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• Rewarding effect of nicotine is
associated with ventral tegmental area
(VTA) where there are nAChR on
dopaminergic neurons.
Abstinence
syndromeirritability
insomnia
Nicotine is
very
addictive.
nAChR that contain α4β2
component are especially
important for the rewarding
effect of nicotine.
DEFAULT STYLES 04
Nicotine
– Partial agonists of α4β2
nAChR: citizine and
varenicline.
– Bupropion!
– Cognitive and behavioral
therapy.
05
Treatment
Benzodiazepines and
barbiturates• Benzodiazepines are safer than
barbiturates.
• Physical addiction on benzodiazepines
is very common.
• Abstinence syndrome: irritability,
insomnia, phonofobia, photofobia,
depression, muscle cramps and
convulsions.
Alcohol
Alcohol modulates function of several
receptors and cell functions:
• GABAa receptors
• Kir3/GIRK channels
• return entry of adenosine
• glycine receptors
• NMDA receptors
• 5-HT3 receptors
Alcohol
• Physical addiction becomes evident
after 6-12 hours of heavy drinking
cessation.
• Abstinence syndrome: tremor (mostly
hand tremor), vomit, nausea, excessive
sweating, agitation and hearing
hallucinations 12 to 24 hours after
drinking cessation.
Alcohol
• Generalised convulsions can appear 24
to 48 hours after drinking cessation.
• After 48 to 72 hours delirium tremens
can appear: patient is disoriented,
hallucinates and there is autonomic
instability.
• Mortality rate of delirium tremens
is 5-15%.
Treatment
Treatment of alcoholabstinence syndrome is basedon lorazepam and oxazepam.
Psycho-social approach is veryimportant.
Ketamin and phencyclidine
Ketamin and phencyclidine are non competitive antagonists of NMDA receptors.
Psychedelic affect lasts for about an hour.
They do not cause addiction.
Chronic abuse can cause permanentpsychosis similar to schizophrenia.
Inhalant drugsNitrates, ketones and aromatic
hydrocarbons: sniffing, huffing or bagging.
Most of inhalant drugs create euphoria: for example, toluene
causes increase in VTA excitability.Amyl nitrate (poppers) cause
smooth muscle relaxation andimprove erection.
VTA: ventral tegmental area
Inhalant drugs
They have toxic affect on many organs.
They cause lesions of white matter in central nervous system.
Treatment of overdose is supportive.