Deck 12: Psychomotor Stimulants: Cocaine, Amphetamine, and Related Drugs

Question 1

Which statement about cocaine is true?

A) It is a synthesized drug.
B) It is an alkaloid that comes from the leaves of a South American bush.
C) It has a high pH.
D) It can exacerbate altitude sickness.

Answer 1

B

Question 2

Which statement regarding cocaine's status in the late nineteenth century is true?

A) Freud wrote an essay, Über Coca, warning people about the dangers of cocaine.
B) Cocaine was being used as a treatment for morphine addiction and infant teething pain.
C) Chewing of coca leaves was the most popular way to administer cocaine.
D) Cocaine abuse was declining among the U.S. population.

Answer 2

B

Question 3

Cocaine use in the twentieth century

A) was prohibited in over-the-counter medicines by the Harrison Narcotic Act.
B) was ignored by government officials who considered marijuana to be "public enemy number one."
C) involved administration via intravenous injection, snorting, or smoking.
D) Both a and c

Answer 3

D

Question 4

Which statement about U.S. cocaine use trends between 2014 and 2018 is true?

A) The rate of deaths due to cocaine use increased threefold even though the number of individuals using or addicted to cocaine remained level.
B) The rate of deaths due to cocaine use increased threefold even though the number of individuals using or addicted to cocaine decreased.
C) Both cocaine use and addiction increased with a corresponding increase in death rate.
D) Both cocaine use and addiction decreased with a corresponding decrease in death rate.

Question 5

Freebasing

A) is the procedure used to derive crack cocaine for smoking.
B) is especially dangerous because the ether used to extract the cocaine is highly flammable.
C) results in a paste that is 80% cocaine.
D) requires that baking soda be mixed with the cocaine during the extraction process.

Question 6

Which statement about cocaine administration and absorption is true?

A) The cocaine metabolite benzoylecgonine can be detected for only a few hours after the last dose of drug.
B) Slow absorption occurs with intravenous and smoked forms of cocaine.
C) Cocaethylene is a metabolite of cocaine and alcohol that exerts an effect similar to cocaine, but that has a long half-life.
D) Smoking crack cocaine is addictive because the brain receives a large surge of drug, and its effects are very long-lasting.

Question 7

If two people take the same dose of cocaine but one takes it orally and one injects it, they will likely have _______ neurochemical and behavioral responses because _______.

A) different; both dose and route of administration affect response.
B) different; response depends more on body chemistry than any other factor.
C) the same; only dose affects response.
D) the same; oral and injected routes of administration produce the same effects.

Question 8

Cocaine acts in the nervous system by blocking _______ and voltage-gated _______ channels.

A) monoamine transporters; potassium
B) monoamine release; calcium
C) monoamine transporters; sodium
D) monoamine synthesis; calcium

Question 9

What have studies with mutant mice that have a cocaine-insensitive serotonin reuptake transporter (SERT) shown?

A) Serotonin levels do not play a role in cocaine-related reward and reinforcement.
B) Inhibiting serotonergic signaling counteracts cocaine-related reward and reinforcement.
C) The effect of serotonin on reward and reinforcement is not clear.
D) Activation of serotonergic signaling counteracts cocaine related reward and reinforcement.

Question 10

Which of the following is an effect of low to moderate doses of cocaine?

A) Amplification of both euphoria and dysphoria
B) Decreased sexual interest
C) Sleepiness
D) Incoherent speech

Question 11

If someone who has taken cocaine is exhibiting _______ you would expect that they have been taking high _______ doses of the drug.

A) fear; high
B) delusions of grandiosity; high
C) decreased sexual interest; low
D) slow motor activity; low

Question 12

A sympathomimetic drug taken at acute doses would produce side effects such as

A) sedation and weakness.
B) digestion of food and slowing of heart rate.
C) increased heart rate and vasoconstriction.
D) reduced breathing rate and vasodilation.

Question 13

Psychostimulant injections

A) increase stereotyped behavior when microinjected into the nucleus accumbens.
B) increase locomotor behavior when microinjected into the striatum.
C) have their reinforcing effects effectively blocked by 6-OHDA lesions of the nucleus accumbens.
D) of amphetamine into the nucleus accumbens do not appear to be rewarding to animals, as they will not self-administer the drug.

Question 14

Which technique has allowed researchers to study the effects of psychostimulants on measures like DAT occupancy in the living human brain?

A) MRI
B) CT
C) EEG
D) PET

Question 15

Which factor is not important for determining the drug user's "high," according to imaging studies?

A) The number of dopamine transporters that are occupied by the drug
B) The route of administration of the drug
C) The baseline level of dopamine in the mesolimbic pathway
D) The age of the user

Question 16

What is the minimum dopamine transporter (DAT) occupancy required to achieve a "high" from either cocaine or methylphenidate, based on imaging studies?

