Drugs Flashcards
What is a drug?
Natural or synthetic substance that is used to produce psychological or physiological effects in humans or other higher order animals
Drugs of abuse or illicit drugs
When drugs are produced legally or illegally, and are taken strictly for pleasure
When drugs are taken for a therapeutic reason, they are known as what?
Pharmaceuticals
Body’s physical need– or addiction– to a specific chemical
Drug dependence
The severity of likelihood of the dependence is influenced by what?
Nature of the drug
Route of administration
Dose
Frequency of use
Individual rate of metabolism
Personal characteristics of user
Drug dependence can be . . .
Physical, psychological, or involve aspects of both
Physical dependence involves what?
Physiological side effects of tolerance and withdrawal that usually results from chronic use
Physical dependence can result in what?
Withdrawal sickness
What is withdrawal sickness?
When the drug is abruptly stopped, the body will go through an illness that can have side effects worse than taking the drug
Examples of specific classes of drugs that are more prone to physical dependency?
Narcotics and depressants
Psychological Dependence is considered what?
Addiction
Addiction involves what?
Perceived need or desire for a drug
Inability to function normally without drug
Addicts often ponder drug use long after ____________ has subsided
Physical need
Two major patterns of abuse?
Initiated medically and unable to stop after medication course is over
Experimentation and recreational use
Tolerance
The need to ingest progressively larger amounts of a drug to maintain a desired effect
Tolerance is characterized by marked decrease in both _______ and _______ of desired effect of a dosage
Time duration and intensity
Tolerance development?
Inconsistent and unpredictable
What often accompanies increased tolerance?
Toxic side effects
Natural drugs?
Chemicals used either therapeutically or recreationally that are made from plants or animals
What kind of drugs can be either raw or refined?
Plant-derived
Raw plant-derived drugs
Cannabis, mushrooms
Refined plant-derived drugs
Heroin, cocaine
What type of drugs tend to be more pharmaceutical in nature?
Animal-derived drugs
Examples of animal-derived drugs that tend to be more pharmaceutical in nature?
Insulin
Cod liver
Thyroid
Bufotenine (venom from toads)
Many recreational drugs have plant-based sources?
Flowers
Seeds
Stems
Leaves
Roots
Fruit
Bark
Synthetic drugs
Derived from mineral sources using chemical processes
What type of drug has no natural ingredients?
Synthetic drug
Examples of synthetic drugs?
LSD
Methamphetamine
“Designer Drugs”
Synthetic drugs created from an illegal drug source
Examples of “Designer Drugs”?
Synthetic marijuana
“bath salts”
N-bomb (alternative to LSD)
Psychotropic drugs
Mind altering chemicals
Different categories of psychotropic drugs depending on the effect?
Excitantia
Inebriantia
Hypnotica
Euphorica
Phantastica
Entactogens
Psychodysleptics
These are drugs that cause an excited state, or are stimulants; known as “uppers”?
Excitania/Stimulants
Stimulants
Usually cause enhanced alertness, wakefulness, and temporary improvements to physical or mental functions
Also known as psychoanalytic in pharmacology?
Stimulants
Examples of stimulants?
Caffeine
Amphetamines
Nicotine
Cocaine
These are drugs that create a feeling of pleasure or happiness in a person? (also known as Depressants)
Inebriantia/Intoxicants
What are the most noted side-effects of intoxicants?
Pain-relief
Memory impairment
Lowered blood pressure
Lowered heart rate
Examples of intoxicants?
Alcohol
Nitrous Oxide
Barbiturates
These drugs induce sleep, usually treating insomnia, night terrors, and other sleep disorders?
Hypnotica/Soporifics
The most commonly prescribed soporifics (Hypnotica) fall in which category/
Benzodiazepines
Hypnotica/Soporifics are also known as what in pharmacology?
Psychodysleptic
These are drugs that are used as a tranquilizer or an analgesic?
Euphorica/Sedative
Side effects of sedatives?
Slurred speech
Staggering
Loss of reflexes
Unconsciousness
Are sedatives used therapeutically?
Yes
What are sedatives also known as in pharmacology?
Psycholeptic
Examples of sedatives?
Lorazepam
Valium
Klonopin
These are drugs that cause hallucinations
Phantastica/Hallucinogens
What are hallucinations?
A distortion of the perception of reality
Side effects of hallucinogens?
Hearing sounds
Seeing images that are not there
Feeling sensations that are not there
Examples of hallucinogens?
LSD
Peyote
PCP
Also known as an empathogen?
