Club Drugs

Question 1

MDMA

Answer 1

Club Drugs
• aka Ecstasy, “Molly”
Effect
• *Psychoactive: enhances the sensory effects; Feeling of ↑Energy, Euphoria, Emotional Warmth, Distortions: time/perception/Tactile.
MOA (MDMA (3,4-methylenedioxymethamphetamine)
1) ↑release of serotonin, dopamine, and norepinephrine from presynaptic neurons
2) prevents their metabolism by inhibiting monoamine oxidase.
• Synthetic, Chemically similar to Stimulant Methamphetamine & Allucinogen Mescaline.
ADE
• *Trismus (jaw clench);
- *bruxism (teeth-grinding)
- can be reduced by sucking on a pacifier or lollipop.

Question 2

Bath Salts

Answer 2

Club Drugs
Clinical Effects
• *Euphoria
• ↑d sociability and sex drive
Contents
• (Synthetic Cathinones) = family of drugs containing ≥1 synthetic chemicals related to *Cathinone, an amphetamine-like stimulant found naturally in Khat plant.
A/E
• some users experience paranoia, agitation, and hallucinatory delirium
• some even display psychotic and violent behavior – deaths have been reported

Question 3

GHB

Answer 3

Club Drugs
Date Rape Drugs
• *Gamma-HydroxyButyrate
• * aka Xyrem
• *CNS depressant
Effects:
• euphoria, progressing with higher doses to dizziness, hypersalivation, hypotonia, and amnesia.
MOA
• Acts on 2 site in brain:
1) GABA-a Receptor
2) Specific GHB-Bind site
• Metabolite of Inhibitory Neurotransmitter GABA, which exists naturally in brain but at much lower conc. than those found in GHB abuse.
A/E
• uncontrolled movements & Depression of Respiratory and CNS
• Bradycardia and hypothermia
• HighDose/ Overdose: Sedative effects = *Cheyne-Stokes respiration, Sleep, Coma, Death.
• Coma may be interrupted by agitation, with flailing activity described similar to a drowning swimmer fighting for air.

Question 4

Ketamine

Answer 4

Club Drugs
Date Rape Drugs
• “Special K”
• *“dissociative anesthetic”, bc it distorts perceptions of sight and sound and produces feelings of detachment from the environment and self.
• Ketamine is difficult to manufacture; therefore, illicit supply diverted from human and veterinary anesthesia products.
• Ketamine often is taken in “trail mixes” of methamphetamine, cocaine, sildenafil citrate (Viagra), or heroin.”
Effects (Similar to drug PCP)
• Low-dose intoxication results in impaired attention, learning ability, and memory.
• higher doses, ketamine can cause dreamlike states and hallucinations; and at higher doses still, ketamine can cause delirium and amnesia.”
Human medical ketamine Uses:
1) Anesthesia: a sedative and anesthetic
2) in the ED for procedural sedation in children
MOA
- NMDA-R Blocker
• Blocks a type of glutamate receptor (NMDA receptor)

Question 5

Flunitrazepam

Answer 5

Club Drugs
Date Rape Drugs
• aka *Rohypnol
Effect
- effects greater w/concurrent use of ETOH or other sedating drugs.
• ↓s anxiety, inhibition, and muscular tension
• hypotension, dizziness, confusion, visual disturbances, urinary retention, or aggressive behavior.
• 30 min after ingestion, peak at 2 hours, and may last up to 8-12 hrs.
MOA
• potent *Benzodiazepine ; Rapid onset.
- potency = *10x of diazepam (Valium).
A/E:
• Higher doses = Anterograde amnesia, lack of muscular control, loss of consciousness
• Chronic Use (any Benzodiazepine) ⇒ dependence & Addiction
- *Withdrawal Syndromes: headache, tension, anxiety, restlessness, muscle pain, photosensitivity, numbness/tingling extremities + ↑d seizure potential
ANTIDOTE
• If respiratory depression occurs, it can be reversed with **Flumazenil (benzodiazepine antidote).