CHAPTER 1 DB TEXT

1) How Prevalent Is Drug Use? People of all ages, genders, races, and nationalities use
drugs. Drug use is not evenly distributed across countries; a nation’s laws, traditions,
and religious proscriptions can influence the drug use of its citizens. Other
demographic factors such as age, sex/ gender, and race also influence the type and
amount of drug used

2) In the US, men are more likely to use illicit drugs than are woman.
➢ Of those age 12 +: 12.8% M & 8.5 % F report illicit drug use in the last
month

3)High/middle school students: Hispanics = use for most legal and illegal drugs
Blacks = substantially lower usage rates
Whites = in the middle
❖ Some demographics shift in adulthood:
Asians = lowest illicit drug use rates

4)Among those 18+ = w/o high school diploma had lowest current illicit drug use rates,
followed by college students, and then high school graduates.
❖ Drug use is highest for those who attended but did not complete
college (perhaps drug use interfered?)
5)Most used drugs = alcohol, tobacco, marijuana, & nonmedical use of Rx drugs
6)Nearly 70% of US are on at least 1 Rx drug, more than 50 % take 2
7)1990-2014: spike in US pop (28%^), Rx’s went up 131%, spending on drugs ~600%
8)Each year, at least 100,000 people die from properly prescribed & administered drugs:
2M+ experience serious side effects
9)Most prescribed Rx drugs = antibiotics, anti-depressants, & pain killing opioids
10)Since 2002, people seeking help/treatment for drug abuse/dependency on Rx
painkillers has increased more than 100%
11)54 people die per day from Rx painkiller OD
12)Drug use fluctuates over time, can be due to combo of social, political, economic
factors
13)Some factors for fluctuating drug use/popularity of individual drugs: Penalties for
use(harsh?), presentation of drugs in the media (shown in pos/neg light? - impacts our
desire to use or avoid), perceived risk & accessibility (can one get the drug easily? Cost?
Risk? Local laws; lifestyle
14)Why do people use drugs? To feel pleasure (beer at a game, joint at a campfire),
avoid pain (relieve depression, anxiety, loneliness, insomnia, boredom) alter state of
consciousness (make routine seem new/interesting again, stimulate creativity) enhance
spiritual, religious, or mystical experiences (peyote, marijuana, psilocybin, alcohol),
facilitate/enhance social interactions (peer pressure, relieve anxiety, lower inhibitions),
to alter/improve the body/performance/weight loss (cocaine, amphetamines)
15)Individuals who abuse drugs for years can experience many problems. A single use
of a drug can lead to consequence.
16)When taking illegal drugs, it is hard or impossible to know how much to take or what
else may be in the substance – rely on honesty of dealer/source.
❖ Impurities, allergic reaction, infections (e.g., IV drugs), burns (e.g., snorting
cocaine), overestimate amount and OD, too much at once (10 shots at
once, snorting crushed pills not knowing the dose)
17)Some drugs increase risk of psychiatric problems like: paranoia, depression,
psychosis
18)How are drugs classified? Many ways: by their legality, illicit or not, purpose, origin.
19)Illegal drugs = drugs restricted at any level of gov or authority by laws
20)Illicit drugs = may be forbidden by laws, rules, customs but are not illegal (underaged
drinking, nonmedical use of Rx = use is illegal, drugs necessarily aren’t)
21)Recreational drugs = psychoactive substances taken for nonmedical purposes, can
be legal or illegal (Legal rec: tobacco, alcohol... Illegal rec = heroin, cocaine)
22)Drugs also named by chemical structure, therapeutic use, mechanism of action (the
way they work in the body), origin (natural: from body/plant or synthetic: lab), & what
schedule they are (how classified by fed. Gov)
23)1950’s: researchers realized many psychoactive drugs fit into receptor sites on
nerve cells (Ex: morphine(opioid) binds directly into receptors in parts of brain
controlling mood/pain)
❖ These receptors exist because our bodies produce substances that
bind/fit into them
24)Endogenous substance: produced within an organism
25)1975: endogenous form of morphine – endorphin – was discovered
26)Endorphins: neurotransmitters produced in the brain in response to pain, fear, stress.
Bind to receptors to promote analgesia: produced feelings of euphoria.
27)Anandamide: an endogenous substance that is our body’s natural form of marijuana.
Binds to receptors in brain/body that affect mood, appetite, memory, reproduction, &
immune function
28)At least 50% of meds on the market are derived from natural products: molecules
produced by living organisms for a variety of functions.
