Substance Use, Misuse and Abuse Ch. 10-13

In 2009, the Family Smoking Prevention and Tobacco Control Act
authorized the FDA to regulate tobacco products in specific ways.
One big factor associated with lower rates of cigarette smoking among adults is
Higher level of education
Per capita sales of cigarettes in the U.S. began to decline
after the 1964 Surgeon General’s report
Reynolds was unable to market Premier, a plastic cigarette containing catalytic crystals coated with tobacco extract, because
the FDA considered them a “nicotine delivery device” rather than an agricultural product
The major commercial species of Nicotiana that is grown for tobacco products is
Nicotiana tobacum.
People who switch to low tar and nicotine brand cigarettes
typically take more and deeper puffs and probably get no safety benefit.
90 percent of all U.S. cigarettes sold are now
Filter cigars
Tobacco use became popular in European culture because:
it was associated with wealth and status
During the 18th century, which method of use of tobacco increased in England
Snuff
In 2000, the U.S. Supreme Court ruled that the FDA
Had no authority to regulare tobacco products
Chewing was the most popular form of tobacco use until about 1900, but by 1920 the most popular form was
cigars
The biggest health concern for users of smokeless tobacco has been
cancer of the mouth, pharynx, and esophagus.
As a potent poison, nicotine causes death by
increasing blood pressure until a stroke occurs.
Recent research on the dependence produced by nicotine has focused on genetic differences related to:
acetylcholine receptors
One recent fad in tobacco use has been
hookahs (water pipes)
Gum, patches, lozenges, and inhalers are all various forms of
nicotine replacement therapy
Although lung cancer is not common, about _______ percent of all lung cancers occur in smokers.
85
In 1993, the Environmental Protection Agency declared that
secondhand smoke is a known carcinogen that increases lung cancer risk.
Nicotine acts in the brain by
first stimulating and then blocking cholinergic receptors
In July 2011, the nicotine vaccine NicVax was
found to be no better than placebo.
The psychological effect of cigarette smoking is
arousal and activation–a mild stimulant effect
calm and relaxation–a mild antianxiety effect.
In 2006, the FDA approved a nicotine partial agonist drug as a smoking treatment. The drug is
varenicline (Chantix)
Annual “smoking attributable mortality” in the U.S. is estimated at
440,000
About 90 percent of the more than 40 million former smokers in the U.S. report that
they quit smoking without a treatment program.
One of the most consistent and best-documented effects of cigarette smoking during pregnancy is
low birth weight
In 1970, Americans drank more coffee than any other nonalcoholic beverage product. By 2009,
Americans drank approximately twice as many gallons of soft drinks as compared to coffee
Most regular brewed teas have about how much caffeine per cup?
40-60 mg (about half the amount in coffee)
_____________ is prescribed to asthma sufferers because it relaxes bronchial passages.
theophylline
The early history of coffee included a 1674 pamphlet from England titled
The Women’s Petition Against Coffee.
Theobroma, the genus name for the cacao tree, is Latin for
food of the gods
The largest exporters of coffee to the U.S. are
Colombia, Brazil, Guatemala, and Mexico.
Green, black, and oolong tea are all prepared from leaves of
Camellia sinensis
In the 18th century, English coffeehouses were referred to as
penny universities
The legend of the discovery of coffee relates to
Kaldi and his dancing goats
The world’s greatest per-capita consumers of tea are found in
Turkey
All of the xanthines have similar effects. But which one has the greatest overall effect?
caffeine
According to current FDA rules on “cola” drinks
they cannot contain more than 6 mg caffeine per ounce
One important determinant of the behavioral effects of caffeine is
whether the person is a regular user
The most consistent withdrawal symptom after chronic caffeine use is
headache
In 1909, the FDA seized some Coca-Cola syrup and filed charges against the company partly because
the syrup contained caffiene
Often people who drink too much alcohol attempt to “sober up” by drinking coffee. Several studies support the idea that caffeine
is likely to lead to increased arousal, but the drinker is still impaired
Caffeine has been shown to be an effective treatment for
migraine headaches
The unique xanthine in chocolate is
theobromine
Drinking 5 or more cups of coffee per day
doubles the risk of heart attack
Caffeine works in the brain by
blocking adenosine receptors
The main active ingredient in Red Bull and other energy drinks is
caffeine
Caffeine is thought to relieve headaches because it is
a vasoconstrictor.
The maximum CNS effect of caffeine is reached about _____ after drinking coffee.
2 hours
The 1994 Dietary Supplement Health and Education Act
expanded the definition of dietary supplements and restricted the FDA’s regulatory authority over them.
What dietary supplement ingredient has been tested for its ability to improve memory in Alzheimer’s disease, but has produced only small and unreliable improvements in published research?
