2. Types of drugs, their actions and patterns of use in Australia Flashcards
1
Q
What is pharmacology
A
the branch of medicine concerned with the uses, effects, and modes of action of drugs.
2
Q
what does the effect a drug has on someone depend on?
A
the person, drug and environment
3
Q
what are the elements of a person
A
age, gender, individual health, cognitions/expectations
4
Q
what are the elements of a drug?
A
how it’s taken (oral, IV, smoked), amount used, frequency of use, duration of use/history and drug interactions
5
Q
what are the elements of the environment
A
social factors
6
Q
what are the two aspects of how a drug works?
A
pharmacokinetics, and pharmacodynamicss
7
Q
what are pharmacokinetics?
A
has to do with absorption, distribution, metabolism and extraction of a drug, or ‘what the body does to the drug’
8
Q
what are pharmacodynamics?
A
has to do with the biochemistry, pharmacology and effects of the drug, or what the drug does to the body
9
Q
what is involved in absorption in pharmacokinetics?
A
the way the body intakes the drug. either via the skin oral, smoked, IV
10
Q
how are drugs absorbed by the skin?
A
with patches, absorbed into the circulation
11
Q
how are drugs absorbed orally?
A
ingested, through the small intestine, through the liver and then into the circulation
12
Q
how are drugs absorbed by smoking?
A
through the mouth/lung lining an into the circulation
13
Q
how are drugs absorbed by IV?
A
Directly into the circulation
14
Q
what is involved in the distribution of drugs into the body
A
distribution is how the drug is taken to parts that affect your body. It goes to the organ with high blood flow first (such as the Brain) and the fat, muscles and skin later
15
Q
what is drug dependence/neuroadaption?
A
after a period of continual use a person can become dependant on a drug. dependence can be social, psychological as well as physical
16
Q
what is drug tolerance?
A
when dependant, less affected by drug/need more to feel effects
17
Q
what is drug withdrawal
A
when physically dependant, cessation results in withdrawal. In general withdrawal symptoms have opposite effect on the drug
18
Q
What is cross-dependence?
A
one substance can take place of another to continue physical dependence and avoid withdrawal
19
Q
what is the agonist effect?
A
an increase or stimulation the action of a neurotransmitter
20
Q
what is the antagonist effect?
A
decrease or inhibition of the action of a neurotransmitter
21
Q
what is dopamine?
A
Neurotransmitter related to reward/pleasure
22
Q
what is a half-life?
A
the time for the drug in blood to reduce by 50%. A short half life/short action is more likely to be abused (e.g. Cocaine and Nicotine)
23
Q
What is metabolism & excretion?
A
how to body releases the drug. This is mostly through urine, some through lungs or gut
24
Q
what are synapses?
A
They are in the brain and involve millions of pathways (nerves) similar to a mass of electrical wires. These nerces carry and transport Communication using chemical messages (neurotransmitters). Everything that we think, feel and do are the result of these chemical communications
25
how do most drugs act?
by mimicking normal neurotransmitters thus occupying receptor sites and sending "false" messages
26
what are examples of agonistic drug effects?
increases the synthesis of neurotransmitter molecules, increases number of neurotransmitter molecules by destroying degrading enzymes, increases the release of neurotransmitter molecules from terminal buttons, binds to autoreceptors and blocks their inhibitory effect on neurotransmitter release, binds to postsynaptic receptors and either activates them or increases the effect on them of neurotransmitter molecules, blocks the deactivation of neurotransmitter molecules by blocking degradation or reuptake
27
what are examples of antagonistic drug effects?
Drug blocks the synthesis of neurotransmitter molecues, causes the neurotransmitter molecules to leak from the vesicles and be destroyed by degrading enzymes, blocks the release of the neurotransmitter molecules from the terminal button, activates autoreceptors and inhibits neurotransmitter release, blocks the receptor and binds to the postsynaptic receptors and blocks the effect of the neurotransmitter
28
what are the three types of drug classes?
depressants, hallucinogens, stimulants
29
what do depressants do
slows your body down, may cause initial high/euphoria, impair coordination, some may cause emotional depression
30
what do hallucinogens do?
affects your perception, distort the brain's perception of reality, can cause auditory, tactile or visual hallucinations, include varying degrees of depression or stimulation depending on the substance
31
what do stimulants do?
speeds your body up, increase the body's state of arousal, accelerate central nervous system
32
what are examples of depressant drugs?
alcohol, herion, benzodiazepines, volatile substances
33
what can be classed as a depressant and hallucinogen?
