Drugs of Abuse 2 Flashcards
Describe marijuana (pot, weed, grass)
Greenish-gray mixture of the dried, shredded leaves, stems, seeds and flower of Cannabis sativa (users smoke in hand-rolled cigarettes called joints)
What is a weed combo?
- weed plus coke
- weed plus bevs
How does weed suppress pain perception?
CB receptor 1 & 2
_______ use leads to tachycardia and conjunctival congestion or red conjunctiva
Marijuana
Acute effects of marijuana (3)
- Tachycardia
- Bronchial dilation
- Blood vessels in the eyes dilate → red conjunctiva
Effects of chronic use of marijuana
- Burning, stinging of the mouth and throat (often accompanied by a cough)
- Frequent acute chest illnesses & infections
- Obstructed airways
_____ produce rapid emotional swings, the perception of images, sounds, and sensations that do not exist.
Hallucinogens
Three examples of hallucinogens
- LSD
- Mescaline
- Psilocybin
Mechanism of action hallucinogens
Stimulate presynaptic and post synaptic serotonin receptors
What is the most potent hallucinogenic drug?
LSD
(clear, white, odorless water-soluble; man-made; similar to ergot alkaloids)
How is LSD most commonly sold?
postage stamp size paper impregnated with a dose of LSD
Which drug causes horizontal and vertical nystagmus?
PCP
(it will make it difficult to hold the patient down)
LSD is rapidly absorbed and effects begin at _____ (how long after ingestion). Peaking at _____.
- 40-60 minutes (25 µg)
- 2-4 hours
(gradually returning to baseline over 6-8 hours)
At doses of _____, LSD produces perceptual distortions, hallucinations, mood changes (elation, paranoia and depression), intense arousal, and (sometimes) panic.
100 mg
Physical effects of LSD (6)?
- Pupillary dilation
- Increased blood pressure
- Tachycardia
- Flushing
- Salivation, lacrimation and hyperreflexia
- Visual effects are prominent; color seems more intense and shapes may appear altered
Dissociative agents distort perceptions of sight and sound and produce feeling of being “out of body” and detached from environment. What are 3 commonly used dissociatvie agents?
- Phencyclidine (PCP)
- Ketamine
- Dextromethorphan (cough suppressant; high doses → like PCP)
White crystalline powder that is readily soluble in water or alcohol that blocks NMDA-type glutamate receptors in the cortex & limbic structures.
PCP (snorted, smoked or ingested)
(Memory loss and depression may persist for as long as a year after a chronic user stop taking PCP)
Meth or Crystal meth MOA
- Dopaminergic and adrenergic reuptake inhibitor.
- Euphoria and excitement occurs via stimulation of mesolimbic reward pathway
Methamphetamine is taken orally, IV or smoked in form referred to as “ice”. Short-term repeated administration (“spree”) causes ______ (4).
- Intense euphoria (“rush”)
- Increases alertness, self-confidence and ability to concentrate
- Increase in sexual urge
- Decreased appetite
Chronic use of methamphetamine will lead to drug craving, weight loss, _______ (5).
- Tooth decay
- Neurotoxicity
- Paranoia
- Hallucinations
- Depression
What is the tablet form of methamphetamine?
Ecstasy (aka MDMA)
(3,4 methylenedioxymethamphetamine)
Acute effects of ecstasy / MDMA
- Tachycardia
- Dry mouth
- Jaw clenching
- Muscle aches
(higher doses effects include visual hallucinations, hyperthermia and panic attacks)
High doses of ecstasy/MDMA can interfere with which process?
- Thermal regulation
(This can lead to liver kidney and cardiovascular failure)
Opiates mechanism of action
Stimulation of mu receptors → decreased pain reception, euphoria, sedation, respiratory depression
What is oxycontin?
Extended release of opiates
(patients open the capsule and put it into alcohol→OD)
Opiate withdrawal symptoms (5)
- Autonomic hyperexcitability
- Muscle spasms
- Lacrimation
- Tremor
- Diarrhea
(peaks at 48-72 h. after discontinuation or by precipitated withdrawal: administration of opioid antagonist)
What are the treatment options for opiate abuse (3)?
- Methadone: short-term detox (30 days; long-term 180 days)
- Buprenorphine (subutex): initial tx
- Buprenorphine + Naloxone (Suboxone): maintenance
What is the date rape drug?
Flunitrazepam (BZD)
(duration 8 hours, anterograde amnesia)
BZD side effects:
- hypotension
- memory impairment
- dizziness
- GI irritation
(withdrawal may cause delayed-hallucinations and seizures)
BZD intoxication managed with ______.
Flumazenil
(withdrawal may include hallucination & seizures)
Withdrawal/Detoxification of BZD is treated with _______ (2).
chlordiazepoxide or lorazepam tapered over 5-7days.
BZD abstinence symptoms:
- anxiety
- insomnia
- irritability
(May persist for several weeks)
Cocaine and amphetamines will block dopamine reuptake in the_____.
Nucleus accumbens
Opioids, nicotine and alcohol block dopaminergic neurons in the ________ .
VTA
Which drugs of abuse have no withdrawal symptoms?
LSD and PCP
Intoxication by caffeine, ______ (3) is only treated with supportive care (there is no specific treatment).
- Amphetamines
- Cocaine
- Marijuana
Which two drugs of abuse are treated with clonidine, Lorazepam, chlordiazepoxide or disulfiram?
- Alcohol
- Barbiturates
Nicotine is treated with bupropion or _____
Clonidine
_______ (drug of abuse) is treated with naloxone, methadone or Clonidine.
Opioids
_______ (drug of abuse) is treated with life support, diazepam, haloperidol.
PCP
Withdrawal from which drugs of abuse cause anxiety, seizures, hypertension, and irritability (2)?
- Barbiturates
- Benzodiazepines
Withdrawal from opioids causes which symptoms?
- Dysphoria
- Nausea
- Diarrhea
Withdrawal from marijuana causes which symptoms?
- Irritability
- Nausea
Withdrawal from nicotine causes which symptoms?
- Anxiety
- Dysphoria
- Increased appetite
Withdrawal from opioids causes which symptoms?
- Dysphoria
- Nausea
- Diarrhea
Which two drugs of abuse cause withdrawal symptoms of dysphoria and fatigue?
- Cocaine
- Amphetamines
What are the primary differences between Meth & Cocaine?
Meth: non-medical use, man-made, 50% of drug remains after 12 hours
