CNS Depressants Flashcards
Other names for Optimum
Papaver somniferum / afeem / kasoomba / madak / chandu / poppy
Poppy seeds/ khus khus are non-toxic (as demulcent, in cooking)
Stages of opium toxicity
Stage of excitement
Stage of stupor
Stage of coma
Tests for detecting opium
MDH
Marquis test
Deniges test
Husemann’s test
Semisynthetic opium
Heroin ( diacetyl morphine)
Aka junk / dope / smack / brown sugar
Ways of taking Heroin / brown sugar / smack / dope / junk
Chasing the dragon (thick smoke)
Hot shot (with strychnine)
Speed ball (with cocaine)
Cutting in (with adulterants)
Sniffing
Subcut. / iv injections (main liners)
Adulterants as fructose, quinine, mannitol, chalk powder.
Alkaloids of opium
Morphine (FD 200mg)
Codiene (FD 800 mg)
Thebaine
Narcotine
Papaverine
Narcein
Heroin (FD 50 mg) is semisynthetic.
Standard opium
Contains 10% morhine
Standardized at Ghazipur factory (UP)
Opioids
Opiates are natural derivatives
Opioids are synthetic analogues
Tramadol
Methadone (FD 100 mg)
Pethidine (FD 1g)
Pentazocine
Loperamide
Diphenoxylate
Propoxyphene
Fentanyl
Preparation of opium
Unripe Capsule (when flower petals fall off) is vertically incised to collect white milky latex
Hardened
Crude opium (dried blackish plastic gummy) is used for alkaloid preparation
MOA of opium
Half life - 2h
1st pass metabolism
Enterohepatic circulation
Crosses placenta within 5 min
On opioid (G protein coupled) receptors in CNS.
Delta - antidepressant
Kappa - Analgesia
Miosis
Dysphoria
Sedation
Mu - Analgesia
Physical dependence
Sedation
Respiratory depression
MOA of heroin
Half life - 38min
Coverts to 6-monoacetylmorphine then to morphine.
Heroin is not present in blood on analysis.
Adulterated with quinine, scopolamine, strychnine, lactose, mannitol.
MLI of opium
Euthanasia ( by John Badkin Adams)
Accidental poisoning in addicts
Putting children to sleep
Body packer syndrome (packed in condoms and swallowed for smuggling)
Stage of excitement (very short)(absent in large doses)
Euphoria
Excitement
Talkativeness
Face flushing
Hallucination
Neonatal seizures
Restlessness
Stage of stupor
Initially
Drowsiness
Giddiness
Headache
Itching sensation
Nausea + vomit
Later
Desire to sleep
No arousal by external stimulus
Cyanosis
Contracted pupils
Stage of Narcosis (coma)
All reflexes lost
PINPOINT PUPIL (contraction)
Miosis
CNS depression
Respiratory depression
Pale face (+ perspiration)
Cold skin (+clammy)
BP decresed
RR decresed
Non-cardiogenic pulmonary edema
Death by asphyxia
