Drug Abuse And Dental Patients Flashcards
(41 cards)
Define drug abuse
Defined as a pattern of pathological behaviour associated with the continual use of a drug or drugs, despite persistent social, psychological or physical problems caused by such use
What issue can drug abuse cause
Drug abuse can produce pathological changes eg cardiac and liver damage
Dependence divided in
Dependence divided in psychological and physical.
Dependence divided in psychological and physical.
psychological=
Psychological; Feeling of satisfaction or psychic drive requiring periodic or continuous
administration of the drug to produce pleasure, or avoid discomfort.
Dependence divided in psychological and physical
physical=
Physical; or neuroadaptation , is characterised by physical disturbances when the drug is suspended, or when its actions are antagonized
… DEPENDANCE OFTEN OUTLASTS … DEPENDANCE AND IS THE MAJOR CAUSE OF … IN TREATED ADDICTS.
Psychological
Physical
Relapse
Drug tolerance?
Tolerance is the reduction in the effect of the drug due to prior exposure, and is dependant on the dose and frequency of the exposure.
The physiological basis for tolerance can be due to the decrease in the number of drug receptors, depletion of essential mediators, or a decrease in the plasma concentration with prolonged usage.
Tolerance may be overcome by increasing the dose of the drug.
ALCOHOL: THE SOCIALLY ACCEPTED ADDICTIVE BEVERAGE
ONE OF THE FEW DRUGS THAT DOES NOT ACT ON A SPECIFIC RECEPTOR SITE OF ITS OWN IN THE BODY
PERHAPS AS MANY AFFECTS OUTSIDE THE BRAIN, AS WITHIN, YET ITS USE IS PRIMARILY FOR ITS EFFECTS ON THE CNS
IT IS TOXIC TO ALMOST EVERYTHING, INCLUDING THE LIVER, HEART, BRAIN, GUT, PANCREAS AND FOETUS
PREDOMINENTLY ETHANOL, LESS SO METHANOL
PREDOMINENTLY ORALLY ADMINISTERED, LESS SO SNORTED OR VIA ENEMAS!!
How does alcohol affect the body?
10% ABSORBED VIA STOMACH WALL, 90% VIA SMALL INTESTINE (UNDERNORMAL CONDITIONS)
ALCOHOL PASSES CELL MEMBRANE VERY READILY
- ALCOHOL DEHYDROGENASE BREAKS ALCOHOL INTO ACETALDEHYDE
- ALDEHYDE DEHYDROGENASE TO ACETYL CO-ENZYME A
- THEN INTO KREBS CYCLE
- FINALLY PRODUCING CARBON DIOXIDE AND WATER
What causes hangovers from alcohol and how is this formed?
ACETALDEHYDE IS THE CAUSE OF THE MAJORITY OF THE UNPLEASENT AFFECTS OF ALCOHOL HANGOVER
EG FLUSHING, SWEATING, NAUSEA
METRONIDAZOLE INHIBITS ALDEHYDE DEHYDROGENASE LEADING TO ACETALDEHYDE ACCUMULATION IN TISSUE
What is a competitive inhibitor of methanol
Ethanol
It competes for the enzyme site on alcohol dehydrogenase
How should alcoholism be treated
ALCOHOLISM IS A PSYCHIATRIC CONDITION WHICH ORAL HEALTH CARE PROVIDERS MUST TREAT AS A SPECIFIC DISEASE WITHOUT MORAL IMPLICATIONS
Affects of long term alcoholism
MALNUTRITION
VIT DEFICIENCES ESPECIALLY VIT B COMPLEX JAUNDICE
NEUROLOGICAL DISORDERS EG TREMOR LIVER DYSFUNCTION
AGGRIVATED CARDIOVASCULAR DISEASE DRUG INTERACTIONS
IMPAIRED COORDINATION
PERSONALITY CHANGES
IMMUNOSUPRESSION
MEMORY LOSS
Affects of alcohol on the oral cavity
POOR ORAL HYGIENE
UVULITIS
INCREASED DECAYED, MISSING OR FILLED TEETH PERIODONTAL DISEASE
ORAL MUCOSAL CHANGES
CHANGES IN APPEARANCE OF TONGUE ENLARGED PAROTID GLANDS
XEROSTOMIA
PREDISPOSITION TO ORAL CANCER
Metamphetamine
What is it
Potent CNS stimulant
Can be smoked, swallowed, snorted or injected during drug use, with varying rapidity of onset.
