Exam 3 Flashcards
What class of drugs is cocaine known as?
Psychostimulant
Where does cocaine come from?
from the erythroxylan coca plant (their leaves contain cocaine)
Is cocaine synthesized or naturally occurring?
It is a naturally occurring drug
Who previously used cocaine?
The Native Americans used to chew the leaves from the coca plant in order to stay awake during battle.
What was cocaine mainly known for in the 1860’s?
during this time, it was used for medical purposes because they found it to be a local anesthetic
What did Sigmund Freud initially think of cocaine? What changed?
Freud used it as a treatment for heroin addiction, depression, and chronic fatigue syndrome
What is the Harrison Narcotic Act?
In 1914, this act was passed and it banned the use of cocaine in products
What is cocaine scheduled to be?
Schedule 2
Are the coca leaves highly concentrated with cocaine?
No, only about 15 of the leaf is cocaine
How is cocaine turned into a paste?
the coca leaves ca be soaked in water and mashed up to create a paste
How is cocaine paste turned into cocaine powder?
It is treated with Hydrochloric acid and it creates a salt like powder
What is pure cocaine HCl?
It is the cocaine powder that is not mixed with anything
What is the “normal” cocaine? The one that people typically snort
It is usually the cocaine that is cut with other substances such as talcum, baking soda, vitamins and even levamisole
What is levamisole?
It is a deworming agent given to dogs and cats that can be cut with cocaine HCl
What illness can levamisole cause?
Agranulocytosis which is a decrease in white blood cells (affects immune system)
What are the risks associated with injecting cocaine into the bloodstream?
It can lead to blood clots which lead to heart attack or stroke
What is free base cocaine?
It is Hydorchloric cocaine free from the ionic salt. Instead, ammonia or ether is used and it is extremely potent and dangerous
What is crack cocaine?
When HCl is mixed with baking soda so that it can bind to each other instead of cocaine.
What is a speed ball?
cocaine and heroin
What is a frisco speed ball?
The mixing of cocaine, heroin, and LSD
How is cocaine absorbed
- Snorted
- Injected
- Oral (uncommon)
- Smoked (crack only)
Is snorting cocaine an efficient way or absorbing the drug?
No because only about 20-30% of it is absorbed.
How is cocaine injected?
It is injected by mixing with water
What is meant by cocaine being a vasoconstrictor?
It means that it shrinks our blood vessels
What is the half life of cocaine?
30-90minutes once in the liver (rapidly metabolized and excreted)
How long for cocaine to get out of the brain?
8 hours
What is cocaine’s first metabolite?
Benzoylecgonine and it is inactive
what is the metabolite that forms when alcohol and cocaine is processed at the same time?
Cocaethylene, it is active and more toxic
What are cocaines mechanisms of action?
- vasoconstrictor
- local anesthetic
- psychostimulant (reinforcing effect that can lead to abuse)
What receptors does cocaine affect?
It will block the reuptake of dopamine, norepinephrine and serotonin. Since not much will be released, there will be an increase. Cocaine is an agonist to them
What are some of the dangers associated with cocaine use?
- less oxygen levels in the body
- cardiac complications
- complications in nasal and pulmonary systems
What is the difference between crack cocaine and free base cocaine
Freebase: made with ammonia or ether (highly flammable)
Crack cocaine: cocaine hydrochloride with baking soda
What is toxic paranoid psychosis syndrome?
A syndrome that occurs with cocaine users and the symptoms include anxiety, sleep issues, paranoia, hyperactivity, hallucinations (formication)
How is cocaine tolerance described?
there is a significant tolerance to cocaine, it can cause a 20% reduction in dopamine receptors which means more drug will also be needed to feel effects
How is cocaine dependence described?
There is both physical and psychological dependence which are both serious
What are some of cocaine’s withdrawal symptoms?
- increase in depression
- loss of coordination
- tremorsand seizures
- dysphoria
- cravings
Which is the ONLY way in which cocaine can be smoked?
Crack cocaine
What are some cocaine treatment options?
inpatient treatment: staying in a hospital
Outpatient treatment: visiting hospital during the day,
Short inpatient program followed by outpatient treatment.
Other resources provided
What is the first step in obtaining treatment for cocaine?
Detoxification and total abstinence
What are some medications that can treat cocaine withdrawal symptoms?
Ritalin
Zofran (reduce cravings)
cocaine vaccine
When working with cocaine addicts, what is one factor we must take care of during withdrawal?