Entactogen
These drugs create experiences of oneness, emotional openness, and other emotion-based experiences?
Entactogens
These are considered different from hallucinogens, psychedelic, amphetamine or stimulants
Entactogens
Example of an entactogen?
MDMA
An analgesic or pain-killing substance that depresses the central nervous system?
Narcotics
What do Narcotics do?
Lowers vital body functions such as blood pressure, pulse rate, and breathing rate
Narcotics are also known as what?
Opioids
What do opioids include?
Morphine
Heroin
Thebaine
Methadone
Codeine
Opiates are drugs that are derived from what?
Opium poppy, which has the scientific name of Papaver somniferum
There is a group of drugs which are not derived from opiates but are considered opioids
These can be synthetic or semi-synthetic
What is the drug, Opium?
An emulsion of the poppy microparticles suspended in an aqueous solution (latex)
What is Opium?
A brown powder which has a morphine content ranging between 4% - 21%
Opium drug is most frequently sold, transported, and smuggled as what?
Heroin
Therapeutically, opioids were used as what?
Anesthesia
Cough suppressant
Diarrhea suppressant
What is Methadone used for?
Reverse opioid overdose
Side effects of opioids?
Itchiness
Sedation
Nausea
Respiratory depression (main effect in overdose)
Euphoria
Constipation
An analgesic that is used as a painkiller?
Morphine
When is morphine frequently used?
During myocardial infarction or during labor
Can be given orally, injected into muscle or dermal, or IV
Maximum effect occurs within 20-60 minutes (depending on delivery method) and wears off after 3-7 hours
Why does morphine have a high potential for abuse and addiction?
Patients and addicts will go through withdrawal if the drug is removed from their system
Morphine withdrawal stage I
6-14 hours after last dose; craving, anxiety, irritability, dysphoria
Morphine withdrawal stage II
14-18 hours; yawning, mild depression, crying, headaches, “yen sleep”
Morphine withdrawal stage III
16-24 hours; runny nose, dilated pupils, goosebumps, muscle twitches, inability to regulate temperature, aching bones/muscles, loss of appetite, intestinal cramping
Morphine withdrawal stage IV
24-36 hours; involuntary leg movements, insomnia, elevated blood pressure and body temperature, tachycardia
Morphine withdrawal stage V
36-72 hours; fetal position, vomiting, diarrhea, increased WBC count, weight loss between 2 to 5 kg per 24 hours
Morphine withdrawal stage VI
> 72 hours; recovery begins; acute symptoms becoming chronic (mostly psychological); may also involve increased pain sensitivity, hypertension, colitis, weight control problems
Heroin
Addition of an acetic anhydride or an acetyl chloride to morphine
Commonly, how is heroine put in the body?
Injected, which creates an instantaneous effect with maximum sensitivity
The “high” is accompanied by a sense of well-being and drowsiness, which lasts how long?
At least 3-4 hours
Thebaine
Unlike other opiates, this creates a stimulatory effect
Not used therapeutically, but thebaine can be converted into what?
Oxycodone
Oxymorphone
Naloxone
Created from an opiate with additional chemicals added?
Semi-synthetic opioids
Examples of semi-synthetic opioids
Oxycodone
Hydromorphone
Hydrocodone
Synthetic opioids that do not have natural opiates, but work on the same opioid receptors in the brain so they are included in the category
Demerol
Fentanyl
Dilaudid
Methadone
Normally used as an analgesic, ______ is frequently used to detoxify people who have an opioid dependence
methadone
Two ways methadone is used as an analgesic?
Methadone Maintenance Treatment
Methadone Reduction Programs
Methadone Maintenance Treatment (MMT)
Where a person will always be taking some dose of methadone
Methadone Reduction Programs
Where a person will reduce their dose of methadone until they are weaned off completely
Is addiction to methadone possible?
Yes; this can result in withdrawal and/or overdose
While codeine is a natural occurring opiate, it is now frequently synthesized from what?
Morphine
Where is codeine frequently found?
In cough medicine; it is used therapeutically for cough, diarrhea, and pain relief
For pain relief, it is frequently combined with what?
Acetaminophen, aspirin, or an NSAID (nonsteroidal anti-inflammatory drug)
As with other opiates, there is the possibility of addiction, withdrawal, and overdose with codeine
The proper way to minimize withdrawal is to gradually reduce medication with the supervision of health care providers
Hallucinogens
A drug which causes hallucinations, “out of body experiences,” and substantial changes in thoughts
According to L.E. Hollister and the National Institute on Drug Abuse, the criteria for hallucinogens is what?