Cannabis
34
what are examples of hallucinogens?
LSD, magic mushrooms
35
what can be classed between hallucinogens and Stiumulants?
Ecstacy
36
what are examples of stimulants?
nicotine, caffine, amphetamines, cocaine
37
what can small doses of depressants do?
put you in a state of relaxation, drowsiness and loss of inhibition
38
what can large doses of depressants do?
can cause loss of consciousness, respiratory inhibition and death. These are particularly dangerous when drugs are combined
39
what are the mechanisms of action of alcohol and benzodiazepines?
GABA agonist and glutamate antagonise
40
what does it mean by GABA agonist
reduces overall brain activity
41
what does it mean by glutamate antagonist
excitatory function reduced (effect of BZD on this system is not clear)
42
what do benzodiazepines focus on?
anxiolytic or sedative effects depending on the type. There are also differences in high-life and strength
43
why are benzodiazepines and alcohol cross-depressants?
because of the similar action on GABA system
44
what is GABA?
The GABA receptors are a class of receptors that respond to the neurotransmitter gamma-aminobutyric acid (GABA), the chief inhibitory compound in the mature vertebrate central nervous system. GABA receptors influence cognition by coordinating with glutamatergic processes.
45
what is the immediate affect of alcohol after a few drinks?
happy, more relaxed, less concentration, slow reflexes and less inhibited
46
what is the effect of alcohol after a few more drinks?
disinhibited, more confidence, less coordination, slurred speech, intense oods
47
what is the effect of alcohol after more than a few more drinks?
confusion, blurred vision, poor muscle control
48
what is the effect of alcohol after more and more and more drinks?
nausea, vomiting, sleep, and if you have more a coma or death
49
what parts of the body are affected by long-term heavy drinking?
the nervous system, liver, withdrawal related risks, other health effects, emotional/psychological/social
50
what are the long-term effects heavy drinking has on the nervous system?
brain damage, effects of memory (Korsakoff's syndrome)
51
what are the long-term effects of heavy drinking on the liver?
Damaged by alcohol processing - cirrhosis, liver cancer
52
what are the long-term effects of heavy drinking on withdrawal related risks?
seizures and in worst cases death
53
what are other long-term health risks of heavy drinking?
heart, muscle, pancreas, sexual organs, skin, stomach, intestines
54
what are the possible long-term effects of large consumption of ethanol on the brain
impaired development, wernicke-korsakoff syndrome, vision changes, ataxia, impaired memory, and other psychological effects
55
what are the possible long-term psychological effects of large consumption of ethanol?
cravings, irritability, antisociability, depression, anxiety, panic, psychosis, hallucinations, delusions, sleep disorders
56
what are the possible long-term effects of large consumption of ethanol on the mouth, trachea and esophagus
cancer
57
what are the possible long-term effects of large consumption of ethanol on the blood
anemia
58
what are the possible long-term effects of large consumption of ethanol on the heart
alcoholic cardio-myopathy
59
what are the possible long-term effects of large consumption of ethanol on the liver
cirrhosis, hepatits
60
what are the possible long-term effects of large consumption of ethanol on the stomach
chronic gastrinitis
61
what are the possible long-term effects of large consumption of ethanol on the pancreas
pancreatitis
62
what are the possible long-term effects of large consumption of ethanol on the peripheral tissues
increased risk of type 2 diabetes
63
what are the possible long-term effects of small to moderate consumption of ethanol on the systemic system/
increases insulin sensitivity, lower risk of diabtes
64
what are the possible long-term effects of small to moderate consumption of ethanol on the brain
Atrophy, reduced the number of silent infarcts, decreased risk of dementia
65
what are the possible long-term effects of small to moderate consumption of ethanol on the blood
increases HIDL, decreases thrombosis, reduces fibrinogen, increases fibrinolysis, reduces artery spasm from stress, increases coronary blood flow
66
what are the possible long-term effects of small to moderate consumption of ethanol on the skelton
higher bone mineral density
67
what are the possible long-term effects of small and large consumption of ethanol on the joints?
reduced risk of rheumatoid arthrisis
68
what are the possible long-term effects of small to moderate consumption of ethanol on the gallbladder
reduced risk of developing gallstones
69
what are the possible long-term effects of small to moderate consumption of ethanol on the kidney
reduced risk of developing kidney stones
70
what is the korsakoff syndrome caused by?
brain impairment due to chronic, heavy alcohol consumption and severely depleting vitamin B1 (Thiamine) which affects the formation of new memory
71
what is the main active ingredient in Cannabis?
