Deck 16: Inhalants, Ghb, and Anabolic-Androgenic Steroids

Question 1

Inhalants

A) are substances such as glues and contact cement that can cause a temporary "high" but are rarely dangerous.
B) include illegal abused substances such as Resistol.
C) have been linked to long-term damage to the brain and other organs.
D) are mainly abused in other countries other than the United States; children in the United States have generally not used or abused these drugs.

Answer 1

C

Question 2

Which of the following is a characteristic of abused inhalant drugs?

A) They can be inhaled in the form of smoke.
B) They are have been used as recreational drugs throughout history.
C) The route of administration involves sniffing, inhaling, or spraying an aerosol.
D) Humans find inhalant drugs to be reinforcing, while animals do not.

Answer 2

C

Question 3

With regard to types of inhalants,

A) sources of aerosols include propane tanks and butane lighters.
B) volatile solvents include moth balls, paint thinners, and nail polish remover.
C) nitrites such as "poppers" act directly on the brain.
D) gases include hair sprays, deodorant sprays, and spray paints.

Answer 3

B

Question 4

Regarding patterns and demographics of inhalant use,

A) surveys indicate that inhalants are the most popular abused substances of 12-year-olds.
B) government studies show that 15% of children have tried inhalants by the fourth grade.
C) initial inhalant use almost always follows experimentation with alcohol or tobacco.
D) among children in middle school, inhalants are second to marijuana in popularity.

Question 5

Which property of inhalants makes younger users particularly vulnerable to them?

A) They are readily available in a wide range of legal products at a relatively low cost.
B) There are no warnings on these products, so they are not perceived as dangerous.
C) They are often sold alongside other products that young people are attracted to.
D) Young people typically switch to inhalants after experimenting with alcohol.

Question 6

All of the following symptoms have been observed during the abuse of inhalants except

A) euphoria.
B) hallucinations.
C) delusions.
D) mania.

Question 7

Studies have shown that radiolabeled toluene injected into the brain disproportionately labels the

A) frontal cortex and cerebellum.
B) hippocampus and thalamus.
C) striatum and cerebellum.
D) frontal cortex and hippocampus.

Question 8

Studies testing how readily rats with self-administer toluene demonstrated that rats adjusted their response rates to obtain

A) variable toluene concentrations, thereby demonstrating the unpredictable effects of the drug.
B) consistent peak toluene concentrations, thereby demonstrating tolerance to the drug.
C) consistent low toluene concentrations, thereby demonstrating an absence of reinforcing effects of the drug.
D) moderate toluene concentrations, thereby demonstrating the weak reinforcing effects of the drug.

Question 9

Which of the following is not an effect of inhalants on the CNS?

A) They enhance the function of GABA_A receptors.
B) They block NMDA glutamate receptors.
C) They activate DA in the VTA.
D) They inhibit the activity of glycine receptors.

Question 10

Many inhalants enhance the activity of _______ receptors and inhibit the activity of _______ receptors.

A) GABA_A; NMDA
B) NMDA; GABA_A
C) nicotinic; NMDA
D) GABA_A; dopamine

Question 11

Inhalants inhibit the CNS and impair behavior in a manner similar to

A) the cannabinoids.
B) ethanol.
C) the opioids.
D) GHB.

Question 12

While not common, a single use of inhalants can potentially be fatal, an effect known as

A) myocardial infarction.
B) sudden inhalant death syndrome.
C) sudden sniffing death syndrome.
D) inhalant toxicity syndrome.

Question 13

All of the following are health risks of inhalant use except

A) fatal cardiac arrhythmia.
B) coronary heart disease.
C) damage to myelin sheaths surrounding axons.
D) white matter damage.

Question 14

It is thought that GHB may be co-released with GABA upon neuronal firing because

A) it can be taken up into GABAergic vesicles.
B) it is produced during the synthesis of GABA.
C) GABA is metabolized into GHB in the vesicles.
D) GHB easily passes through vesicular membranes.

Question 15

Which statement regarding γ-hydroxybutyrate (GHB) is true?

A) It has a very different chemical structure than GABA does.
B) It is produced in the brain as a by-product of GABA metabolism.
C) It acts as a stimulant in both animals and humans.
D) It is available over-the-counter for use as a sedative.

Question 16

Many users take the precursor γ-butyrolactone (GBL) instead of GHB because

A) it is more potent than GHB even though it is shorter-acting.
B) it is easily obtainable and quickly converted to the GHB after consumption.
C) it has fewer side effects than GHB, even though its effects are not as potent.
D) they can't afford GHB.

Question 17

Low doses of GHB produce all of the following except

A) disinhibition.
B) mild euphoria.
C) calmness and relaxation.
D) perceptual disturbances.

Question 18

Which of the following is a symptom experienced following high doses of GHB?