In proportion to other effects, changes in thought, perception, and mood should predominate
Intellectual or memory impairment should be minimal
Stupor, narcosis, or excessive stimulation should not be an integral effect
Autonomic nervous system side effects should be minimal
Addictive craving should be absent
Examples of Hallucinogens?
LSD, Cannabinoids, Phencyclidine (PCP)
What is the active hallucinogenic compound in cannabinoids?
Tetrahydrocannabinol or THC
Cannabis family
C. sativa
C. indica
C. ruderalis
Various ways of using cannabinoids?
Marijuana– smoked or vaporized
Edibles, including tea
Hashish– resin of cannabis plant
Medincinal uses of cannabinoids?
Include reduction of excessive of eye pressure in glaucoma, lessening of nausea from anti-cancer drugs, muscle relaxant
The potency of THC depends on what?
the form of cannabinoid it is prepared as
Loose vegetation has an average THC content of ______
3 to 4.5%
Hashish contains an average THC content of ______
2 to 8%
Liquid hashish/hashish oil contains an average THC content of ______
8 to 22%
One drop placed on cigarette
What kind of dependency do hallucinogens create?
psychological not physical
Do hallucinogens have a withdrawal syndrome?
No since only a psychological dependency not a physical one
Common immediate effects of THC
Increased heart rate
Dryness of mouth
Reddening of eyes
Impaired motor skills and concentration
Frequent hunger and increased desire for sweets
Longterm effects of THC
Motivational symptoms such as:
Apathy
Impaired judgement, memory, and concentration
Loss of interest in personal appearance and goals
Commonly known as LSD, it is a hallucinogenic drug that is derived from ergot?
Lysergic Acid Diethylamide
Fungus that attacks certain grasses and grains?
Ergot
What is thought to be one of the causes of the Salem Witch Trials?
Ergot
LSD is very potent
25ug causes vivid hallucinations lasting up to 12 hours
Effects of LSD?
Mood changes
Anxiety
Tension
Prone to flashbacks and psychotic reactions after use is discontinued?
LSD
Commonly known as PCP?
Phencyclidine
What is a normal dose of PCP?
1-6mg
Common use of PCP?
smoking
ingesting
sniffing
Effects of PCP?
Feelings of strength, invulnerability
Dreaming sense of detachment to the point of unresponsive
Confused
Agitated
Depressed
Irritable
Feeling isolated
Audio and visual hallucinations
Paranoia
When PCP is combined with LSD or amphetamines, what is it known as?
“Angel dust”
How do depressants get their names?
Their depressing action on the Central Nervous System
This includes bradycardia, bradypnea, and eventually loss of consciousness and coma or death
Do depressants cause a physical dependence that can involve a withdrawal sickness?
Yes
Frequent depressants that are abused are?
Alcohol
Barbiturates
Methaqualone
Tranquilizers
Toluene
Ethyl alcohol (recreational drinking)
Suppresses the brain’s control of thought processes and muscle coordination
Low dose of ethyl alcohol
Inhibit mental processes of judgement, memory, and concentration
Memory becomes expansive, exudes confidence
Moderate dose of ethyl alcohol
Reduce coordination
Inhibit orderly thought processes and speech patterns
Slow down reaction times
Higher doses of ethyl alcohol
Highly irritable and emotional
Extremely high dose of ethyl alcohol
May lapse into unconsciousness or comatose state
Also known as “downers”
Barbiturates
~Creates a feeling of well-being, relaxation, and produces sleep
The most commonly used barbiturates in medical applications are?
Amobarbital
Secobarbital
Pentobarbital
Butabarbitol (short acting and absorbed fast)
Phenobarbital (long acting and absorbed slowly)
Taken orally, average sedative dose for barbiturates?
10-70 mg
Also known as quaaludes; powerful sedative and muscle relaxant
Non-barbiturate depressant– Methaqualone
Methaqualone was extremely popular in the late 1960s and 1970s, also known as what?
Ludes, sopers/soaps
One of the most commonly used recreational drugs in South Africa
Methaqualone
Overdose of Methaqualone can cause what?
Delirium
Convulsions
Kidney failure
Coma and/or death
A lethal dose of Methaqualone?
8000 mg
BUT, with an alcoholic beverage, it is reduced to 2000 mg
Produces relaxing tranquility without impairing high-thinking facilities
Tranquilizers
Also used to induce sleep, treat anxiety, or relieve tension
Tranquilizers
Drugs most commonly used as tranquilizers are?
Reserpine
Chlorpromazine
Minor tranquilizers include?
