Clinical Aspects of Substance Misuse Flashcards
What type of drug is cocaine?
Monoamine reuptake inhibitor
What does a monoamine reuptake inhibitor do?
Increase dopamine, serotonin and noradrenaline
How quickly does cocaine affect someone if they smoke it?
Almost immediately
How quickly does cocaine affect someone if they smoke it?
3-5 minutes
What are some of the negative effects of cocaine?
- damage to nose and airways
- convulsions with respiratory failure
- cardiac arrhythmia’s and MI
- paranoid psychosis
What are the withdrawal effects from cocaine?
- Depression
- Irritability
- Agitation
- Craving
- Hyperphagia
- Hypersomnia
What is the common amphetamine that is used?
Amphetamine sulphate
What are the effects of amphetamine sulphate similar to?
Cocaine
the effects are longer lasting
What are the negative effects of amphetamines?
Toxic confusion
Convulsions
Death
What is common with chronic use of amphetamines?
Amphetamine psychosis
What are some examples of opioids?
- Opium
- Morphine
- Heroin (diamorphine)
- Methadone
- Codeine and dihydrocodeine
What was heroin first synthesised from?
Morphine
What was heroin used to treat initially?
Morphine addiction
How can heroin be administered?
Smoking
Injecting
What is the main receptor that heroin acts on?
Mu receptor
What is the result of heroin acting on the Mu receptor?
Mood effects
Analgesia
Euphoria
What are some of the effects of heroin on the body?
- Emotional analgesia
- Nausea initially
- Euphoria
- Pin point pupils
- Itching/sweating
- Constipation
- Decreased libido/menstrual irregularities
- Reduced cough reflex
What can a heroin overdose cause?
- Respiratory depression
- Snoring indicates risk
- Bradycardia
- Hypotension
- Death
How does opiate withdrawal syndrome present?
- craving
- insomnia
- yawning
- muscle pain and cramps
- increased salivary, nasal and lacrimal secretions
- dilated pupils
- piloerection (hence ‘cold turkey’)
What are some examples of benzodiazepines?
- Diazepam (Valium)
- Nitrazepam
- Temazepam
- Alprazolam (Xanax)
- Lorazepam
What type of drugs are benzodiazepines?
GABA agonists
What are the effects of ecstasy?
- relaxed euphoric state without hallucinations
- euphoria followed by feeling of calm
- increased sociability
How long do the effects of ecstasy last?
20 minutes to 2-4 hours
What are the side effects of ecstasy?
- Nausea and dry mouth
- increased blood pressure and temperature
- in clubs users risk dehydration
- large doses can cause anxiety and panic
- drug induced psychosis
What is the most commonly used illicit drug?
cannabis
What is the psychoactive agent in cannabis?
Tetrahydrocannabinol
What are the negative side effects of cannabis?
- respiratory problems as with tobacco
- toxic confusion
- exacerbation of major mental illness
- cannabis psychosis
What are some examples of performance and image enhancing drugs?
- Anabolic Steroids
- Growth Hormone
- Injectable Tanning agents eg Melotan
What are anabolic steroids legitimately prescribed for?
Hypogonadism
Muscular dystrophy
Various anaemias
Wasting in AIDS
What are anabolic steroids used for?
To enhance appearance -increase muscle mass and reduce body fat
What are cardiovascular side effects of anabolic steroids?
Increased cholesterol and hypertension
How can growth deficits occur with anabolic steroids?
Anabolic steroids cause premature closure of the epiphyses
What liver disease can anabolic steroids cause?
Cholestatic jaundice
Liver tumours
What are the psychological side effects of anabolic steroids?
- Irritability and anger – ‘roid rage’
- Hypomania and mania
- Depression and suicidality on withdrawal
What effects can anabolic steroids have on the skin?
Acne
Stretch marks
Baldness
What effect can steroids have in males?
Feminisation in males with hypogonadism and gynaecomastia
What effect can anabolic steroids have in women?
Virilisation in women including Hirsutism Deep voice Clitoral enlargement Menstrual irregularities Hair thinning