A) 10% to 20%
B) 20% to 40%
C) 40% to 60%
D) 60% to 80%

Question 17

Which condition will produce the greatest psychostimulant effect, based on dopamine transporter (DAT) occupancy?

A) Intranasal administration of drug
B) 30% of transporters affected by drug
C) IV administration of drug
D) Low baseline of dopamine in the mesolimbic tract

Question 18

Which evidence supports the finding that the NAcc shell is closely associated with psychostimulant-related reward and reinforcement and the NAcc core is closely related to psychostimulant-induced hyperlocomotion?

A) Rats will self-administer cocaine into the NAcc core but not the shell.
B) Rats will self-administer cocaine into the NAcc shell but not the core.
C) The loss of DA innervation through 6-OHDA lesioning of the core was correlated with a decrease in amphetamine reward.
D) The loss of DA innervation through 6-OHDA lesioning of the shell was correlated with an increase in amphetamine reward.

Question 19

D₁ receptor knockout mice do not self-administer cocaine, which suggests that

A) dopamine is not important for cocaine's reinforcing effects.
B) blockade of this transporter plays a key role in the reinforcing action of cocaine.
C) the mutant dopamine transporter is unable to take up dopamine from the synaptic cleft.
D) these mutant mice are able to experience cocaine reward but not cocaine reinforcement.

Question 20

Which statement concerning the receptor subtypes involved in psychostimulant effects is true?

A) The locomotor-stimulating effects of cocaine involve the D₅ receptor.
B) D₂ receptors are required for cocaine self-administration.
C) Pimozide, a D₂ receptor blocker, completely eliminates amphetamine-induced euphoria.
D) D₁ receptor knockout mice are insensitive to both the locomotor stimulating and reinforcing effects of cocaine.

Question 21

In mice, _______ receptor agonists were shown to reduce the locomotor activity effects of cocaine, while, _______ receptor agonists increased locomotor activity.

A) D₁; D₂
B) D₁; D₃
C) D₂; D₃
D) D₃; D₂

Question 22

One factor that often drives the occasional cocaine user to more regular use is

A) that lower doses can create the same high as higher doses over time.
B) the switch to smoking, freebasing, or IV injection.
C) the mixing of cocaine with other stimulants to create an even greater high.
D) the switch from smoking to snorting.

Question 23

Cocaine binges

A) result in a period of exhaustion, depression, and cravings.
B) may involve use of up to 1500 grams of cocaine.
C) do not produce an abstinence syndrome.
D) typically last a week or longer.

Question 24

Imaging studies have shown that if a cocaine-dependent person view cues related to the drug, a neural circuit consisting of _______ is activated.

A) PFC, striatum, limbic system, and hypothalamus
B) VTA, locus coeruleus, and hippocampus
C) putamen, hypothalamus, and NAcc
D) ACC, hippocampus; and amygdala

Question 25

Chronic cocaine use results in diminished _______ activity, including down-regulation of neurotransmitter synthesis, release, and neurotransmitter transporter and receptor levels.

A) striatal cholinergic interneuron
B) striatal dopaminergic
C) PFC catecholaminergic
D) midbrain catecholaminergic

Question 26

Repeated exposure to cocaine and other psychostimulants

A) can cause behavioral tolerance but not sensitization.
B) can cause behavioral sensitization but not tolerance.
C) can cause either behavioral tolerance or sensitization, depending on the pattern of exposure.
D) causes neither behavioral tolerance nor sensitization.

Question 27

Which statement about sensitization to psychostimulants is false?

A) It can be divided into two phases-induction and expression.
B) Its expression involves enhanced dopamine activity in the VTA $\rightarrow$ nucleus accumbens pathway.
C) Glutamate from the medial prefrontal cortex plays a role.
D) It results from continuous drug infusion.

Question 28

Sensitization of the mesolimbic DA pathway at the level of both VTA dopaminergic cell bodies and the nerve terminals in the NAcc

A) can be produced by a single drug exposure.
B) is only produced by multiple drug exposures.
C) can be only be produced if two drugs synergize, thus speeding sensitization.
D) is only produced in individuals with a specific genetic mutation.

Question 29

Long-access (6 hours per day) cocaine self-administration by rats has been shown to cause

A) behavioral tolerance to the drug.
B) reduced basic functioning of the dopaminergic system with no drug challenge.
C) up-regulation of postsynaptic dopamine receptors.
D) increased sensitivity of terminal D₂ DA autoreceptors.

Question 30

Chronic or high dose cocaine use can cause all of the following except

A) damage to somatosensory systems.
B) a stroke.
C) psychosis.
D) perforation of the nasal septum.

Question 31

Which statement about pharmacotherapy for cocaine dependence is false?

