Advanced Psychopharmacology

Week 11 Note-taking Tool

Stahl

1. How are impulsivity and compulsivity hypothesized to be regulated in the brain?
2. Which neurotransmitter is implicated in all drugs of abuse?
3. What qualities of a drug make it more reinforcing?
4. In stimulant addiction, what is the difference between therapeutic actions and reinforcing actions?
5. What is the neurobiological explanation of drug-seeking behavior?
6. What is dopamine’s role in later stages of addiction?
7. What is the mechanism of action of varenicline and how does it help with nicotine addiction?
8. What is the proposed mechanism of action of bupropion in smoking cessation?
9. How does alcohol impact dopamine circuits?
10. How does naltrexone work to reduce craving and alcohol use?
11. What is the mechanism of action of acamprosate?

Supplemental Materials

Neurobiological Advances of from the Brain Disease Model of Addiction

1. How are learning and memory formation associated with the binge/intoxication stages of addiction?
2. Explain the anti-reward system and its implications in withdrawal and negative affect.
3. How does impaired signaling of dopamine and glutamate in the prefrontal regions of the brain affect executive functioning?
4. What are the symptoms of intoxication and withdrawal for the following drugs of abuse?
   1. Cocaine
   2. Amphetamine
   3. Opioids
   4. Sedative hypnotics
   5. Alcohol
   6. Nicotine
5. Describe the neuroscience of alcohol dependence.
6. Which of the above drugs of abuse in Question 1 have the potential for lethality in states of intoxication?
7. Which of the above drugs of abuse in Question 1 have the potential for lethality in withdrawal states?
8. What are the FDA approved treatments for substance use disorders?
9. Describe recommended treatments for the following:
   1. Opioid withdrawal
   2. Nicotine withdrawal
   3. Alcohol withdrawal
   4. Stimulant withdrawal
10. Describe the recommended treatments for maintaining abstinence from the following:
    1. Opioids
    2. Nicotine
    3. Alcohol
11. Identify the important prescribing information for all medications used in the withdrawal and maintenance stages of substance treatment. For example:
    1. When in treatment, should buprenorphine be administered?
    2. What are the treatment guidelines for prescribing buprenorphine?
    3. What is the identified as the preferred treatment for opioid maintenance?
    4. Which withdrawal symptoms does clonidine treat?
    5. What are the safety issues, if any, with recommended treatments for substance use disorders?
12. What is cross addiction and how can it be avoided?

Understanding the Concepts
Review the Learning Materials for the week and be able to answer the following:

1. Review the neuroscience of addiction.
2. Review the behaviors and addiction regarding dopaminergic neurons.
3. Review the neurobiology of impulsivity and compulsion regarding the orbital prefrontal cortex.
4. Review the anti-award system in substance abuse.
5. Review the purpose of the CIWA and COWS.
6. Review the guidelines for administering Buprenorphine.
7. Review which drug is the preferred treatment for opioid maintenance therapy.
8. Review glutamate and MDA receptors in alcohol addiction.
9. Review medications that facilitate a safe detox from alcohol.
10. Review medications administered for nicotine replacement when in nicotine withdrawal.