29)Many new drugs come from bacteria or fungi
30)Some substances originate from animals. Ex: BP Rx ‘captopril’ came from venom
40)Most psychoactive drugs originally come from plants
41)most times after the active substance in the plant has been identified, it is
purified/synthesized in lab
42)Morphine is a purified form of opium
43)cocaine comes from the coca leaf
44)mescaline (hallucinogen) is purified from the peyote cactus
45)Natural drugs tend to be more complex than refined/synthesized
46)THC = the main psychoactive ingredient in marijuana
47) to create a synthetic drug a chemist takes a purified form of the natural drug and
changes the chemical structure to vary the properties
48)companies develop, patent, sell synthetic drugs they have exclusive rights
$$$$$$$$$$$$
49) when a drug is first discovered it is given a chemical name = describes molecular
structure, after patent filed drug is given a. generic name (its official name/brand/trade
name)
50) generic names are not capitalized – the names often give clues to nature of drug
51)Generic drugs often less expensive than drugs under patent (same chemical formula
though)
52) Trade names are capitalized – chosen to give buyer a sense of drugs
characteristics (drugs to aid sleep often include “Z”, Paxil: pax in latin is peace)
53)Drug scheduling: classifying drugs based on their potential for abuse, med benefits
(if any), & likelihood for dependence
❖ schedule I drug is most dangerous, high abuse, no current med use
❖ Schedule V drug least dangerous, accepted medical use
❖ Schedule II drug has high potential for abuse & physical/psych harm,
some medical use
❖ Schedules III (medium risk), IV (low risk), and V(lowest) have
decreasing abuse potential & risk, medical use
54)New drugs usually come from 3 sources:
❖ rediscovery of traditional uses or various naturally occurring products
❖ the accidental observation of an unexpected drug effect
❖ the synthesis of known or novel compounds
CHAPTER 3 DB TEXT THE NERVOUS SYSTEM
1)Neurons: cells that process & transmit info to aid communication through the body;
receive & integrate vast amounts of info from outside & internal environments; change
constantly to the body’s demands, sensations, environmental influences
2)Sensory neurons: carry info into the brain & spinal cord
3) motor neurons: send signals from brain & spinal cord to muscles, nerves, glands in
order to produce a response
4)1990’s: scientists discovered the human brain does create new neurons in certain
brain areas, although most do not live long or integrate into the brain
5)Neurogenesis: the production of new neurons; occurs in bursts during 1st 3 years of
life, puberty, then young adulthood
6) learning and physical activity promote neurogenesis
7) various types of stress can suppress new neuron production
8) Neuroglia: accounts for ~90% of brain tissue, provides neurons with nutrients and
oxygen, cleans debris, protects and insulates neurons, and aid in transmission of info
9) If you look at a neuron it resembles a long wire & the neuron is designed to carry info
from one location to the next (telephone wire)
10) Neurons generate electrical signals = action potentials (travel down the axon – long
wire like)
11) neurotransmitters are released from the end of the axon and bind to receptors on
the tree like branches of the dendrites of the subsequent neuron
12) Soma = cell body
13) nucleus = within the soma; contains genes that code for proteins (ex:
neurotransmitters & enzymes)
14) axon = long wire component of the neuron; neurons have 1 axon – but can split into
many branches called “collaterals”
15) myelin = white, fatty substance; insulates the axon and speeds up electrical
transmission
16) Node of Ranvier = a gap in the myelin sheath of an axon, where action potentials are
propagated
17) axon terminal = the end of the axon, which contains vesicles of neurotransmitter;
electrical signals travel down the axon until they reach axon terminal
18) vesicles = a small sac in the axon terminal that contains neurotransmitter
molecules; little sacs contained in the axon terminals; protect the neurotransmitter from
degradation by enzymes within the nerve terminal
19) synapse = the gap between 2 nerve cells; the neurotransmitter enters the synapse
and binds to the receptors on the next neuron’s dendrites
20) dendrites = branched outgrowths from the soma, they are the main receptive
surface of the neuron
21) receptors = a protein molecule located on or in a cell, responds specifically to a
particular neurotransmitter, hormone, or drug; proteins with specific size, shape,
chemical and electrical properties are located on the dendrites
