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PMCOL 305 > cocaine > Flashcards

cocaine Flashcards

1
Q

what was the origional use of cocaine

A

as an anesthetic

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2
Q

what is the abuse potential for cocaine

A

high

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3
Q

what does cocaine do to mind (basic, 1 word)

A

euphoria

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4
Q

what is the main source of danger from cocaine

A

the cardiovascular effects

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5
Q

why does cocaine have the potential to cause damage to all organs (2)

A

lack of blood supply from vasoconstriction, increases blood clots

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6
Q

which country is Canadian’s major source of cocaine

A

colombia

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7
Q

how is most cocaine transported

A

in bricks of powder form

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8
Q

where does cocaine come from

A

coca plant

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9
Q

how do locals use the coca plant

A

they chew the leaves mixed with very basic substances to increase extraction(like lime)

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10
Q

how much paste comes from 500kg of coca leaves

A

1kg (0.2%)

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11
Q

how much paste comes from 5000kg of coca leaves

A

10kg (0.2%)

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12
Q

how do they extract active ingredients from coca leaves

A

add kerosene or gasoline

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13
Q

once the coca leaves and kerosene/gasoline are dried, what is left (and what is it made of)

A

cocaine paste, 75% cocaine but heavily contaminated with solvent

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14
Q

what is cocaine hydrochloride

A

when you add HCl to the paste

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15
Q

why do you want to make cocaine hydrochrolide (2)

A

because it makes it more easily transported and polar/water soluble

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16
Q

why is cocaine hydrochloride more water soluble

A

because HCl adds a charge (H+) so that makes it more water soluble

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17
Q

what are things that people cut cocaine with (add/ dilute to make more profit)

A

powdered milk, baby laxative, numbing anesthetics

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18
Q

what is levamisole

A

anti-helminthic drug given to cattle

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19
Q

what does levamisole do to the brain

A

mildly increase DA release

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20
Q

what does levamisole do to human body

A

cause purple discolouration and necrosis of tissue due to vasculitis

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21
Q

what is vasculitis

A

inflammation of vasculature

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22
Q

what % of cocaine is estimated (By DEA) to be contaminated

A

70%

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23
Q

why does levamisole make ears and tips of nose purple

A

because damages lining of vessels, RBC cant go in as easily, clots, immune response, no oxygen, tissues die (this happens a lot in extremities due to the fine vessels)

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24
Q

how fast is the onset when snorting cocaine

A

3-5 mins

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25
Q

how long do cocaine effects last when snorting

A

30-40 mins

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26
Q

how is cocaine absorbed when snorted

A

mucous membranes in nose

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27
Q

what happens to the nose of chronic snorters

why

A

the lose cartilage seperating nostrils

vasoconstriction + acidic erosion (hydrochoric acid of cocaine hydrochloride)

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28
Q

what is cocaine called when its in the form that can be snorted

A

cocaine hydrochloride

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29
Q

how fast is the onset when injecting cocaine

A

15-30 seconds

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30
Q

how long do cocaine effects last when injecting

A

10-20 mins

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31
Q

what are 2 dangers if the needle goes into an artery

A

severe vasoconstriction and necrosis

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32
Q

how does cocaine cause vasoconstriction (2)

A

prevention of NA uptake and decrease NO production

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33
Q

what happens if you try to smoke cocaine hydrochloride

A

it wont work

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34
Q

why cant you smoke cocaine hydrochloride

A

it will burn before it produces vapours so it is destroyed (both cocaine and HCL have pyrolysis at 195)

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35
Q

what is pyrolysis

A

degradation by heat

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36
Q

what temperature does cocaine pyrolysis happen

A

195

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37
Q

what temperature does HCl pyrolysis happen

A

195

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38
Q

what do you do if you wanna smoke cocaine hydrochloride

A

you want to convert it into a freebase form

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39
Q

what temperature does freebase cocaine vaporize at

A

98 degrees C

vaporizes before it burns

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40
Q

what are 4 steps to make freebase cocaine

A
  • dissolve cocaine hydrochloride in water
  • add base (ammonia)
  • extract with ether (explosive, flammable)
  • evaporate to dryness
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41
Q

what is the chemical reaction for making freebase

A

Coc-H+Cl- + NH3 –> Coc +NH4Cl

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42
Q

what are 2 ways to smoke cocaine

A

freebase and crack cocaine

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43
Q

how do you make crack cocaine (4 steps)