Diazepam (Valium)
Chlordiazepoxide (Librium)
Most often solvent used in glue sniffing
Toluene
What is glue sniffing?
Form of inhalant abuse which creates a feeling of euphoria and exhilaration
Typically, people who sniff glue will empty the solvent into a plastic bag and then put their face inside, breathing deeply
The solvent can also be heated and then inhaled
It can also be poured onto a rag and the vapors then inhaled
The effects of toluene?
Dizziness
Loss of coordination
Speech slurring
Respiratory failure
Drowsiness
Coma
Feeling of being able to “achieve the impossible”
Substance taken to increase alertness or activity?
Stimulant
What are stimulants also called?
“Uppers” or “stims” since they stimulate the CNS
What are stimulants commonly used for in medicine?
Treatment of ADHD
Promote weight loss
Treat Narcolepsy
Aid in smoking cessation
Counteract fatigue
The common stimulants that are abused are?
Amphetamines
Methamphetamines
Cocaine
Synthetic drugs that were discovered in 1887
Amphetamines
What are amphetamines used to treat?
ADHD and narcolepsy
For therapeutic reasons, how many mg/day is a normal dosage?
50-20 mg/day
Side effects of amphetamine abuse?
Hypertension or hypotension
Rayaud’s phenomenon
Tachycardia
Abdominal pain
Loss of appetite or nausea
Blurred vision
Dry mouth
Tachypnea
Other gastrointestinal tract issues
Most severe form of amphetamine abuse stems from what?
IV injections of amphetamine or a chemical derivative, known as methamphetamine or “crank”
Methamphetamine
Both used as a euphoriant and aphrodisiac
When created illegally, the form is normally known as ________ for its appearance
“crystal meth”
Form of methamphetamine which can be smoked and has similar effects to crack cocaine but involves a longer duration
“Ice”
Once the effects of the “high” wear off, what happens to the users?
Become depressed and often sleep for days
Chronic users experience what?
Acute psychosis and destructive behavioral
While there are a number of physical side effects, what is one of the more commonly known ones?
“Meth Mouth”
What is “meth mouth”?
This is the loss of teeth due to a combination of dry mouth, teeth grinding, high sugar consumption, and a loss of oral hygiene
Plant-derived drug that causes feelings of euphoria, increased energy and confidence?
Cocaine
~The plant is known as the coca plant
What form of cocaine takes approximately 15 seconds to reach the brain and cause the euphoric effects
Crack
High doses of cocaine have toxic effects such as what?
Cardiac arrest
Respiratory arrest
While there is a psychological dependency, there is no evidence of a ___________ for cocaine
physical dependency
Category of drugs that include those frequently used by teenagers and young adults at clubs, bars, concerts, and other social events
Club drugs
Drugs created in an underground or illegal laboratory
designer drugs
~They have a plant-derived drug as a base and are altered or designed to be more potent or addictive via chemistry
Most commonly used club drugs are . . .
MDMA
GHB
Rohypnol
Ketamine
Synthetic cannabinoids
Also known as MDMA or Ecstasy?
Methylenedioxymethamphetamine
A synthetic drug with methamphetamine at its base
Methylenedioxymethamphetamine
Methylenedioxymethamphetamine causes hallucinogenic effects which include what?
Self-awareness
Decrease of inhibition
Physical effects of Methylenedioxymethamphetamine?
Seizures
Muscle breakdown
Stroke
Kidney failure
Cardio-vascular system failure
GHB/Rohypnol
Gamma-Hydroxybutyric acid is one of the club drugs also known as “date rape drugs”
- It acts as a stimulant and aphrodisiac
- In certain doses, the victim of GHB will become groggy and sleepy, often losing memory
What has similar characteristics as GHB?
Flunitrazepam also known as Rohypnol since:
Both have the ability to form a physical dependence with withdrawal symptoms
Both can be found in blood or plasma, while Rohypnol metabolites can be found in urine up to 60 days
Also known as “Special K”
Ketamine
Therapeutically, ketamine is a drug used for what?
Anesthesia, usually in animals
Ketamine induces a state which can be described as what?
“Trance-like,” which may cause sedation or memory loss
Reactions to ketamine include what?
Hallucinations and confusion as well as elevated blood pressure
The most dangerous aspect of ketamine?
interactions ketamine has with other sedatives, such as alcohol, opioids, and benzodiazepines
Designer drugs that do not contain the chemicals in cannabis but produce the same effects?