Depression, if the patient used cocaine to treat depression, when we take them off cocaine, we have to ensure they are also being treated for depression (that may reemerge)
What is a teratogen? How does this relate to cocaine?
Cocaine is a teratogen meaning it is known to cause malformations of the embryo.
What effects does cocaine have during pregnancy?
- teratogen
- Since it is a vasoconstrictor, it will decrease blood flow between mother and fetus
- Can be found in breast milk
What effects does cocaine have in crack babies?
Can grow up to have learning disabilities, social problems, and ADHD
What are bath salts classified as?
synthetic cathinones: a synthetic version of cocaine
Why are synthetic drugs made?
They are made to have the actions of an illegal drug but not be chemically identical to it so that it technically wouldn’t be considered illegal.
What type of chemicals are in bathdalts?
They are amphetamine like synthetics (ex: MPDV, mephedrone, methylone,etc)
What is cocaines crash described as?
As intake of cocaine increases, the “crash” gets increasingly worse as well and makes users feel even worse than when they first started using
What is the absorption of bath salts?
It can be absorbed orally or in the mucous membranes, the high is very potent for both
Can bath salt chemicals be detected on regular UA?
No, there are special tests that can detect those chemicals 48-72 hours later
Are bath salts stimulants?
Yes, they can produce significant psychological and physical stimulation
What is the synthetic drug abuse prevention act?
It was an act singed in 2012 by Obama to regulate synthetic drugs as schedule 1 (include bath salts)
Are amphetamines synthetic or natural?
Synthetic but they come from the ma huang herb
What is the active chemical in ma huang?
Ephedrine
What did Gordon Alles do?
He was a scientist that developed a synthetic version of ephedrine and named it amphetamine
What has amphetamine previously been used for?
Medical purposes since the 1930s
What was one of the first amphetamine medication?
Benzedrine
What is the US drug regulation and control act?
It was a law that was passed and made amphetamines schedule 2 drugs
What are the 3 other forms of amphetamine?
Dextroamphetamine
Levamphetamine
Methamphetamine hydrochloride (salt version of methamphetamine)
What is the absorption of amptheamines?
- oral (pills_
- intravenously
- Some are smoked (crystal meth)
How is the metabolism of amphetamines described?
Most are unaffected by metabolism so a lot of it is not broken down.
How is the excretion of amphetamines described?
Since they are not broken down well, a lot of it is excreted as methamphetamine and some is pure amphetamine.
Only a very small portion is broken down as mildly active metabolite
What receptors does amphetamine affect?
Dopamine and norepinephrine (it stimulates their release)
Which nervous system does amphetamine stimulate?
the autonomic nervous system (specifically, the sympathetic)
What is amphetamine psychosis?
A syndrome that can develop in users that are high users of amphetamine
(paranoia, delusions, violence, hallucinations, weight loss, mood swings)
What are some of amphetamines withdrawal symptoms?
- increased appetite
- depression
- suicidal
- weight gain
- more sleepy
How is tolerance and dependence to amphetamine described?
It develops quickly and is strong. They correlate with each other
How is crystal meth absorbed?
It tends to get smoked
What is crystal meth’s half life?
12 hours
How is crystal meths metabolism?
It is slow and not a lot is broken down
What is the neurotransmitter effect for methamphetamines?
50% decrease in dopamine and serotonin
Which type of labs are crystal meth produced in?
Clandestine meth labs
For every lb of meth produced, there is ___ lbs of toxic waste
5-7 lbs
What are some of the common products used in meth production? What do these products create?
- red phosphorus (used in matches)
- ephedrine (chemicals from ma huang)
-blue iodine (chemical)
The combination creates phosphine gas which is highly explosive and toxic and can explode
What is ADHD?
It is an attention deficit hyperactivity disorder that affects youth
What is ADHD diagnosed by?
inattentive symptoms, hyperactivity symptoms, impulsive symptoms
What drugs can be used for ADHD?
Ritalin
Concerta
Focalin
Aderall
What is the half life of ritalin?
2-4 hours
Is ritalin amphetamine based?
No, it blocks the reuptake of DA and NE
Why is ritalin effective?
Because it has a similar mechanism of action as cocaine
What is aderall a combination of?
Amphetamine and dextroamphetamine
What is aderall’s half life?
7-8 hours (unlike ritalin, it does not need to be taken twice)
Why is it bad to use ADHD medications as a study aid?
Study has found it to be sort of a myth because too much stimulation can block our cognitive performance
Is caffeine addictive?