Ginkgo biloba
Starting in 2007, the only FDA-approved OTC weight-control ingredient is
orlistat (alli).
The FDA was given additional authority over dietary supplements in 2006 to set up
an “Adverse Events Reporting” process.
Because of the way the FDA reviews and approves OTC drugs,
various brands of a given type of remedy usually contain the same few active ingredients
Many of the capsules, pills, and powders that look like drugs and that consumers think of as drugs are actually classified by the FDA as
food products
If you buy a bottle of St. John’s wort 300 mg tablets, each tablet will contain 300 mg
total tablet weight, with an unknown amount of plant material or ingredients
The U.S. market for over-the-counter drug products totals about
$18 billion
The only active ingredient the FDA allows in OTC stimulants is
caffeine
The 2006 revised PATRIOT Act required that products containing __________ be kept “behind the counter,” and buyers must show identification and sign for their purchase.
pseudoephedrine
SAMe (S-adenosyl-L-methionine) is a dietary supplement that has some research support for its possible use in treating
depression
Why would you want dextromethorphan in a cold remedy?
It acts as a cough suppressant
NSAID stands for
non-steroidal anti-inflammatory drug
Suppose you have a cold and you choose to take Tylenol Cold to treat your symptoms (runny nose, congested nasal passages, and fever). Which of these ingredients in this OTC product is unnecessary?
dextromethorphan
There has been some reported abuse by young people of products containing _________, which they take in high doses to produce visual and auditory hallucinations
dextromethorphan
The generic name for Tylenol and Datril is
acetaminophen.
Acetylsalicylic acid was developed in the Bayer laboratory in Germany in 1898 and sold under the brand name
Aspirin
Aspirin should not be used with children who have a viral infection because of increased risk of
Reye’s syndrome
The textbook suggests that consumers are best able to choose from among the wide variety of OTC products by
knowing a fairly small number of ingredient names.
Suppose you had a fever, a headache, and a swollen knee. Which medication would be most appropriate to treat all three symptoms?
dextromethorphan
Besides analgesia (pain relief), another important effect of aspirin is as a(n)
antipyretic (reduces fever)
The acronym GRAS stands for
generally recognized as safe
Cold viruses are usually transmitted
by being picked up on the hands and touching your eyes or nose
The earliest recorded use of opium as a medicine was probably by
Egyptians, around 1500 BC
The 16th century European physician Paracelsus, and later Dr. Thomas Sydenham promoted the use of
laudanum.
In 1898, Bayer laboratories marketed diacetylmorphine tablets under the brand name
Heroin
The two major active chemicals in opium are
morphine and codeine.
Papaver somniferum is the scientific name for
the opium poppy
Heroin became the drug of choice for many opioid users
during the 1920s, because it was easier to smuggle the small amounts needed for an effective dose.
One thing that apparently contributed to the spread of opium smoking in China was
a 1644 edict from the emperor forbidding tobacco smoking.
By the beginning of the 20th century, a greater percentage of Americans were dependent on opioids than at any time before or since. Opium smoking and medical use of injected pure morphine were important contributors to this, along with
Patent medicines containing opium extracts or morphine
Possession of opium, morphine, or heroin without a prescription was made a crime by
a 1915 Supreme Court decision.
The Opium War of 1839-1842 resulted, among other things, in
the island of Hong Kong becoming a British possession.
“Black tar” is
a name given heroin from Mexico that is brown or black in its pure form
At the current time, most of the heroin in the U.S. originates from poppy fields in
Colombia and Mexico.
Vicodin and OxyContin are examples of
prescription opioids that are being misused at relatively high rates.
Which of these opioids is about 100 times as potent as morphine?
fentanyl
Naloxone, nalorphine, and naltrexone are examples of
opioid antagonists.
Enkephalins, endorphins, and dynorphins are
three classes of endogenous chemicals that have effects similar to morphine
Although pain relief is now the major medical use for opioids, they have been used to save many lives (especially in underdeveloped countries) because of their ability to
treat diarrhea
Siegel and his colleagues have shown in animal studies that tolerance to opioids
is partly due to conditioned responses
The textbook says that opioid withdrawal is similar to
a bad case of intestinal flu
The fact that animals with no history of opioid withdrawal will press a lever to self-administer low doses of intravenous morphine or heroin demonstrates the importance of ____________ in developing opioid dependence.
positive reinforcement
In a heroin user, negative reinforcement of drug-taking behavior can occur when
withdrawal symptoms are alleviated by another injection
Long-term exposure to opioid drugs
has not been clearly shown to produce damage to any tissue or organ system
Heroin is more potent than morphine because
it more readily crosses the blood-brain barrier