Highly addictive, cheap and readily available when compared to some other illicit drugs
Methamphetamine is a powerful, highly addictive stimulant that affects the central nervous system. Also known as meth, chalk, ice, and crystal, among many other terms, it takes the form of a white, odourless, bitter- tasting crystalline powder that easily dissolves in water or alcohol
What is met-amphetamine used for clinically
Clinically its used to treat conditions such as ADHD
How is metamphetamine used recreationally
Smoking or injecting methamphetamine puts the drug very quickly into the bloodstream and brain, causing an immediate, intense “rush” and amplifying the drug’s addiction potential and adverse health consequences. The rush, or “flash,” lasts only a few minutes and is described as extremely pleasurable. Snorting or oral ingestion produces euphoria—a high, but not an intense rush. Snorting produces effects within 3 to 5 minutes, and oral ingestion produces effects within 15 to 20 minutes.
Because the pleasurable effects of methamphetamine disappear even before the drug concentration in the blood falls significantly, users try to maintain the high by taking more of the drug. In some cases, abusers indulge in a form of binging known as a “run,” foregoing food and sleep while continuing to take the drug for up to several days.
Metamphetamine long term effects
Addiction
Psychosis, including:
paranoia
hallucinations
repetitive motor activity
Changes in brain structure and function Deficits in thinking and motor skills
Increased distractibility
Memory loss
Aggressive or violent behaviour Mood disturbances
Severe dental problems
Due to clenching, dry mouth, poor oh, poor nutrition and gross neglect Weight loss
Cocaine - what is it
- Central Stimulant, amphetamine like drug, blocks the reuptake of Dopamine into nerve terminals
- Usually snorted
- Cocaine hydrochloride is water soluble, so can inject it
- Can also rub onto gums for absorption, as well as dissolve it and inject it
- Often mixed with all sorts of things to increase profits, eg cornstarch, talc, flour
- But can be mixed with other substances such as Methamphetamine, fentanyl or Heroin eg “a speedball”
What effects does cocaine cause regarding dopamine
- Normally, dopamine recycles back into the cell that released it, shutting off the signal between nerve cells.
- However, cocaine prevents dopamine from being recycled, causing large amounts to build up in the space between two nerve cells, stopping their normal communication.
- This flood of dopamine in the brain’s reward circuit strongly reinforces drug-taking behaviours, because the reward circuit eventually adapts to the excess of dopamine caused by cocaine, and becomes less sensitive to it.
- As a result, people take stronger and more frequent doses in an attempt to feel the same high, and to obtain relief from withdrawal.
Other affects of cocaine in the body
Cocaine inhibits the reuptake from nor-adrenaline (norepinephrine) by nerve terminals
Causes extreme happiness, mental alertness, hypersensitivity to sight, sound and touch, irritability, paranoia
Also constricted blood vessels, pupil dilation, nausea, irregular heart rate, increased body temperature, increased blood pressure, tremors and muscle twitches, (especially of the face), restlessness AND XEROSTOMIA
Long term increased risk of Parkinson’s, malnourishment due to appetite suppression
Cocaine freely passes through the placenta, leading to fetal hypoxia….. Retardation, congenital malformations, premature birth and in some cases death
How does cocaine overdose occur
An overdose occurs when a person uses enough of a drug to produce serious adverse effects, life-threatening symptoms, or death.
An overdose can be intentional or unintentional.
Some of the most frequent and severe health consequences of overdose are irregular heart rhythm, heart attacks, seizures, and strokes.
Other symptoms of cocaine overdose include difficulty breathing, high blood pressure, high body temperature, hallucinations, and extreme agitation or anxiety.
Marijuana
What is it
The plant contains the Tetrahydrocannabinol (THC) a mind-altering chemical
How does Marijuana cause effects
When a person smokes marijuana, THC quickly passes from the lungs into the bloodstream. The blood carries the chemical to the brain and other organs throughout the body.