THC
72
what does THC bind to?
cannabinoid receptors
73
What does cannabis interfere with?
the normal functioning of brain such as the cerebellum (affects coordination), hippocampus (affects memory), cerebral cortex (affects thinking)
74
what are the common effects of THC?
feelings of intoxication, loss of coordination and concentration, increased appetite, reddened eyes, anxiety or panic, hallucinations, paranoia, confusion
75
what are the long term effects of heavy use of cannabis?
health risks, brain function, ammotivational syndrome, severe psychotic behaviour
76
what are the health risks that occur as a result of long term effects of heavy use of cannabis?
bronchitis, lung cancer & respiratory disease, lower sperm count / irregular mestural cycle
77
what are the results on brain function of long term effects of heavy use of cannabis
loss of concentration, memory & learning abilities
78
what is amotivational syndrome?
loss of interest in activities, loss of energy, boredom, less sex drive
79
According to medicinal cannabis research what does medicinal cannabis improve?
Improvement in seizure disorders, especially in children, pain management, nausea associated with chemotherapy, and some other conditions
80
what is CBD
canabodile. It is an element in Cannabis
81
what does canabodile do?
antipsychotic, antidepressant, anxiolytic
82
why is medicinal use of cannabis controversial?
potential for misuse/inappropriate prescription, and risks associated with cannabis use (e.g. Psychosis)
83
according to queensland health, based on limited evidence, what are the conditions that may benefit from medicinal cannabis?
* severe muscular spasms and other symptoms of multiple sclerosis
* chemotherapy-induced nausea and vomiting
* some types of epilepsy with severe seizures
* palliative care (loss of appetite, nausea, vomiting, pain).
84
what is there no evidence that cannabis can treat?
cancer
85
what should patients NOT do when considering or using medicinal cannabis?
consider medicinal cannabis as an alternative treatment for cancer, defer their standard treatment in favour of using medicinal cannabis.
86
what are opiates good for?
pain relief as they have opiate receptors (endorphins)
87
what chemical in the body do opaites affect?
dopamine (reward effects)
88
what is main risk of opiate use?
high risk of overdose
89
what are the common effects of opiates?
feelings of well-being or euphoria, pinpoint pupils, sedation, shallow breathing, nausea and vomitting
90
what are the long term health effects of heavy use of opiates
constipation, weightloss/malnutrition, chronic heart/lung condition, infertility in women, irregular periods, injecting risks
91
what are other long term effects of of heavy use of opium?
loss of sex drive, dependency, overdose
92
what can save someone from an opium overdose?
Narcan (Naloxone)
93
what are the immediate effects of inhalant depressants?
all areas of the body are affected, psychological, hangovers and headaches can last for severl days
94
what are the effects inhalants have on all areas of the body?
can cause serious health effects to body including death
95
what are the psychological effects inhalants?
confusion
96
what are the long-term effects of inhalants?
Tremors, loss of sense of smell & hearing, problems with blood production, Irregular heart beat & damage to heart muscle, Liver & kidney damage, effects on brain function and psychological effects
97
what are the long-term psychological effects of inhalants?
irritability, hostility, feeling depressed or feeling persecuted
98
what are the long-term effects of inhalants on brain function?
Forgetfulness/memory impairment, Inattention/reduced ability to think clearly & logically
99
what do small doses of stimulants do?
increase awareness and concentration, decrease fatigue and amplify positive moods
100
what do large doses of stimulants do?
can cause excessive activity, irritability, nervousness, insomnia, delusions and hallucinations (drug-induced psychosis), convulsions, death
101
what is the dopamine agonist of nicotine?
reinforcing
102
what is the glutamate agonist of nicotine?
stimulant
103
what is the short term effect of nicotine?
it is highly addictive
104
what is nicotine so addictive?
due to the small half-life
105
what is the pro of nicotine
improves short-term memory
106
what is the con of nicotine?
serious long term health effects of smoking
107
what does methamphetamne do to the body>
significantly alters levels of dopamine (extreme agonist) and norepinephrine
108
what are the common effects of methamphetamines?
speeding up of bodily functions, dry mouth, sweating, large pupils, headaches, energetic & increased confidence, awake & alert, Talkative, restless, excited, trouble sleeping, panic attacks, reduced appetite, anxiety, hostility, aggression
109
what is the long term health effects of heavy use of methamphetamines?
rapid & irregular heart beat, high blood pressure, major seeping problems, malnutrition, injecting risks
110
what are the psycho-pathological long term effects of heavy use of methamphetamines?
anxiety and tension, amphetamine psychosis
111
what does ecstacy or MDMA affect?
serotonin
112
what is the half-life of MDMA?