22) Action potential = the short-term change in electrical potential between the inside
and outside of a neuron that leads to transmission of nerve signals; the movement of
ions into and out of the cell create voltage change
23) at rest, the inside of the neuron is more neg charged than the outside
24) neuron stimulated = voltage-gated channels open in the nodes of Ranvier, & pos
charged sodium ions rush into the neuron
25) depolarization = become pos charged; when the charge across the neuron is
reversed; in a neuron, depolarization refers to the inside of the neuron becoming more
pos charged than inside
26) Presynaptic neuron = the neuron that releases neurotransmitter
27) Postsynaptic neuron = the neuron that the neurotransmitter effects
28) Some common neurotransmitters = dopamine, norepinephrine, serotonin,
acetylcholine, gamma-aminobutyric acid (GABA), and glutamate
29) Neurotransmission involves several steps
❖ 1) at the start of neurotransmission, the neurotransmitter is produced &
packaged into vesicles, which are stored in the axon terminal
❖ 2) When an action potential travels down the axon & reaching the axon
terminal, it opens voltage-gated calcium channels
❖ 3) Calcium enters the axon terminal from the extracellular fluid & causes
vesicles containing neurotransmitter to fuse with the presynaptic
membrane
❖ 4) The neurotransmitter is then released in the synapse
❖ 5) Next, the neurotransmitter binds to receptors that are located on the
dendrites of the postsynaptic neuron
❖ 6) When the neurotransmitter binds, it can cause ion channels of the
postsynaptic neuron to open or close, allowing ions to flow in or out of the
cell

30) Depending on the neurotransmitter, the target organ, and other factors, the effect on
the postsynaptic cell may be either excitatory or inhibitory
31) Excitatory = increase likelihood of firing an action potential
32) Inhibitory = post synaptic cell is now slightly less neg charged decreasing likelihood
of firing an action potential
33) Ionotropic receptor: A type of receptor that is also an ion channel; when a substance
binds, the receptor quickly opens, and an ion such as sodium or chloride rushes into the
cell.
34) Metabotropic receptor: A type of receptor that is separate from an ion channel; if a
substance binds to the receptor, a series of events may open a separate ion channel or
cause another change in the cell, but it happens relatively slowly.
35) Presynaptic autoreceptor: A type of receptor located on the presynaptic membrane,
which detects the presence of neurotransmitter in the synapse and sends a signal to
inhibit synthesis or release of that neurotransmitter.
36) neurotransmitters or drugs can bind to receptors that are themselves an ion
channel
37) Neurotransmission stops when the neurotransmitter is removed from the receptor
38) 3 main mechanisms by which a neurotransmitter stops:
❖ 1) Reuptake: The process by which a presynaptic neuron reabsorbs a
neurotransmitter that it has released.
❖ 2) Enzymatic degradation - enzymes associated with the postsynaptic
membrane or in the synapse break down some neurotransmitters.
❖ 3) Diffusion - a process by which molecules move from areas of greater
concentration to areas of lesser concentration, the neurotransmitter drifts to
areas lacking receptors, where it is broken down and is removed by the
general circulation of fluids in the brain.
39) Most termination occurs when the neurotransmitter undergoes reuptake
40) Many of the actions that drugs have on the nervous system are due to changes
produced at the synapse.
41) The nervous systems are the control centers of the body, they gather info and
create a response
42) The brain and spinal cord together form the central nervous system (CNS)
43) The peripheral nervous system (PNS) = is made up of all the nerves going to and
from the brain and spinal cord
44) The PNS is further divided into the somatic nervous system and the autonomic
nervous system.
45) The somatic nervous system consists of neurons that carry sensory information
(from the eyes, ears, nose, mouth, and sense of touch) into the CNS, as well as nerve
fibers that carry motor signals from the CNS to skeletal muscle cells.
46) Neuromuscular junction (NMJ) The site at which motor neurons from the somatic
nervous system innervate skeletal muscles
47) Innervate: To supply a part of the body with nerves, or to stimulate an area by a
nerve.
48) Automatic Nervous System (ANS): Part of the PNS, the ANS consists of nerves that
go to and from smooth muscle, heart muscle, and glands
49) The ANS regulates visceral functions such as heart rate, blood pressure, digestion,
defecation, and urination
50) Many drugs, including atropine and amphetamine, affect the ANS.
