Drug Misuse- Clinical aspects Flashcards
What are the most dangerous drugs?
Heroin Cocaine Barbiturates Street methadone Alcohol Kefamine Benzodiazepines Amphetamine Tobacco
What is cocaine?
Most potent natural stimulant
Extracted from leaves of coca leaves
What are the different forms of cocaine?
Coca leaves- chewed or brewed
Cocaine hydrochloride is snorted or injected
Cocaine freebase of crack cocaine is smoked
What are the effects of cocaine
Depends on dose and rate of entry to brain
Smoking- almost immediate
Injecting 15-30s
Snorting 3-5 minutes
Crack smoking effects are very intense but go away after 15 minutes or so
What does cocaine do
Stimulant and euphoriant
Increased alertness and energy
Increased confidence and poor judgement
Less sleep and increased appetite
What are the health damages of cocaine
Damage to nose and airways Convulsions respiratory failure Cardiac arrhythmias and MI Hypertension and CVA Toxic confusion Paranoid psychosis
What are the withdrawl effects of Cocaine?
Depression Irritability Agitation Craving Hyperphagia Hypersomnia
What is an amphetamine
Generally amphetamine sulphate
Sniffed,swallowed or injected
Effects similar to cocaine but longer lasting (many hours)
Toxic confusion occasionally convulsions and death
Amphetamine psychosis in chronic use (looks like schizophrenia)
What are opiates
Opium Morphine Heroin (diamorphine) Methadone Codeine and dihydrocodeine
What is the biggest risk to opioids?
How you take it
What is heroin?
First synthesised from morphine in 1874
Addictive potential unrecognised for years
May be in power or tar form
Purity varies from 1%-98%
How do you take heroin
Snort
Smoke- safe but expensive
Inject- most dangerous
What are the physical affects of heroin
Analgesia Drowsiness, sleepiness Mood changes (plEausre) Respiratory depression Cough reflex depression Sensitisation of the labyrinth with nausea and vomiting Decreased sympathetic outflow Lowering of body temperature Pupillary constriction Constipation Bradycardia/hypotension
What are the side effects of opioids
Short term- intense pleasure, physical and emotional anaesthetic
Medium term- phlebits, anorexia, constipation
Long term- tolerance, withdrawl, social and health problems
What are the withdrawl effects of opiates
Craving Insomnia Yawning Muscles pain and cramps Increased salivary, nasal and lacrimal secretions Dilated pupils Piloerection (goosebumps)
What is the purpose of methadone
To decriminalise drug users
Allows normalisation of lifestyle
Reduces IV misuse
Leakage onto the illicit market
What is ecstasy and what does it do?
Mixture of LSD and amphetamines Euphoria followed by the feeling of calm Increased solubility Can’t distinguish between what you want and what you don’t want Effects last 2-4 hours
What are the side effects of ecstasy
Nausea and dry mouth Increase blood pressure and temperature Club users risk dehydration Large doses can cause anxiety and panic Drug induced psychosis Liver and brain cell damage?
What is the most serious long terms effects of ecstasy
Seriously depleted serotonin centres
What is cannabis
Most commonly used illicit drug
Tetrahydrocannabinol is the psychoactive component (THC)
CBD is the relaxing aspect
What are the psychological effects of cannabis?
Relaxing or stimulating, euphoriant. Increases sociability and hilarity, increases appetite changes in time perception, synaesthesia
In high dose- anxiety panic, persecutors ideation, hallucinatory activity
What are the negative effects of cannabis?
Respiratory problems as with tobacco
Toxic confusion
Exacerbation of major mental illness
Cannabis psychosis
What are anabolic steroids
Also called androgenic steroids
Anabolic steroids, steroids for brevity
Family of drugs comprising testosterone and many synthetic analogies
Legitimately prescribed in hypogonadism, muscular dystrophy, various anemia’s and wasting in AIDS
What do anabolic steroids do?
Used in sports requiring muscle mass and strength
Also used to enhance appearance, increases muscle mass and reduces body fat
What are the side effect of steroids?
Acne, stretch marks and baldness
Feminisation in makes with hypoganadism and gynaecomastia (occasioning use of anti-oestrogen)
Virilasation in woman including hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning
What are the medical side effects of steroid use
Cardiovascular increased cholesterol and hypertension
Growth deficits due to premature closure of epiphyses
Liver disease (cholestatic jaundice, liver tumours)
Irritability and anger (roid rage)
Hypomania and mania
Depression and suicidality on withdrawl