6-10 hrs
113
what are the three phases of Ecstasy?
coming up, plateau, coming down
114
what happens in the coming up phase of ecstasy?
drug starts to take effect. Nausea, increased body temp, heart rate increase, difficulty focusing or make sense of what you are seeing, confusion, or panic
115
what happens in the plateau phase of ecstasy?
effects of levelling off. Heightened sensations, increased energy, confidence, talkativeness, feeling of warmth towards others
116
what happens in the coming down phase of ecstasy?
effects wearing off. Flat, depressed, exhausted
117
wat do high doses of ecstacy lead to?
```
o Convulsions
o Vomiting
o Floating sensations
o Irrational or bizarre behaviour
o Hallucinations
```
118
what are the long term effects of ecstacy?
brain damage, depression, anxiety and paranoia
119
what do emerging psychoactive substances have in common with current ones?
similar metabolic structures that mimic the effect of the traditional psychoactive drugs.
120
how do emerging psychoactive substances differ from current or traditional ones?
they are sufficiently different to avoid detection - metabolites
121
what are examples of emerging psychoactive substances?
```
o Cannabis (JWH-018, JWH-073, cannabicyclophexonal) – cannabiniod agonist
o Mephedrone (4-methylmethcathinone, 4-methylephedrone) – substituted cathionones
o NBOMe (251-NBOMe, 2C-I-BOMe) – psychedelic
o DMT (N,N-Dimethyltryptamine) and AMT (α-Methyltryptamine) general tryptamines
```
122
why are the effects of emerging psychoactive drugs ultimately known?
Ultimately unknown effects due to wide variety of drugs and subtle variations in chemical structure
123
what drugs are available via prescription?
Many opiates, benzodiazepines, amphetamines, and maybe in the near future cannabis, are available via prescription from a doctor
124
what is the trend of smoking between 2010 and 2013
there has been a significant decline
125
what is the ratio of Australians that smoke tobacco and drink alcohol at risky levels or used an illicit drug?
2 in 5
126
what is the trend of alcohol consumption in 2013
fewer people in Aus drank alcohol in harmful quantities
127
what is trend of illicit drug use in2013
declines in use of some illegal drugs in 2013 and othe relatively stable
128
who are more likely to smoke daily and drink alcohol in risky quantities and use meth in the previous 12 months?
people living in remote and very remote areas were twice as likely as people in major cities
129
who are more likely to smoke?
lowest socioeconomic status, unemployed, and indigenous australians
130
who are illicit drugs far more common to?
among people who identified as being homosexual or bisexyal
131
what is the trend of smoking sicne the early 19s?
gradually decreasing
132
what is the trend of daily smoking
declined (from 15.1% to 12.8%). rates almost haved since 1991 (24.3%)
133
what is the possible reason for the decline in smoking?
younger people delaying the take up of smoking - from average age 14.2 in 1995 to 15.9 years in 2013 (14-24yo)
134
how much was the average number of cigarettes smoked per week reduced to?
111 - 96
135
who smokes the most?
* Men more likely to be daily smokers and smoke more cigarettes per week
* Females were more likely to have ‘never smoked’
* People aged 40-49 most likely to be daily smokers
* However, 50-59 age group smoke most cigarettes per week
136
why do people quit smoking?
effects health or fitness, costing too much, wanting to get fit, family and friends asked to quit, worried it was affecting the health of others, anti-smoking ads, health warnings on packets, advice from doctos, other, restrictions on smoking in public places, pregnant or wanting to start family, restrictions smoking in the workplace, quitline, tobacco information line
137
what is the trend of alcohol?
recent decline, 2016 results necessary to assess this trend
138
what is the trend of alcohol consumption between 2010 and 2013?
declined significantly (from 7.2% to 6.5%) lowest level since 1991
139
what is the trend of those who have never consumed a full serve of alcohol?
significant increase (12.1% to 13.8%)
140
what is the trend of 12-17 ear olds drinking abstainers?
fewer 12-17 year olds drinking abstainers inceased significantly (from 64% to 72%)
141
who are the most likely to drink at risky levels?
men (32%)
142
what percentave of women are mostly likely to drink at risky levels?