A) Rapid respiration
B) Rapid speech
C) Hunger
D) Manic behavior

Question 19

GHB has all of the following effects in animals except

A) increased anxiety in the elevated plus maze.
B) hypolocomotion.
C) sedation.
D) catalepsy.

Question 20

Animal studies designed to measure the reward value of GHB

A) have been reliably consistent with human studies.
B) have shown positive findings in self-administration paradigms but not place-conditioning tasks.
C) have found even stronger evidence for the reinforcing effects of GHB than in human studies.
D) are inconsistent, with rodents showing positive findings and baboons demonstrating variable results.

Question 21

There is evidence that GHB's effects are mediated by

A) G protein-coupled metabotropic receptors.
B) high-affinity GHB-specific receptors, a group of inhibitory extrasynaptic GABA_A receptors, and GABA_B receptors.
C) a hormone-receptor complex that translocates into the cell nucleus where it regulates the transcription of certain genes.
D) low-affinity GHB-specific receptors in the cerebellum and brainstem.

Question 22

Which statement supports the hypothesis that GHB acts on the GABA_B receptor?

A) GHB has definitively been shown to be metabolized in the brain to GABA, which then stimulates GABA_B receptors.
B) GHB has been shown to have a high affinity for the GABA_B receptor.
C) The behavioral and physiological effects of GHB can be reversed by baclofen.
D) Mice genetically engineered to lack the GABA_B receptor do not show behavioral or physiological responses to GHB.

Question 23

With respect to GHB tolerance, dependence, and withdrawal,

A) tolerance to GHB has been found in animal studies.
B) anecdotal reports suggest that dependence does not develop with repeated use of GHB.
C) withdrawal symptoms are mild (sleep disruption), even at very high doses.
D) tolerance to GHB in humans has been well-studied and does not seem to exist.

Question 24

A feature of GHB that sets it apart from other recreational drugs is that

A) it is synthesized ("man-made"), not produced by the brain or derived from plants.
B) it is produced in the brain and not derived from plants or synthesized ("man-made").
C) it is produced endogenously in high levels in the cerebellum.
D) endogenously-produced GHB is occurs at high levels in the brain.

Question 25

In the human brain, the highest levels of endogenous GBH are found in the _______ and the lowest levels are found in the _______.

A) amygdala; hippocampus
B) hippocampus; amygdala
C) striatum; cerebellum
D) cerebellum; striatum

Question 26

GHB's only legitimate use in the United States is

A) as an anesthetic.
B) as a sleep aid.
C) to treat anxiety.
D) to treat narcolepsy.

Question 27

What did a recent meta-analysis of clinic trials on the use GHB (sodium oxybate, or Xyrem) for the treatment of narcolepsy show?

A) It treated symptoms of narcolepsy but only temporarily.
B) It treated symptoms of narcolepsy, but reduced quality of life.
C) It reduced in cataplexy, daytime sleepiness and incidence of hallucinations.
D) It reduced in cataplexy, but daytime sleepiness and incidence of hallucinations were not improved.

Question 28

Anabolic steroids are structurally related to

A) oxandrolone.
B) nandrolone.
C) stanozolol.
D) testosterone.

Question 29

Which statement about the history of anabolic steroid use is true?

A) East Germans were the first to use these drugs as performance enhancers in weightlifting competition.
B) The United States did not administer these drugs to its elite athletes until the late 1980s.
C) Oral Turinabol use by female athletes in the GDR was linked to many achievements and Olympic medals.
D) Although these drugs have been abused by many professional athletes, very few college and high school athletes have access to them.

Question 30

Which statement about anabolic-androgenic steroids (AAS) is false?

A) They increase muscle mass.
B) They are always injected intramuscularly.
C) They have masculinizing properties.
D) They are used and abused as performance enhancers.

Question 31

Why might people who take anabolic steroids engage in a pattern of use called cycling?

A) To allow time for the use of a second steroid
B) To lower the cost related to obtaining steroids
C) To avoid the obvious signs of increased muscle mass
D) To avoid detection of a banned substance

Question 32

What type of steroid use might an endurance athlete or a sprinter choose?

A) Stacking
B) High doses right before the event
C) Pyramiding
D) Low dosing

Question 33

Recent research shows that the rewarding properties of AAS may be mediated by β-endorphin-mediated activation of _______, and not by _______.

A) VTA dopaminergic neurons; androgens
B) VTA dopaminergic neurons; opioid receptors
C) serotonin; androgens
D) serotonin; opioid receptors

Question 34

Controlled studies of the effects of anabolic steroids on muscle strength, muscle size, and sexual function showed all of the following except

A) a dose-dependent increased in size of the quadriceps muscle.
B) an increase in leg press strength.
C) a dose-dependent increase in thigh muscle volume.
D) a large increase in sexual drive or activity.