Yes, it is generally safe but highly addictive
What class of drugs is caffeine?
psychostimulant
Where does caffeine come from
coffee plant and beans
What is the theory in regards to caffeine being in plants (naturally occuring)?
That it should act as a natural insecticide
What did the six day Starbucks research suggest?
That caffeine portions can vary
Caffeine belongs to which family of chemicals?
Xanthines
How is caffeine’s absorption described?
Rapid and full
What is caffeine’s half life?
4-6 hours
What enzyme degrades caffeine?
CYP1A2
What are the 2 metabolites from caffeine?
Theophylline and theobromine (weak but active)
What receptors does caffeine affect?
adenosine (A2A and A1)
What are adenosine receptors responsible for?
Making someone sleepy (when blocked, they will make one feel awake)
What is an important physical effect that caffeine does to our arteries?
It tends to dilate coronary arteries (these carry blood to the heart)
Dilating them makes them larger and allows more blood flow
What does caffeine do to our brain blood vessels?
The brain blood vessels carry blood into the brain and caffeine makes them smaller
What is the theory behind caffeine and headaches?
Headaches enlarge blood vessels and cause pressure (causing the pain) so by constrict blood vessels (after drinking caffeine) it helps
How is dependence to caffeine described?
There is both physical and psychological dependence (both are strong)
What is caffeinism?
When people take very high volumes of caffeine (100 mg per day)
What is the only legal FDA approved stimulant?
Caffeine
What are the 2 main products found in redbull?
Taurine and glucuronolactone
What is taurine?
A major part of the bile
What is glucuronolactone?
A carbohydrate
Why did Redbull settle a class action suit?
Because its advertising promoted false claims about energy and performance
Why are vodka redbulls dangerous?
Because it is a combination of caffeine, alcohol, and sugar. this can dehydrate the body and promote the release of fluids
What is the common ingredient in rockstars?
B vitamins
Why was four loko banned from caffeine and alcohol?
Because the combination was too high
Where does nicotine come from?
Tobacco plants
What are the 2 main types of smoke that is released from cigarettes?
Mainstream and side stream
What is mainstream smoke?
The smoke that travels through the cigarette
What is side stream smoke?
The smoke that comes out of a cigarette and released into the environment
What are the 2 phases in maistream smoke?
gaseous and particulant
What is the cilia elevator? How does tar affect it?
A part of our airway that is affected by tar because the tar can coat the lungs and trachea whi h can cause cancer and other issues
Can tar be taken out of cigarettes?
No because it is attached to nicotine
What is an important gas from the gaseous phase?
Carbon monoxide
How is carbon monoxide toxic?
It binds to the hemoglobin and our hemoglobin is responsible for taking o2 from lungs to the body. Our blood will instead carry carbon monoxide
Carbon monoxide binds to hemoglobin with a ___x stronger affinity
200X
Why do people get dizzy when smoking?
Because they are deprived from oxygen
How is nicotine’s metabolism described?
A good amount of nicotine is metabolized in the liver
What is nicotine’s half life?
1-2 hours
What enzyme metabolizes nicotine?
CYP2A6
What is nicotine’s metabolite?
Cotinine (weak and active)
What receptor does nicotine bind to?
nicotinic acetylcholine receptor
What happens when nicotine binds to its receptor
It allows sodium to pass through the channels and since it is a positive ion, itll stimulate
Why do people claim nicotine is a sedative?
Because it calms people down but this is false it simply relieves people from their withdrawal symptoms
What autonomic nervous system is activated by nicotine?
Both sympathetic and parasympathetic
Why does nicotine relate to stomach problems?
Because it promotes the release of HCl in the stomach making it more acidic
What hormone is released from smoking?
antidiurectic hormone
What is the antidiurectic hormone responsible for at high levels?
At high levels, it can cause fluid retention which is why smokers have puffy hands and feet
What is the area postrema?
A part of the brain that regulates nausea and vomiting and it is not protected by the blood brain barrier
How does nicotine affect the area postrema?
Our body can detect it as a toxin and it can activate the area postrema and induce nauseal vomiting. Over time, there can be tolerance and the effects to this area can shut down
Why is quitting smoking very hard?
Because there is a lot of habit involved
What is artherosclerosis?
This is an illness that occurs when there is a build up of fat and plaques on the blood vessel walls.
What is thrombosis?
When a clot develops around artherosclerosis. If thrombosis occurs in the heart, it is a heart attack. If it occurs in the brain, it is a stroke
What is arteriosclerosis?
Hardening of the arteries
What are the 2 main prescription drugs that can help quoit smoking?
Zyban and Channix