14.6%
143
why is the trend of drinking alcohol declining?
• “Tobacco smoking is the single most preventable cause of ill health and death... It is responsible for more drug-related hospitalisations and deaths than alcohol and illicit drugs combined.”
o (AIHW 2010)
• “Alcohol causes the deaths and hospitalisation of slightly more children and young people than do all the illicit drugs combined…”
o (Loxley et al., 2004)
144
what percentage of the population in 2013 used illicit drugs?
42% including misuse of pharmceutical
145
how many people used illicit drugs in the last 12 months
3 million 15%
146
how many people used illicit drugs in 2010?
2.7 million (14.7%)
147
what drugs have there been a significant decline in?
ecstacy, heroin, GHB
148
how much has the misuse of phamaceuticals increased by>
4.2% to 4.7%
149
what is the most commonly used illicit drug?
cannabis - 10.2% recently; 35% lifetime
150
who are more likely to (males or females) to use illict drugs?
males more than femailes (18.1% compared with 12.1%)
151
who had the lowest rate of recent illicit drug use?
people aged 50 or older. However, recently shown the largest increase in illicit drug use (8.7% to 11.1% for 50–59yo; 5.1% to 6.4% for 60+)
152
what percentage of people aged 15-24 have used EPS in the Eurpean Union?
5%
153
what was the tend in the use of meth in 2013?
no significant increase
154
what was the trend of power and ice use in 2013?
powder use decreased (51% to 29%), ice (crystal methamphetamine) more than doubled (22% to 50%)
155
what was the trend of dailly or weekly use in ice users in 2013?
Significant increase in daily or weekly use (from 9.3% to 15.5%), particularly among ice users (from 12.4% to 25.3%).
156
what percentage of participants in the European Union study used synthetic cannabinoids in the last 12 months?
1.2% and 0.4% had used another EPS
157
what percentage of ecstacy users in Roxburgh's study in 2013 used recent use of any form of EPS?
44% - most commonly synthetic cannabinoids
158
what is the trend of non-medical use of pharmaceuticals between 2007 and 2013?
increased (3.7% in 2007 and 4.7 in 2013)
159
which gender is more likely to use illicit drugs?
males more than females with some notable exceptions
160
which gender between 14-17 years old is more likely to use illicit drugs?
females - 13.3% vs 15.7%
161
what percentage of Australians have used heroin?
1.4% and recently 0.2%
162
what is the trend of herione use btween 1998 and 2013?
much higher in 1998 and 2013.
o 1998 - males 1.1%, females 0.5%
o 2013 - males 0.3% and females 0.2%
163
what is the trend of tobacco use worldwide?
decline
164
what is Australia's position in the highest smoking countries?
Aus is one of the lowest according to the Organisation for Economic Cooperation and Development
165
what is Australia's position in the world with regard to alcohol consumption?
14th highest in the world per capita consumption of alcohol
166
how many litres of pure alcohol does a person in Australia drink a year and how does this compare to other years?
9.8 litres. Up from 7.5 litres in 2003. Equivalent to approx. 500 pints of beer each
167
who is the lowest alcohol drinking coutnry?
turkey 1.3 litres per year
168
who is the highest drinking country?
Luxembourg 15.5 litres
169
what is the community support for tobacco?
* Support for policies aimed at reducing harm caused by tobacco remained high
* Support for stricter enforcement law and penalties for supplying to minors (9 in 10 supportive)
* Reduction in concern about tobacco generally
170
what is the community support for alcohol?
• More people thought alcohol caused most drug-related deaths
o for the first time was higher than tobacco.
• Excessive use of alcohol the drug issue of most concern (4 in 10 people).
• Support for policies to reduce alcohol harm
o more severe penalties for drink driving (85%),
o stricter enforcement of the law against supplying to minors (84%).
171
what is the community support for illicit drugs?
• Meth/amphetamines illicit drug of greatest concern (increase from 9.5% to 16.1%)
o Increase in belief meth/amphetamines caused most deaths (4.7% to 8.7%), still lower than heroin (14.1%).
• Proportion nominating cannabis and heroin as ‘drug problem’ declined,
• Proportion nominating meth/amphetamines and pain-killers/analgesics increased.
• Most people try illicit drugs because they are curious (66%),
o And continue use to enhance experiences (30%) or for excitement (17.5%).