51) The ANS is further divided into the sympathetic and parasympathetic nervous
systems
52) Sympathetic nervous system: Part of the PNS, the sympathetic nervous system
regulates “fight or flight” impulses; “fight or flight”; Remember the letter “E” for the
functions of the sympathetic system: emergency, energy, expending, exercise,
excitement, embarrassment
53) Parasympathetic system: Part of the PNS, the parasympathetic nervous system
regulates restful, “business as usual” impulses; is for ordinary, restful situations; The
functions of this system can be remembered by the letter “D”: digestion, defecation,
diuresis, dozing, and downtime.
54) The central nervous system (CNS): comprised of the brain and spinal cord.
55)The spinal cord is the major conduit of information from the skin, joints, muscles,
and viscera (internal organs) to and from the brain.
56) The brain is functionally and anatomically divided into the forebrain, the midbrain,
and the hindbrain.
57) The forebrain contains the cerebrum, thalamus, hypothalamus & limbic system;
58) Cerebrum: includes the cerebral cortex, hippocampus, and basal ganglia
59) The midbrain includes the tectum and tegmentum
60) The hindbrain includes the pons, cerebellum, and medulla
61) The cerebral cortex, the outermost portion of the brain, is highly folded, which
increases its surface area; every person has a different pattern of grooves (more
individual than fingerprints)
62) The brain and spinal cord are made up of neurons and neuroglia. The dendrites and
cell bodies of the neurons are called “gray matter” and the axons (covered with white
myelin) are called “white matter.”
63) The cerebrum is the largest part of the brain and is divided into two hemispheres
that are each concerned with sensory and motor functions for the opposite side of the
body.
64) The 2 hemispheres are mostly symmetrical but not entirely equal in function.
65) The left hemisphere is involved with analysis of a sequence of stimuli, so that you
can recognize and control a consecutive series of events and behavior.
66) The right hemisphere is for synthesis (putting isolated elements together as a
whole). Spatial perceptions, map reading, geometry, art, and music appreciation are
localized to the right brain, as are emotions, intuitions, understanding emotional tone in
speech, and recognition of faces.
67) The cerebral cortex is traditionally divided into four anatomical and functional lobes:
❖ Corpus callosum (plural: corpora callosa): The band of nerve fibers
that connect the left and right hemispheres of the brain.
❖ Frontal lobe: The part of the cerebrum responsible for planning,
programming, speech, and initiating voluntary movements.
❖ Prefrontal cortex: The part of the cerebrum responsible for reasoning,
judgments, and decision-making.
❖ Parietal lobe: The part of the cerebrum that contains the primary
somatosensory area of the cortex, where sensations such as pain,
temperature, and touch are processed.
68) The prefrontal cortex is not fully developed until approximately age 26
69) The temporal lobe: processes hearing, memory, and the integration of sensory
functions.
70) The occipital lobe: where visual images are sent.
71) For a long time, the fifth lobe—the insula—was ignored; involved with mind-body
integration
72) The midbrain is composed of the tectum and the tegmentum. The tectum contains
nuclei that control eye movements, pupillary response to light, and reactions to moving
stimuli, as well as auditory reflexes.
73) The tegmentum is a neural network involved in many reflexive and homeostatic
pathways. It includes the periaqueductal gray, substantia nigra, ventral tegmental area
(VTA), and reticular formation.
• The periaqueductal gray is important in the modulation of pain. Opioids
work here to diminish pain.
• The substantia nigra is a cluster of cell bodies that affect the basal
ganglia and are important in movement. Some drugs that treat
Parkinson’s disease are targeted to this area.
• The VTA is composed of dopaminergic cells (cells that release the
neurotransmitter dopamine) involved in addiction, reward, and rational
 processing. Neurons in the VTA connect with many areas of the brain,
including the nucleus accumbens, the prefrontal cortex, and the
hippocampus. The VTA-nucleus accumbens pathway plays an important
role in addiction, and nearly all re-warding behaviors, including food, sex, and
addictive drugs, influence this pathway
• A collection of nuclei called the reticular formation is
important attention-deficit/hyperactivity disorder for arousal, attention,
sleep, muscle tone, and other homeostatic pathways. Some of the drugs
thought to influence these pathways include LSD and drugs to
treat (ADHD)
74) The hindbrain contains the pons, medulla, and cerebellum.
75) The pons is part of the brainstem and contains respiratory nuclei that help to
smooth out breathing patterns. The pons is also important in sleep and arousal.
76) The medulla oblongata controls basic vegetative processes such as heart rate,
blood vessel diameter, respiratory rate, coughing, swallowing, and sneezing. When a
person dies of an overdose of alcohol, heroin, or other drugs, it is often due to
depression of respiratory cells in the medulla.