Question 35

Androgen receptors

A) are found in muscle tissue, where they increase protein synthesis and muscle growth when activated by androgens.
B) are found in the cell nucleus in the inactive state.
C) translocate into the cell cytoplasm when bound to an androgen.
D) shut down gene transcription when activated.

Question 36

Which statement concerning the side effects of anabolic steroids is true?

A) The masculinizing effects of steroids on women are reversible.
B) The idea that steroids "stunt your growth" is merely a popular myth.
C) Common effects of steroid use include acne and cardiovascular problems.
D) "Roid rage" almost always occurs with anabolic steroid use.

Question 37

Specific effects of anabolic steroids on males and females include all of the following except

A) smaller testes in males.
B) shrinking of the prostate in males.
C) breast development in males.
D) enlarged clitoris in females.

Question 38

In addition to their desired effects on muscle, anabolic steroids negatively affect several physiological systems, including the heart, _______, and _______.

A) kidneys; gastrointestinal system
B) immune system; liver
C) kidneys; liver
D) immune system; gastrointestinal system

Question 39

According to the story of Mr. A and other case studies, which statement regarding "roid rage" is true?

A) It rarely leads to extreme violence or murder.
B) It doesn't occur unless there is a history of psychiatric illness.
C) It can occur for short periods of time in otherwise quiet and considerate people.
D) It does appear not affect younger people, such as adolescents.

Question 40

Heavy users of anabolic steroids may show all of the following psychological or behavioral symptoms except

A) a perception that the user is weak and small.
B) increased irritability or anxiety.
C) impaired cognitive function.
D) depressed mood during withdrawal.

Question 41

Dependence on anabolic steroids is

A) supported by multiple previous studies that suggested that users met most of the DSM-IV criteria for substance abuse and withdrawal.
B) supported by the fact that many individuals seek help for problems stemming from anabolic steroid abuse.
C) shown in the strong cravings reported by users who are no longer taking steroid drugs.
D) shown in the report that even first-time steroid users find the drugs to be rewarding and desirable.

Question 42

The reinforcing properties of anabolic steroids

A) are demonstrated in self-administration and place conditioning studies in animals.
B) are produced by activation of intracellular androgen receptors.
C) manifest immediately in human users as euphoria.
D) are amplified in rats genetically engineered to have nonfunctional androgen receptors.

Question 43

Research has found that serotonin activation of 5-HT₃ receptors in the hypothalamus plays a key role in the transition from aggressive to anxiety-like behaviors

A) during withdrawal from AAS.
B) during ASS overdose.
C) when AAS are combined with amphetamines.
D) when AAS are combined with alcohol.

Question 44

AAS is used to treat primary hypogonadism, which is a condition in which

A) damage to the pituitary or hypothalamus causes a reduction in LH and FSH secretion from the pituitary.
B) the testes are unresponsive to LH and FSH due to genetic mutations or disease.
C) LH and FSH are metabolized before they reach blood circulation.
D) the pituitary releases LH and FSH in an irregular fashion due to a genetic mutation.

Question 45

In which case would AAS most likely be prescribed as a therapeutic intervention?

A) For a young man who is contending with social anxiety.
B) For an elderly man who is experiencing cognitive decline.
C) For a young man who is experiencing delayed puberty.
D) For an elderly man who is experiencing loss muscle mass and bone density.

Question 46

Identify the four different types of inhalants that are abused and give a few examples from each category. What three characteristics do all inhalants have in common?

Question 47

Describe the ways in which the inhalants are similar to alcohol. Include information about their acute and chronic effects, mechanism of action, and impact on fetal development.

Question 48

Describe the specific health effects of inhalants on juveniles' or adolescents' development.

Question 49

What is known about the action of inhalants in the CNS? Describe the evidence that supports that these drugs stimulate brain areas associated with reward. Are these substances reinforcing? Why are inhalants particularly difficult to study as a class of drugs?

Question 50

Describe the discovery and early marketing/promotion of GHB by health food stores. Why is GHB called a "club drug"? What problems with the drug led to its being classified as a Schedule I drug in 2000?

Question 51

Describe the therapeutic uses of GHB/sodium oxybate in the United States and Europe. What measures have been taken to prevent recreational use of this compound?

Question 52

Briefly describe the historical use of anabolic steroids in the Soviet Union, United States, and East Germany. What legislation changed this state of affairs in the United States?

Question 53

List four reasons why a steroid user might engage in the practice of cycling. Describe two other patterns of use that are sometimes combined with cycling.

Question 54

Explain how AAS androgens play a role in altering gene transcription and lead to positive effects for athletes with regard to androgenic action.

Question 55

Identify several side effects of anabolic steroid use. List two effects that are specific to male users and two that are specific to female users.

Question 56

Discuss what the literature and case studies have to say about the likelihood of anabolic steroids causing aggression and "roid rage." Is the case of Mr. A. typical or not?

Question 57

List the ways in which anabolic steroid use meets the criteria for drug dependence. In what ways is steroid use atypical?