A

1-dissolve in water (low purity)
2-add baking soda (neutralize HCl)
3-heat
4-freebase will precipitate and be purified

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44
Q

is crack cocaine or freebase more pure

A

freebase

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45
Q

what is the chemical reaction for making crack cocaine

A

Coc-H+Cl- + NaCHO3 –> Coc +H2O + CO2 + NaCl

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46
Q

what is the onset effect for freebase and crack cocaine

A

6-10 seconds

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47
Q

what is the duration for freebase and crack cocaine

A

short, only a few mins

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48
Q

do people that smoke cocaine usually require repeated doses

A

yes

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49
Q

what is the major metabolite of cocaine

A

benzoylecgonine

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50
Q

what is benzoylecgonine

A

a major metabolite which appears within 4 hours of using cocaine

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51
Q

what is the metabolite of cocaine that is only found when taken with alcohol

A

cocaethylene

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52
Q

what is cocaethylene

A

metabolite of cocaine that is only found when taken with alcohol

53
Q

what are 3 side effects of cocaethylene

A

potent vasoconstrictor, damage heart tissue

may enhance euphoria

54
Q

what is methylecgonidine

A

pyrolysis metabolite that indicates that cocaine was smoked

55
Q

which is the pyrolysis metabolite that indicates that cocaine was smoked

A

methylecgonidine

56
Q

what are the 4 main cocaine metabolites

A

methylecgonidine
cocaethylene
benzoylecgonine
ecgonine methylester

57
Q

can you get psychosis from cocaine

A

yes

58
Q

what does cocaine do to your energy levels

A

increase

59
Q

what does cocaine do to your euphoria

A

increase

60
Q

what does cocaine do to your confidence

A

increase

61
Q

what does cocaine do to your sexuality

A

hypersexual

62
Q

what does cocaine do to mundane tasks

A

makes more pleasurable

63
Q

what is the mechanism of action of cocaine (2) (physiologically, NOT IN BRAIN)

A

blocks sodium channels

stimulates sympathetic system

64
Q

what does cocaine do to Na channels

A

blocks

65
Q

what happens when Na channels are blocked by cocaine

A

prevents nerve conduction (no pain)

66
Q

why can cocaine cause dysrhythmias

A

because blocking Na channels in the heart tissue inhibits depolarization

67
Q

why can cocaine cause sympathetic stimulation

A

excess NT in synapse (DA NA A 5HT)

68
Q

what does cocaine do to HR

A

increase

69
Q

what does cocaine do to BP

A

increase

70
Q

what does cocaine do to your weight

A

lose weight

71
Q

what does cocaine do to sleep

A

insomnia

72
Q

what does cocaine do to agitation levels

A

causes increase

73
Q

what does cocaine do to DA in NAc

A

causes accumulation

74
Q

what does cocaine do to transporter proteins that normally remove NTs

A

blocks

75
Q

what does cocaine do to post synaptic receptors (2)

A

prolongs and greater stimulation

76
Q

what are 2 important structural things in cocaine

why

A

the aromatic ring and amine group

mimics groups found in NTs like DA

77
Q

why is the the aromatic ring and amine group important for the mechanism of action of cocaine

A

because they mimic the same groups found in DA and other NTs

78
Q

which transporter does cocaine bind to and where

A

dopamine transporter, the same site as DA

79
Q

what happens when cocaine binds to the DA transporter

A

it locks the transporter into a certain conformation so that it no longer is able to function (cant cycle through open and closed states)

80
Q

what does DAT do normally

A

transports DA back into the presynaptic receptor to terminate the signal

81
Q

what happens to presynaptic uptake of DA when cocaine is there

A

it is blocked

82
Q

what happens do DA in synapse with cocaine present

A

it remains in the synapse

83
Q

what happens to the signal when cocaine is present

A

it is prolonged

84
Q

does cocaine influence phasic bursts of cocaine

A

no

85
Q

does cocaine influence basal or phasic DA release

A

more so tonic because it just causes a massive buildup of DA

86
Q

what happens to DA reusability with cocaine

A

its not reused as efficiently - you can run out of DA after a big binge

87
Q

what happens to DA levels in the NAc with cocaine

A

increased

88
Q

besides DAT, does cocaine effects other NT transporters

A

yes, noradrenaline and adrenaline and serotonin transporters are blocked too

89
Q

what happens when you try to mimic cocaine effects with drugs that exclusively block DAT