77) The cerebellum takes in sensory information and figures out the best way to
coordinate force, direction, extent of muscle contraction for smooth, appropriate,
coordinated movements based on incoming information. (Balance, posture,
coordination)
78) The spinal cord is a longitudinal system of neurons and supporting tissue that
carries signals between the brain and the peripheral nervous system. About 18 inches
long and three-quarters of an inch wide, the spinal cord is protected by the bony
vertebral column.
79) The walls of the blood brain barrier (BBB)—a name for the specialized capillaries of
the brain—are surrounded by cells that are not only tightly joined together, but also are
covered by a layer of glial cells, which limit the access of blood-borne materials into the
brain
80) Nutrients, oxygen, CO2, & lipid-soluble drugs can pass through the BBB & access
brain, while wastes, proteins, toxins, and most drugs can't
81) GABA (gamma-aminobutyric acid): is a small neurotransmitter that acts as the
major inhibitory neurotransmitter of the brain. As many as 40 percent of the synapses in
the CNS use GABA as their primary neurotransmitter.
82) GABA is synthesized from amino acid glutamate
83) Glutamate is both an amino acid and a neurotransmitter; The major excitatory
neurotransmitter in the central nervous system; Synthesized from the amino acid
Glutamine which is released by glial cells; involved in sensory signals
84) Domoic acid is a toxin that activates glutamate receptors.
85) The glial cells pump glutamine into the axon terminal, where it is converted into
glutamate. After glutamate is released, transporters present in the presynaptic terminal
and in nearby glial cells remove it from the synapse. Glial cells contain enzymes that
convert glutamate back into glutamine, and the process begins again.
86) Some of the drugs that bind to glutamine receptors include PCP, ketamine, ethanol,
and dextromethorphan.
87) After being released, GABA is transported from the synapse into nearby glial cells,
where it is transformed to glutamate, carried into the axon terminal, and converted back
into GABA. GABA also is transported directly back from the synapse into the
presynaptic terminal by protein carriers.
88) Many drugs bind to the GABA receptor. Barbiturates such as phenobarbital and
benzodiazepines such as Xanax bind to the receptor. When these drugs bind, they
affect the chloride channel in a way that allows more chloride to enter the cell, leading
to neuronal inhibition
89) Dopamine is synthesized from DOPA
90) Serotonin: A neurotransmitter found throughout the brain and body, involved in
many functions, including mood, sleep, appetite, and visual perception; Serotonin is an
inhibitory neurotransmitter found throughout the brain and body. Serotonin got its name
from “sero” (blood) and “tonin” (tone) due to its effects on vascular tone
91) Serotonin is synthesized from tryptophan, an essential amino acid found in grains,
meat, and dairy.
92) Serotonin modulates raw information and gives it emotional tone.
93) Many drugs affect serotonin. Both MDMA (also known as ecstasy or Molly) and LSD
affect serotonin. Prozac, Zoloft, and other selective serotonin reuptake inhibitors
(SSRIs) elevate serotonin levels
94) Acetylcholine, the first neurotransmitter to be dis-covered, is also the most common
neurotransmitter in the body (although GABA and glutamate are more common in the
brain).
95) Acetyl coenzyme A (acetyl-CoA) and choline are con-verted into acetylcholine in the
axon terminal, stored in vesicles, and released into the synapse. Unlike other small
molecule neurotransmitters, there is no reuptake of acetylcholine. Instead, acetylcholine
is broken down by the enzyme acetylcholinesterase (AChE), which is found in various
locations and forms. AChE breaks acetylcholine down into acetic acid and choline, and
the choline is then taken up into the presynaptic axon terminals by a transporter
96) if there are receptors in our brain for a substance, that means that our bodies
produce a natural form of that chemical.
97) Drugs such as morphine, codeine, and heroin bind to opioid receptors. (Although the
term opiate often is used as a synonym, opioid is the broader and more appropriate
term). Opioids are large chemicals with a complex synthetic pathway. In general, the
synthesis and release of larger neurotransmitters is slower and more complex than that
of smaller neurotransmitters
98) Opioid: Any natural, synthetic, or endogenous substance that binds to the opioid
receptor
99) In the late 1980s, scientists discovered that THC, one of the psychoactive
substances in marijuana, bound cannabinoid receptors in the brain.
100) Cannabinoid receptors are all slow and metabotropic.