A) Over 100 blinded placebo-controlled clinical trials have already been conducted to test medications against cocaine dependence.
B) The FDA has approved several effective medications that have been shown to help people overcome their cocaine dependence.
C) Many drugs that have been tested as potential therapeutic agents for cocaine dependence target some aspect of the dopamine system.
D) Evidence shows that high-dose amphetamine treatment (agonist approach) is most promising.

Question 32

Vaccines against cocaine

A) have not been consistently effective in producing significant reductions in cocaine-induced behavior in animal studies.
B) have not been tested in humans.
C) could act by creating antibodies that bind the cocaine molecules, reducing the amount of drug that crosses the blood-brain barrier.
D) may create antibodies that break down in the bloodstream, causing long-term toxic side effects.

Question 33

The approach of a contingency management program involves reducing _______ while increasing _______, and is based on the idea that drug-taking is an operant response.

A) drug-associated reinforcement; nondrug reinforcers
B) nondrug reinforcers; pharmacotherapeutic use
C) relapse; self-esteem
D) high-risk situations; coping strategies

Question 34

The intended purpose of brain stimulation techniques (such as transcranial magnetic stimulation) is to treat underlying drug craving and other factors contributing to substance misuse by

A) directly increasing certain neurotransmitters in the brain.
B) altering brain circuitry.
C) preventing relapse by shutting down brain reward centers.
D) altering blood flow in the brain.

Question 35

Ephedra

A) is used as a sedative.
B) has been approved by the FDA for weight loss use.
C) has no effect on appetite or weight, in spite of advertisers' claims.
D) has dangerous effects on the sympathetic nervous system.

Question 36

An early use of amphetamine was as a

A) medication in early inhalers.
B) pain killer.
C) treatment for anxiety
D) treatment for insomnia.

Question 37

Amphetamine and related psychostimulants in the amphetamine-like family

A) are drugs of abuse with no therapeutic value.
B) resemble the neurotransmitter DA in their chemical structure.
C) are all synthetic.
D) are drugs of the twentieth century, having no use prior to 1900.

Question 38

What is one way amphetamine differs from methamphetamine?

A) Amphetamine is metabolized quickly, whereas methamphetamine is degraded slowly.
B) Methamphetamine is more frequently used for recreational use because it is more potent.
C) Amphetamine is more frequently used for recreational us because it has more powerful effects on the CNS.
D) Methamphetamine is much more expensive to produce than amphetamine.

Question 39

Amphetamine and methamphetamine affect synaptic transmission by

A) increasing catecholamine reuptake.
B) increasing metabolism by MAO.
C) releasing dopamine from vesicles into the cytoplasm and from the cytoplasm into the extracellular fluid.
D) shutting down the dopamine transporter and releasing dopamine back into the cytoplasm.

Question 40

Amphetamines increase catecholamine release in part by

A) increasing calcium influx.
B) reversing the transporter.
C) increasing the firing rate of catecholamine neurons.
D) decreasing autoreceptor function.

Question 41

Amphetamines have been medically prescribed for narcolepsy and weight loss but have largely been replaced with alternative drugs because

A) of the high cost associated with producing these drugs for medical use.
B) they are not as effective as other drugs in treating these conditions.
C) it is very difficult to control dosage for medical purposes.
D) they have such high abuse potential.

Question 42

What is the limitation of cross-sectional studies that show that people with methamphetamine addiction have problems with impulse control, memory, verbal learning, and social cognition compared with healthy individuals?

A) These studies are short term and do not take into account the impairments caused by long term drug use.
B) These studies do not sample a large enough population of addicted individuals to be conclusive.
C) It is impossible to know if the deficits were there before the addiction or were caused by the addiction.
D) It is difficult to determine if the deficits are due to the methamphetamine or other drugs that might be in the user's system.

Question 43

Compared to opioid and alcohol withdrawal, methamphetamine withdrawal symptoms are _______ severe and the drive to obtain more drug is due its _______ effects.

A) less; negative reinforcing
B) less; positive reinforcing
C) more; negative
D) more; positive

Question 44

Approximately _______ of individuals who develop methamphetamine use disorder experience at least one psychotic reaction.

A) 10% to 20%
B) 30% to 40%
C) 50% to 60%
D) 70% to 80%

Question 45

The precondition of _______ would make heavy amphetamine use particularly dangerous.

A) low blood pressure
B) atherosclerosis
C) depression
D) hypothryroidism

Question 46

Therapeutic doses of methylphenidate _______ DATs in the striatum and NETs in the frontal cortex, thereby _______ the level of both DA and NE in the extracelluar fluid.

A) block; increasing
B) block; decreasing
C) release; increasing
D) release; decreasing

Question 47

Which statement concerning the drugs used to treat ADHD is true?

A) These medications appear to have almost no adverse side effects.
B) Low doses of these medications increase activity and arousal in children but not adults.
C) Most of these drugs affect dopamine, with the exception of the drug Strattera, which works by affecting norepinephrine.
D) These drugs are safe to use because they have no abuse potential.