A

you dont get the same effects (you need NA A 5HT)

90
Q

is dopamine entirely responsible for the effects of cocaine by itself

A

no, you need NA A 5HT effects too

91
Q

how do we know that NA and A are involved with cocaine too

A

because of cardiovascular effects - NA=hypertension, A=tachycardia
(more levels of them due to blockade of their transporter)

92
Q

what happens to DAT activity in chronic users

A

it is increased

93
Q

why can you be depressed in absense of cocaine

A

because DAT is increased so less DA in cleft

94
Q

why is there an increased risk of stroke with cocaine

A

increase coagulation and impaired thrombosis (clot breakdown)

95
Q

what is thrombosis

A

clot breakdown

96
Q

what happens to HR and resp. with high acute doses + WHY

A

respiratory and circulatory failure due to effects on medulla

97
Q

what is rhabdomyolysis

A

breakdown of muscle tissue

98
Q

how does cocaine cause hyperthermia (2)

A

hyperactivity + vasoconstriction

99
Q

what can hyperthermia cause

A

rhabdomyolysis

100
Q

what does rhabdomyolysis cause (1 word)

A

myoglobinuria

101
Q

what does myoglobinuria cause

A

kidney failure

102
Q

what is myoglobinuria

A

myoglobin in urine

103
Q

who gets psychosis with cocaine

A

chronic users of high doses

104
Q

what is the increase of myocardial infarction within 1st hour after cocaine use

A

24 fold increase

105
Q

what % of heart attacks between 18-45 year olds is cause by cocaine

A

25%

106
Q

What does cocaine do to sympathetic output

A

increase

107
Q

What does cocaine do to catecholamine release

A

increase

108
Q

what 4 things happen with increased sympathetic output and catecholamines

A

increase HR and BP

coronary spams, vasoconstriction

109
Q

what does increase HR and BP cause

A

increase O2 demand

110
Q

what doe scoronary spams and vasoconstriction

A

decrease O2 supply

111
Q

what happens with increased O2 demand and decreased O2 supply

A

ischemia and infarction

112
Q

how does cocaine cause ischemia and infarction

A

sympathetic outflow, increase HR BP vasoconstrict/coronary spasm, more O2 demand less supply

113
Q

what is ischemia

A

organ not getting enough oxygen to function

114
Q

what is infarct

A

when parts of the heart dies off due to no oxygen - heart attack

115
Q

what is withdrawal of cocaine like when compared to alcohol and sedatives

A

fairly mild

116
Q

what is the most common characteristic of cocaine withdrawal

A

depression

117
Q

what is “let down” from cocaine

A

when you feel depressed within 30 mins of cocaine use

118
Q

what is “let down” severity linked to

A

dose and duration of use

119
Q

what is the role of benzos in controlling acute symptoms

A

controlling agitation from acute intoxication

120
Q

how do benzos help with acute cocaine

A

they decrease CNS effects and decrease NT release so that redeuces BP and HR

121
Q

what 2 drug classes have been used to decrease acute cocaine mortality

A

benzos (52%) and antipsychotics (29%)

122
Q

what is the first line of treatment for myocardial infarction

A

nitroglycerine

123
Q

how does nitroglycerine work, mechanism of action

A

produces nitric oxide which is a vasodilator

124
Q

how does nitroglycerine help the heart (3)

A

increases O2 to heart via vasodilation, reduces workload, reduces O2 consumption

125
Q

what does cocaine do to NO production

A

inhibits!!!

126
Q

how can you help treat hyperthermia with acute cocaine

A

cooling with ice water

127
Q

what kind of drugs work well for decreasing the reward of cocaine

A

drugs that increase GABAergic activity

128
Q

what does topirimate do

A

drug that enhances GABA-A receptor activity and inhibits glutamate receptor activity

129
Q

what can topirimate do to cravings

A

reduce

PMCOL 305 (26 decks)

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