Drugs of Abuse Flashcards
Define drug abuse
Drug abuse in its broadest sense can be defined as the use of a drug in a manner that deviates from the approved medical patterns within a given society.
Decrease in response to a drug as a result of repeated treatment with that drug.
Tolerance : can be dispositional, pharmacodynamic, behavioral or cross-tolerance
Describe drug dependence
Physical - Physical symptoms are produced by drug withdrawal
Psychological - Compulsive feelings of the need to take a particular drug
What’s the difference between substance USE disorders and substance INDUCED disordres?
Substance Use Disorders
– Substance Abuse
– SubstanceDependence
Substance-Induced Disorders
– Substance Intoxication – Substance Withdrawal – Substance Induced
How are substance USE disorders classified?
By drug class
Define General Substance Use Disorder
A problematic pattern of substance use within a 12 month period manifest by two or more symptoms that cause impairment in functioning.
What are the criteria symptoms for substance use disorder
Taken in larger amounts or for longer than intended.
Persistent desire or unsuccessful efforts to cut down use.
Great deal of time spent in activities necessary to obtain the substance, use the substance, or recover from it’s effects.
Important social, occupational, or recreational activities are reduced or given up because of substance use.
Craving or a strong desire or urge to use the substance.
Psychological and/or physiological dependence are not necessary for diagnosis
What are the Criteria for Cannabis Use Disorder
Problematic pattern leading to clincally significant impairment or distress seen in 12 mo period, at least 2 of following:
- Cannabis often taken in larger amounts or over longer period then intended
- Perisistant disre or unsuccesful efforts to cut down or control use
- Great amt time spent to obtain, use and recover from cannabis
- Craving or strong desire to use
- Recurrent cannabis use may result in failure to fulfill major obligations
- Continued use despite persistant or recurrent social or interpersonal probelms cause or exaccerbated by effects of cannabis
- give up certain activities bc of it
- use in situations that are physically hazardous
- continue to use even though you know you have pyschological problems exacerbated by it
- Tolerance: need more to get high or diminished effect w/ continued use
- withdrawal from use
What is the highest drug of abuse in highschoolers
Marijuanna/Hashish
synthetic marijuianna; then we see prescribed and OTCs abused
**more common in males
*12th grade >>> 8th grade
What is the potent compound in cannabis
delta 9 THC
much more potent in oils
*potency directly related to THC (cannibidiol also effects potency but doesn’t cause high)
More THC, less cannibidiol and vice versa
Cannabis is Rapidly metabolized by____ to 11-OH-∆9-THC, which is highly active in man. Then metabolized to 9-nor-COOH-THC which is inactive.
Metabolites excreted in :
liver
urine and feces. They are detectable in urine for many days.
What is the onset of aciton of cannabis and how long does it take to leave body?
Smoked it reaches brain in 15 to 30 seconds. 3-5 times more potent smoked than when ingested. Oral onset of action is about 30 min.
Metabolized and redistributed in fat. Slowly leaves body.
What is the duration of action and plasma 1/2 life of cannabis
Duration of action 1 to 6 hours
– plasma half-life - 20-50 hours; 20% remains in body after 5 days and is not detectable at 30 days
- unique distribution in brain. High densities in cerebellum hippocampus and basal ganglia. Low in hypothalamus.
Affinity for receptor correlates with psychoactive potency of cannabinoid agonists.
CB1 Receptor (endogenous lingands for this exsist!)
What is the result of activation of the CB1 receptor to THC
Negatively coupled to adenylyl cyclase via Gi. Generally inhibits transmitter release.
What are endogenous agents in our bodies that bind to CB1 receptor
Anandamide and 2-arachidonylglycerol
What is Rimonobant
CB1 antagonist; blocks affect of THC and used for weight loss; but increases thoughts of suicide
Effects of marijuana use
- Euphoria
- Memory Impairment
- Perceptual-Motor alterations
- Cardiovascular
- Pulmonary
- Reproductive
- Psychopathological Effects
How is memory affected by THC use?
Impiar short term memory, hard to recall material learned when high
What type of motor effects are seen with marijuana use
Strong link to driving accidents
alcohol is #1
cannabis #2
CV effects of cannabis use
Dose related tachycardia and othorstatic hypotension, exacerbated angina
can also produce severe hypertension
Pulmonary effects of cannabis use
Bronchodialation, lung irritant (constriction), decrease alvelar macrophage acivity and decrease activity of ciliary function
Effect of marijuana on repro
Lowers testosterone levels and sperm counts.
Inrodents,gonadalweightsaredecreased.