Question 48

How is it thought that guanfacine and α2A adrenoceptor agonist drugs enhance cognitive function?

A) They strengthen excitatory glutamatergic inputs to the PFC pyramidal neurons, thus increasing the cell firing.
B) They increase norepinephrine levels.
C) They strengthen excitatory glutamatergic pyramidal neurons to the VTA, thus increasing the cell firing.
D) They increase DA release in the dorsal and ventral striatum, amygdala, hippocampus, and PFC.

Question 49

Some researchers have hypothesized that optimal prefrontal cortical (PFC) functioning and cognitive performance occur with _______ activation of _______ adrenergic receptors and _______ DA receptors in the PFC.

A) moderate; α_2A; D₁
B) maximum; α₁; D₂
C) maximum; α_2A; D₁
D) moderate; α₁; D₂

Question 50

Modafinil is primarily used therapeutically for the treatment of

A) ADHD.
B) clinical depression.
C) insomnia.
D) narcolepsy.

Question 51

Mephedrone, methylone, MDPV, and α-PVP are all members of the class of

A) methamphetamine-like compounds.
B) drugs used to treat ADHD.
C) naturally occurring psychostimulants.
D) synthetic cathinones.

Question 52

Synthetic cathinones have _______ effects as other psychostimulants, and users tend to be _______ in the _______ age range.

A) similar; women; 18 to 35
B) similar; men; 18 to 35
C) different; women; 30 to 45
D) different; men; 30 to 45

Question 53

In experiments on rats, how did binging on self-administered of MDPV affect the rats' brains?

A) Overall neuronal dendrite branching was reduced.
B) Overall brain size was reduced.
C) There was evidence of neurodegeneration in the perirhinal and entorhinal cortical areas.
D) There was evidence of neurodegeneration in the striatum and hippocampus.

Question 54

Describe the historical use of cocaine in its natural form (chewing leaves), in beverages, and as treatments for various ailments. How did cocaine use change in the twentieth century?

Question 55

How is it thought to be possible for cocaine and amphetamine to increase extracellular DA in the nucleus accumbens (NAcc) in knockout mice lacking the DA transporter?

Question 56

Identify the various routes of administration for cocaine. Which routes of administration yield the most rapid absorption of cocaine? Identify two metabolites of cocaine use; one found after use of cocaine alone and the other found after using a combination cocaine and alcohol.

Question 57

Describe the effects of cocaine at the synapse in detail. What specific effects are most important for cocaine's reinforcing and addictive characteristics? What effects of cocaine are responsible for its action as a local anesthetic?

Question 58

List several effects of cocaine that occur at low to moderate doses. Which of these effects are considered to be part of the cocaine "high"? Identify several aversive effects that occur in high dose users.

Question 59

According to imaging studies of human brains, which three factors influence the occurrence and intensity of a cocaine or methylphenidate "high"?

Question 60

Which dopamine receptor subtype is most important for the functional effects of psychostimulants? What is the evidence for this conclusion?

Question 61

Describe the difference between psychostimulant tolerance and sensitization, indicate what patterns of drug exposure cause one or the other to occur, and identify the two phases of sensitization.

Question 62

What changes occur in the rat dopamine system under conditions of cocaine tolerance produced by long-access cocaine self-administration?

Question 63

Describe the serious neurological consequences of chronic or high dose cocaine use as well as the effects of such use on other systems of the body.

Question 64

Describe how behavioral treatment programs based on operant conditioning principles are designed to reduce cocaine abuse.

Question 65

List several members of the amphetamine family of drugs. How are their chemical structures similar? Identify two such compounds that occur in nature. How have amphetamines been used to treat diseases and enhance daily functioning, prior to governmental restriction?

Question 66

Compare methamphetamine with amphetamine in terms of route of administration, potency, effects at the synapse, psychological effects, and neurotoxicity.

Question 67

Describe the neurochemical effects of methylphenidate. Based on these effects, is methylphenidate more similar to cocaine or to amphetamine in its mechanism of action?

Question 68

Briefly describe the symptoms of ADHD in children, the three different subtypes of ADHD, and how the symptoms of this disorder are altered by psychostimulant medications. Identify some of the concerns that have been raised with respect to long-term treatment of children with psychostimulants.

Question 69

Describe the inverted U-shape function of catecholamine release/activity ascribed to the prefrontal cortex and cognitive functioning and indicate how various ADHD medications can optimize this system.

Question 70

Describe the behavioral and neurochemical effects of modafinil and indicate the major therapeutic use of this drug.

Question 71

List several members of the class of synthetic cathinones. How are these drugs typically consumed? Describe the two categories of synthetic cathinones based on their neurochemical mechanisms of action.

Question 72

Describe the adverse effects of high doses of synthetic cathinones.