulant intoxication
support and specific meds that reverse specific intoxication symptoms
What receptors do opioids target?
mu receptors
What are the symptoms of opioid intoxication?
elevated mood, inc HR, low BP, resp suppression loss of gag reflex constipation and pupil constriction flat and unrelated (essentially blocking Ach so anticholinergic effects)
what is the treatment for opioid intoxication?
support and protect the airway naloxone or narcan to reverse
What are the symptoms of opioid withdrawal?
agitation, restless, flu symptoms, flushing dilated pupils inc HR, BP, GI distress
What is the treatment for opioid withdrawal?
methodone - full agonist replacement buprenorphine - partial agonist replacement
What is the only drug to produce horizontal nystagmus?
PCP - a hallucinogen