Drugs of Abuse and Toxicity Flashcards
this is non-medical use of a variety of drugs that are prohibited by law
illicit drug use
this is use of an illicit drug or the excessive or nonmedical use of a licit drug
drug abuse
this plays a primary role in expression of reward
dopamine
this schedule is no medical use with high addiction potential drugs
1
this schedule is medical use and high addiction potential drugs
2
this schedule is medical use and moderate abuse potential drugs
3
this schedule is medical use and low abuse potential drugs
4
what schedule drugs are these
marijuana
flunitrazepam
heroin
LSD
mescaline
PCP
MDA
MDMA
STP
1
what schedule drugs are these:
amphetamines
cocaine
methylphenidate
short acting barbiturates
strong opioids
2
what schedule drugs are these:
anabolic steroids
babiturates
dronabinol
ketamine
sodium oxybate
3
what schedule drugs are these:
benzodiazepines
chloral hydrate
mild stimulants
most hypnotics
weak opioids
4
MAO of sedative- hypnotics
GABA agonist
nicotinic receptor antagonists
this drug class reduces inhibitions, suppresses anxiety, and produce relaxation
sedative-hypnotics
overdose maintenance of sedative-hypnotics
airway maintenance
flumazenil- benzodiazepine antidote
no antidote for barbiturates or ethanol
withdrawal of sedative hypnotics s/s
seizures
high anxiety
tremor
n/v
delirium and hallucinations
tx of sedative hypnotic withdrawals
long acting sedative hypnotics to suppress the acute withdrawal syndrome, followed by gradual dose reduction
function of these two drugs:
clonidine
propranolol
suppress sympathetic overactivity
what are these three drugs used for:
naltrexone, acamprostate, disulfuram
prevent alcohol consumption
opioid overdose tx
naloxone and ventilatory support
opioid withdrawal s/s
lacrimation
rhinorrhea
yawning, sweating, weakness
gooseflesh
n/v, tremor, muscle jerks
hyperpnea
(think water effect)
tx of opioid withdrawal
replacement of illicit drug with pharmacologically equivalent (methadone)
buprenorphine may be used
naloxone in someone using strong opioids
amphetamine MOA
alters transporters of CNS amines and increases their release (dopamine, NE, serotonin)
chronic high dose abuse of amphetamines can lead to…
psychotic state with delusions and paranoia
amphetamine overdose s/s
agitation
restlessness
tachycardia and hyperthermia
hyperreflexia and seizures
this drug class increases euphoria and self confidence
amphetamines
amphetamine withdrawal s/s
increased appetite
sleepiness
exhaustion
mental depression
(possible antidepressant drugs)
overdose tx of amphetamine
no specific antidote- supportive care for body temp and protection against cardiac arrhythmias/ seizures
chronic abuse of this stimulant may be associated with development of what condition
necrotizing arteritis
cocaine MAO
inhibitor of CNS transporters of dopamine, NE and serotonin
the effects of this stimulant are marked by short lasting euphoria, self-confidence, and mental alertness
cocaine
overdoses of this drug commonly lead to death from arrhythmias, seizures or respiratory depression
cocaine
cocaine cardiac toxicity partly due to blocking of _____ reuptake
NE
this property of cocaine leads to production of seizures
local anesthetic action
this cocaine property may lead to severe hypertensive episodes, MI, or CVA
vasoconstrictive
is there a specific cocaine antidote?
no
this is the study of toxic or harmful effects of chemicals
toxicology
what is the most important tx of poisoned patients?
supportive care- airway support
what are 3 procedures used to reduce absorption of poisons in the GI tract?
inducing emesis
gastric lavage
activated charcoal
these procedures to reduce absorption of poisons must be done within 1 hr of ingestion to be effective and any poison that has moved into the small intestine is not removed
inducing emesis (best if done in 5 min)
gastric lavage
this procedure to reduce absorption of poisons remains in the GI tract and absorbs poison throughout
activated charcoal
this toxicity is the major cause of hepatic failure in US
acetaminophen toxicity
what is the toxic metabolite of APAP
NAPQI
how can NAPQI be toxic
decreases glutathione and leads to cell death
what is the antidote for APAP
N-Acetylcysteine (NAC)
*it’s a precursor of glutathione
why can methanol be toxic?
metabolites are the cause of toxicity
metabolism of methanol
methanol broken down by alcohol dehydrogenase into formaldehyde which is broken down by aldehyde dehydrogenase into formic acid
what organ metabolizes ethylene glycol
liver via alcohol dehydrogenase to glycoaldehyde
what are the two antidotes to ethylene glycol
ethanol
fomepizole
both block metabolism of alcohol dehydrogenase
this drug can be used to treat ethylene glycol poisoning and has 500-1,000x greater affinity for alcohol dehydrogenase than ethanol and is the GOLD standard for tx
fomepizole
this is a tx of ethylene glycol that expedites elimination
hemodialysis
cyanide MOA
complete blockage of oxidative phosphorylation
binds Fe3+ (iron)
what is the most critical enzyme affected by cyanide?
cytochrome a3- loss of ATP synthesis w/o this enzyme functioning
what is the function of cytochrome a3
ATP synthesis
this antidote of cyanide includes sodium nitrate and sodium thiosulfate
nithoidote
MAO of nithoidote for cyanide
nitrite oxide oxidizes iron and converts Hb to methemoglobin which has very high affinity for cyanide and facilitates elimination
what cyanide antidote may cause severe hypotension
nithoidote
this is the antidote of choice for cyanide and has a high affinity for cyanide
cyanokit
in the presence of cyanokit and cyanide this is formed
nontoxic cyanobalamin
this toxin interacts with Na/K transporters and has a narrow TI
digoxin
overdose symptoms of digoxin
unusual blind spots
color mismatch
irregular pulse
tachycardia
digoxin antidote
digibind
digitalis antidote
digiFab
chelating agent of arsenic
dimercaprol
chelating agent of iron
deferoxamine
chelating agents of lead
succimer
EDTA
chelating agents of mercury
succimer
dimercaprol
this drugs acts as inhibiting the vitamin K cycle and reduces the activity of coagulation factor- dependent clotting functions
warfarin
warfarin antidote
ORAL phytonadione (vitamin K)
this antidote is used for paracetamol, chloroform, carbon tetrachloride, and radiocontrast nephropathy by replenishing depleted glutathione stores
acetylcyseine
this antidote is used for cholinesterase inhibitors and insecticides because it blocks muscarinic cholinoceptors
atropine
this antidote is used for drug-induced movement disorders by blocking muscarinic cholinoceptors
benzatropine
this antidote is used for beta antagonists and Ca2+ channel blockers by bypassing blockage of b receptors and stimulating cyclic AMP formation with positive cardiac inotropic effect
glucagon
this antidote is used for antimuscarinic drugs and inhibits acetylcholinesterase, causing ACh to accumulate at cholinoceptors
neostigmine
this antidote is used for hypertension, clonidine and ergotamine by blocking a receptors
phentolamine
this antidote is used for cholinesterase inhibitors or insecticides by reactivating cholinesterase
pralidoxime
this antidote is used for heparin and binds ionically to neutralize
protamine
this antidote is used for salicylate and alkalizes urine to enhance elimination
sodium bicarb
