CNS Stimulants - Lichtblau Flashcards
CNS effects of sympathomimetics?
Increased alertness/wakefulness Initiative, confidence, and alertness Increased motor and speech Decreased food consumption Stimulate respiration (rate and depth)
*Greatest effect seen if fatigue or lack of sleep is present
What kind of toxicity do you get with acute and chronic sympathomimetics use?
Acute: exaggerated therapy effects
- Cardio - headaches, arrythmia, palpitations, anginal pain, hyperthermia
- CNS - dizziness, agitation, confusion, insomnia, seizures, coma
- Treatment - Antipsychotic & Acidify patient urine
Chronic: Amphetamine psychosis
- hallucinations, delusions, and compulsions
- marked weight loss
- drug screen
- symptoms will resolve in 7-10 days
Do Sympathomimetics work for weight loss?
Yes, sort of. BUT very high abuse potential
What are a couple really good therapeutic uses for sympathomimetics?
ADHD
Narcolepsy
What are the three main mechanisms of action of cocaine?
Blocked reuptake of norepinephrine - motor
Blocked reuptake of dopamine - euphoria
Local anesthetic properties
Cocaine toxicity?
Cardiac arrythmia
Thombosis (coronary and cerebral)
In-utero brain development damaged
Ecstasy (MDMA) is derived from methamphetamine. How is it altered to change its effects?
A methyl group is added to increase lipophilicity and allow it to rapidly enter the brain
How does ecstasy(MDMA) act differently than amphetamines in its mechanism?
Stimulates the release and inhibits the reuptake of serotonin
Besides acting on serotonin, what does ecstasy affect?
Stimulates release and inhibits reuptake of epinephrine, noreprinephrine, and dopamine
What are bath salts and how are they abused?
They often contain various amphetamine-like chemicals: Methylenedioxypyrovalerone, Mephedrone
ACt as stimulants on brain. High abuse and addiction liability. (cocaine substitute?)
Toxicity with bath salts?
Chest pains, increased heart rate and BP, agitation, hallucinations, paranoia, delusions
Most commonly used xanthine?
Caffeine
Caffeine effects on CNS?
Stimulates cerebral cortex: (1st affected)
-clearer thoughts, less fatigue, mental dexterity
Medullary centers: (2nd affected)
-respiration and vasomotor center
Spinal cord (very large dose) -hyperreflexia
Apart from acting on the CNS, what kind of crazy stuff could that starbucks be doing to you?
Increased cardiac output Possible arrythmias Skeletal Muscle stimulation Diuretic Relax Smooth muscle
Proposed mechanisms?
Removes intracellular Ca from sarcoplasmic reticulum
Inhibits phosphodiesterase and leads to elevated levels of cAMP
Nonselective adenosine receptor antagonist, which stops sleepiness-inducing adenosine