Synthetic cannabinoids
Since synthetic cannabinoids are designer drugs that do not contain the chemicals in cannabis, it complicates things. . .
prevents drug tests from identifying cannabis
HOWEVER, the metabolites of synthetic cannabinoids are detectable in urine tests
Synthetic cannabinoids
the chemical is absorbed into a plant-based material and then smoked
Frequently known as herbal incense or herbal smoking blends (Scooby Snacks, K2, Spice)
Recently, __________ have been identified as the agent behind psychotic episodes days after recreational use
Synthetic cannabinoids
Because of the crude manufacturing, the composition of the drug is ______, as well as the ______ of each compound
unknown; concentration
Synthetic compounds chemically related to the male sex hormone testosterone
Anabolic steroids
Anabolic steroids are chemicals that promote development on two levels?
Androgen effect– secondary sex characteristic
Anabolic effect– muscle growth
What are anabolic steroids designed to do?
Minimize the androgenic effect and enhance muscle growth
Effects of anabolic steroid abuse includes?
Mood and personality effects
Decreased sex drive
Infertility
Liver disorders
Drug Control Laws
The severity of a penalty associated with the manufacture, distribution, and possession of a drug may depend on the weight of the drug or the concentration in a mixture
Controlled Substances Act
Created to prevent abuse of drugs
Federal law establishes five schedules of classification based upon?
Potential for abuse
Potential for physical and psychological dependence
Medical value
Controlled Substances Act– Schedule 1
The drug has a high potential for abuse
There is no currently accepted medical use in treatment in the US
Lack of accepted safety for use of the drug under medical supervision
Examples:
LSD
Marijuana
Methaqualone (Quaaludes)
Controlled Substances Act– Schedule II
The drug has a high potential for abuse
The drug has a currently accepted medical use with severe restrictions
Abuse of the drug may lead to severe psychological or physical dependence
Examples:
Morphine
PCP
Cocaine
Methadone
Methamphetamine
Controlled Substances Act– Schedule III
The drug has less potential for abuse than the drugs in Schedule 1 and II
The drug has a currently accepted medical use in the US
Abuse of the drug may lead to moderate or low physical dependence or high psychological dependence
Examples:
Anabolic steroids
Codeine/Hydrocodone with aspirin or Tylenol
Some barbiturates
Controlled Substances Act– Schedule IV
The drug or other substance has a low potential for abuse compared to drugs in Schedule III
The drug has a currently accepted medical use in treatment in the US
Abuse of the drug may lead to limited physical dependence or psychological dependence relative to Schedule III drugs
Examples:
Talwin (opioid)
Valium
Xanax
Controlled Substances Act– Schedule V
The drug has low potential for abuse relative to the drugs in Schedule IV
The drug has a currently accepted medical in treatment in the US
Abuse of the drug may lead to limited physical or psychological dependence relative to Schedule IV
Examples:
Cough medicine with codeine
Two steps to identification of drugs with the forensic setting
Screening tests
Confirmation tests
Screening tests
Non-specific, preliminary
Used to reduce possibilities of identification to a smaller number of substances
Confirmation tests
Specific
Usually, a single test which will prove the chemical composition of the substance in question
Screening test– Colorimetric tests
Five primary tests:
Marquis
Dillie-Koppanyi
Duquenois-Levine (plus solutions)
Van Urk
Scott Test (plus solutions)
Marquis
Turns purple in the presence of opium derivatives
Turns orange-brown in the presence of amphetamines and methamphetamines
Dillie-Koppanyi
Turns violet blue in the presence of barbituartes
Duquenois-Levine
Turns purple in the presence of THC
Van Urk
Turns blue in the presence of LSD
Scott Test
Turns blue, pink, and then blue again in the presence of cocaine
Screening tests– Microcrystalline Tests
A specific test which can help identify certain chemicals
A reactant is added which creates specific crystal formations, specific to the drug in question
Screening tests– Chromatography
Thin-Layer Chromatography (TLC) or Gas Chromatography (GC) separates drugs from their diluents for a tentative identification
What is chromatography usually run alongside?
Colorimetric screening tests and/or microcrystalline tests
Confirmation tests– Spectrophotometry
Using the Ultraviolet (UV) or Infrared (IR) regions, the absorption of light by drugs can be graphed and pinpointed to a specific drug
UV is useful for identifying the probable identity and exclude other drugs
IR can specifically identify a substance, but there must be as pure of a composition as possible
Confirmation tests– GC/MS
Combines the power of gas chromatography with the abilities of a mass spectrometer (GC/MS)
With few exceptions, no two substances fragment in the same fashion; therefore, it serves as a “fingerprint” of a chemical substance