5) Non-medical Drug Tox Flashcards
What is the class for Nalmefene (Revex)
Opiod antagonist
What are the important side effects for Nalmefene (Revex)
May produce a prolonged withdrawal state (nausea, vomiting, piloerection, yawning)
What is the class for N-acetylcysteine (Mucomyst)
Antioxidant
What is the mechanism for N-acetylcysteine (Mucomyst)
Supplies sulfhydryl groups to glutathione; improves microcirculation, provides anti-inflammatory effect
What are the therapeutics for N-acetylcysteine (Mucomyst)
Acetaminophen overdose
What is the mechanism for Fomepizole (Antizol)
Blocks alcohol dehydrogenase
What are the therapeutics for Fomepizole (Antizol)
Methanol & ethylene glycol poisoning
What are the miscellaneous for Fomepizole (Antizol)
Very expensive
What is the class for Cocaine
CNS stimulant
What is the mechanism for Cocaine
Blocks reuptake of dopamine, norepinephrine, and serotonin
What are the therapeutics for Cocaine
Topical anesthetic, combined vasoconstrictor and local anesthetic
What are the important side effects for Cocaine
Sympathetic effects; paranoia, aggression
What are the miscellaneous for Cocaine
Rapidly hydrolyzed by plasma cholinesterase; crack is the free base form
What is the class for LSD
Schedule I Hallucinogen
What is the mechanism for LSD
Agonist at 5HT2A receptors on Raphe cell body –> inhibition of Raphe Nuclei firing –> increased sensory input; partial dopamine agonist
What are the therapeutics for LSD
Schedule I hallucinogen; model hallucinogen against which all others compared; limited studies in psychoanalysis, alcoholism, autistic children, and terminal cancer patients
What are the important side effects for LSD
Bad trips (anxiety attack, panic attack), flashbacks, “street drug” lifestyle; no overdoses, birth defects, or chronic psychoses linked to LSD
What are the miscellaneous for LSD
Oxidized in liver; cross tolerance with mescaline and psilocybin
What is the class for Mescaline
Schedule I Hallucinogen
What is the mechanism for Mescaline
Agonist at 5HT2A receptors on Raphe cell body –> inhibition of Raphe Nuclei firing –> increased sensory input; partial dopamine agonist
What are the miscellaneous for Mescaline
Cross tolerance with LSD and psilocybin
What is the class for Psilocybin
Schedule I Hallucinogen
What is the mechanism for Psilocybin
Agonist at 5HT2A receptors on Raphe cell body –> inhibition of Raphe Nuclei firing –> increased sensory input; partial dopamine agonist
What are the miscellaneous for Psilocybin
Cross tolerance with mescaline and LSD
What is the class for Phencyclidine (PCP)
Dissociative anesthetic
What is the mechanism for Phencyclidine (PCP)
Antagonist of ion channel associated with NDMA receptor; agonist at mu opioid receptors
What are the important side effects for Phencyclidine (PCP)
Violent behavior, coma, seizures, arrest; inexplicable psychoses
What are the other side effects for Phencyclidine (PCP)
Dissociation, confusion, ataxia, marked nystagmus
What are the miscellaneous for Phencyclidine (PCP)
Long half-life due to being highly lipid soluble and having active metabolites
What is the mechanism for Amphetamines (Benzadrine)
Indirect sympathomimetic (release biologic amines from nerve terminals in periphery and in CNS); dopamine most important
What are the therapeutics for Amphetamines (Benzadrine)
Narcolepsy, ADHD
What are the important side effects for Amphetamines (Benzadrine)
Vasospasm leading to possible stroke or MI, arrhythmia, weight loss (anorectic effect)
What are the other side effects for Amphetamines (Benzadrine)
Tremor, anxiety, irritability, confusion, possibly paranoid state
What are the miscellaneous for Amphetamines (Benzadrine)
Others: dextroamphetamine (Dexedrine), methamphetamine (Desoxyn), methylphenidate (Ritalin)
What is the class for Marijuana (THC)
Cannabinoid
What is the mechanism for Marijuana (THC)
Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)
What are the therapeutics for Marijuana (THC)
Schedule I hallucinogen; anti-emetic, anti-nausea, and appetite stimulate for cancer chemotherapy and AIDS patients; analgesic for neuropathic pain; potentially: glaucoma, asthma, anxiolytic, migraine, and multiple sclerosis treatment
What are the important side effects for Marijuana (THC)
Vasodilation –> tachycardia, dilation of conjunctival vessels, bronchodilation, decreased intraocular pressure, hunger
What are the other side effects for Marijuana (THC)
May impair reproductive function in adolescents; heavy use may impair development of very young users; possible respiratory damage due to tar
What are the miscellaneous for Marijuana (THC)
Active ingredient is delta-9-tetrahydrocannabinol; metabolized by P450, with chronic use inducing enzyme; highly lipid soluble
What is the class for Anandamide
Endogenous cannabinoid
What is the mechanism for Anandamide
Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)
What are the therapeutics for Anandamide
Endogenous cannabinoid
What is the class for Dronabinol (Marinol)
Synthetic THC
What is the mechanism for Dronabinol (Marinol)
Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)
What are the therapeutics for Dronabinol (Marinol)
Schedule III drug; anti-emetic, anti-nausea, and appetite stimulate for cancer chemotherapy and AIDS patients
What is the class for Nabilone (Cesamet)
Synthetic THC
What is the mechanism for Nabilone (Cesamet)
Hits cannabinoid receptors (CB1, CB2: G-protein coupled receptors)
What are the therapeutics for Nabilone (Cesamet)
Schedule II drug; treatment-resistant nausea and vomiting, weight loss and anorexia in AIDS patients
What are the miscellaneous for Nabilone (Cesamet)
Less psychoactive side effects than marijuana