LHRH release is decreased, which decreases levels of FSH and LH.
Prolactin release is decreased in females. Greater incidence of abnormal menstrual cycles.
Hazard to marginally fertile
Psychopathological effects of cannabis use
Acuteanxietyreaction
Transient paranoid feelings
Exacerbation of schizophrenia
Diffuse acute brain syndrome with high doses – Clouding of consciousness and memory, perceptual and sleep disorders
Amotivational syndrome
Is there tolerance and dependence related to marijuana?
Yes; both humans and animals
– Restlessness – Irritability and mild agitation – Sleep difficulties
– Decreased appetite and nausea – Craving
What is an approved use of cannabis
control of nausea and vomiting and AIDS wasting or cancer releated
What is synthetic marijuana
Sold as K2 or Spice or other names.
Contains synthetic compounds that have THC-like CB1 agonist activity.
Compounds that are not yet DEA scheduled and thus may be “legal”
JWH-018, JWH-073, HU-210 and others
AM-2201>
Which receptor does phencyclidine produce its hallucinogenic effects at?
at the n-methyl-d-aspartate receptor
PharmK for Phencyclidine:
_____absorption
Plasma 1/2 =
Hydroxylated and conjugated in the ___
rapid/complete
12-24 hrs and 72 in OD
in liver
*excreated in urein
Effects of Phencyclidine on the autonomic and CV systemp
Sympathomimetic:
Tachycardia, Hypertension, pothentiation of cathecholamines
**see tolerance
What are teh CNS effects of Ketamine and PCP
CNS effects are complex and dose related. Ketamine is less potent and has a shorter duration of action than PCP
Small doses - “drunken” state with numbness of extremities
Moderate doses - analgesia and anesthesia
Psychic state crudely resembles sensory isolation except that sensory impulses reach neocortex
Cataleptoid motor phenomenon are observed
Large doses may produce convulsions
Non competitive antagonist that act by blocking the NDMA receptor thus block the anion channel
PCP and Ketamine
What do we see in PCP overdose
CNS manifestations: anxiety, aggression, hallucinatins, dysphoria, convulsions, delirum,
Pympathomimetic: tachycardia and HTN crisis
How do we tx a PCP overdose
Support vitals and provide gastric suction; they slow down motility thus may be able to get shit out,
Acidify urine, give diazepam/ or other antihypertensive adn Haloperidol bc of its anticholinergic effects
What is our common hallucinogen?
LSD: its an indolemaine
as well as methamphetamines or amphetamines = phenethylamines (more sypmpathmimetic)
Pharm K of LSD
Less than 1 % crosses Blood-Brain barrier
Onset -15 to 20 minutes, duration - 12 hours
Sensory and subjective effects from LSD
Sympathomimetic-Tachycardia,increasedBP, psychomotor stimulation
Sensory and subjective effects
– Altered perception - particularly visual – Lability of mood – Impaired judgment
What receptor does LSD act on to cause sensory affects?
Sensory effects thought to be due to an action at 5- HT2 receptors - agonist or partial agonist.
Tolerance and cross tolerance
What may happen years after LSD use?
What kind of toxic side effects are seen in the body?
Flashbacks - days to years later, can be associated with drug use.
Neurotoxicity - 5-HT damage may be associated with phenethylamine type drugs such as MDMA
What is MDMA
Ecstasy : phenethylamine
What does ecstasy make you feel like?
How long doe it take to work?
Inducesfeelingsof“well-beingandconnection”, altered time perception
Typical oral dose 100-150 mg
Onset of action 20 - 40 minutes; duration 3-4 hours
What are some negative effects of ecstasy
Pyschomotorstimulation,restlessness,bruxisim, anorexia, sweating, tremor.
Hangover-anhedonia
Neurotoxicity-serotoninneurons??
•Found in brain. It is a precursor and metabolite of GABA
- May have own receptor
- Can be made in body from GBL
GHB (naturally occuring, can make you feel high)
GHBs effect in the body
Primarily a depressant - induces a state of relaxation and tranquility and interacts w/ ethanol
What do we see in OD and high doses of GHB?
Overdose characterized by drowsiness, ataxia, nausea and vomiting
Higher doses - loss of bladder control,
temporary amnesia, clonus and seizures.
Common inhalant abused by younger kids
toluene from model airplane glue
What is Salvia
use as a psychedelic for oral use
hort duration of action- 20 to 45 minutes. Creates dream-like experience with open and close eyed visuals. There can be dissociation at high doses with fear panic and perspiration.
- a Kappa opioid agonist.
Salvinorin-A
