Drugs of Abuse Flashcards
Define intoxication
- transient syndrome
- psychological and physical impairment
Define dependence
- physiological and psychological phenomena
Define tolerance
- decreased effect (increased dose required)
Define withdrawal
Drug is reduced or withdrawn
Main site of action of heroin
- opiate receptors in brain and spinal cord: thalamus, hypothalamus, medulla
- sensory nerves in PNS
Physiological effects of heroin
- pain relief
- suppressed cough
- constipation
- drowsiness and confusion
- impaired coordination
- reduced HR, BP and RR
- constricted pupils
- euphoria and pleasure
Symptoms of opioid withdrawal
- nausea and vomiting
- muscle aches
- lacrimation
- rhinorrhoea
- sweating
- diarrhoea
- piloerection
Treatment of opioid overdose or withdrawal
- naloxone
- long-acting opioids (methadone)
- benzos and loperamide
Metabolism of alcohol
- absorbed into bloodstream in small intestine
- metabolised by liver
- excreted in urine, breath, sweat
Alcohol pharmacology
- CNS depressant
- enhances the inhibitory effects of GABA on its receptor
Physiological effects of alcohol
- altered judgement and reasoning
- pleasure, loss of emotional control
- loss of coordination and balance
- respiration and HR reduced
- alters long term memory formation
Symptoms of alcohol withdrawal
- mild anxiety and shakiness
- severe complications: seizures and delirium tremens
Medical management of alcohol withdrawal
- benzos
- anticonvulsant drug (carbamazepine)
- beta-blocker
Site of action of cocaine
Inhibits actions of Monoamine reuptake transporters
- increases the concentration of monoamines in the synaptic cleft (dopamine, serotonin, nor-epinephrine_
Physiological effects of cocaine
- increased energy and motor activity
- increased heart rate and BP
- euphoria
- decreased appetite
- mental alertness
- increased body temp
- dilated puils
MOA of methamphetamine
- inhibits monoamine reuptake transporters
- induces release of monoamines into synapse
- binds MAO and blocks degradation of monoamines
- causes the monoamine reuptake transporters to act in reverse
Effects of methamphetamine
- irritability and aggression
- anxiety/ paranoia
- increased wakefullness
- tremors/convulsions
- decreased appetitis
- high BP and increased HR
Effects of methamphetamine toxicity
- permanent psychosis
- hyperthermia
- stroke
- heart attack
MOA of cannabinoids
Similar chemical structure to anandamide, so recognised by neurons and alter normal brain messages
- inhibit release of glutamate or GABA
What does THC stand for?
- tetra-hydrocannabinol
Signs of cannabis withdrawal
- restlessness
- irritability
- agitation
- insomnia
- nausea
- cramping
Treatment of cannabis withdrawal
- benzos
- symptomatic relief
What is the two-step testing approach?
- screening test
- confirmation test (gas chromatography- MS)
Drugs tested for
- amphetamines
- barbiturates, benzos
- cannabinoids
- cocaine
- opiates
- phencyclidine
- alcohol
Possible interpretation of negative urine drug test
- not used drug that was tested for
- infrequent use of drug
- collection too long after drug use
- urine tampered
- test not sensitive
Detection time for cannabinoids
Up to 10 days for chronic use
Detection time for opiates
up to 4 days
3 approaches to specimen tampering
- dilution
- adulteration
- substitution
