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Tox Final Exam > Illicit and Recreational Drugs > Flashcards

Illicit and Recreational Drugs Flashcards

1
Q

Uses of amphetamines?

A

several analogues are used for tx of ADD, obesity and narcolepsy in humans, also illegal amphetamine products

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2
Q

Name several amphetamine drugs.

A

benzphetamine CIII, dextroamphetamine CII, methylphenidate CII and lisdexamfetamine

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3
Q

Source of amphetamine toxicosis?

A

accidental ingestion

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4
Q

Street names for amphetamine?

A

amphetamine–>speed, dex, dexies, bennies

methamphetamine–>ice, glass, meth, crystal

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5
Q

Oral LD50 for amphetamine is _____mg/kg and for methamphetamine is _____ mg/kg in the dog.

A

20-27 mg/kg–9-11 mg/kg

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6
Q

ADME of amphetamine?

A

A=readily orally, highly lipid soluble
D=widely including CNS
M=in liver, some metabolites are active
E=in urine–pH dependent

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7
Q

Half life of amphetamine in dogs?

A

3.7-6 hrs

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8
Q

Half life is dependent on what?

A

pH of the urine

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9
Q

MOA of amphetamine toxicosis?

A

CNS stimulant, block reuptake of norepinephrine and dopamine, inhibit MAO, dopamine excitatory receptor agonist, peripherally–sympathomimetic effect by releasing norepinephrine and direct stimulant effect on alpha-adrenergic receptors and beta-adrenergic receptors

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10
Q

T/F Mechanism of action of amphetamines in the CNS is unknown.

A

TRUE!

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11
Q

Clinical signs of amphetamine toxicosis?

A

hyperactivity, restlessness, circling, tremors, ataxia, seizures, mydriasis, hypersalivation, hyperthermia–some show depression, weakness and bradycardia

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12
Q

Laboratory diagnosis of amphetamine toxicosis?

A

hypoglycemia, amphetamines can be detected in blood, urine and saliva, tremors result in metabolic acidosis and rhadomyolysis–may cause myoglobinuria and renal failure (rare)

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13
Q

Prognosis of amphetamine toxicosis?

A

depends on severity of condition

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14
Q

Treatment of amphetamine toxicosis?

A

emesis, activated charcoal, pentobarbital and propofol for seizures, phenothiazine derivatives IV as dopamine excitatory receptor antagonists, treat hyperthermia, tachyarrhythmias treated with beta-blockers or lidocaine, urinary acidifiers, IV fluids

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15
Q

What urinary acidifiers can be used in the treatment of amphetamine toxicosis?

A

ammonium chloride, ascorbic acid–contraindicated in acidotic patient

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16
Q

Use of IV fluids in treatment of amphetamine toxicosis?

A

dehydration, correct systemic acidosis, enhance renal excretion, prevent renal damage due to myoglobinuria

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17
Q

Uses of cocaine?

A

topical local anesthetic for the oral, laryngeal and nasal cavities, used to confirm the cause of miotic pupil in conditions such as horners syndrome, illicit drug

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18
Q

Sources of cocaine toxicosis?

A

accidental ingestion of illicit cocaine

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19
Q

Source of cocaine?

A

alkaloid from the leaves of the plant Erythroxylon coca or E. monogynum–grown in mexico, south america, indonesia and west indies

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20
Q

Properties of cocaine?

A

cocaine hydrochloride is a powder form which dissolves in water and is taken IV or intranasally–the free base is the pure cocaine alkaloid obtained from the hydrochloride form in the shape of crystals, flakes or rock which makes a cracking sound when heated and can be smoked or taken orally

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21
Q

Street names for cocaine?

A

coke, bernies, girl, white lady, snow, star dust

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22
Q

What animals are most susceptible to cocaine toxicosis?

A

dogs esp police dogs!

23
Q

What is the LD50 for pure cocaine IV in the dog? cat?

A

dog=3 mg/kg

cat=7.5 mg/kg

24
Q

What is the oral LD50 for cocaine in the dog?

A

6-12 mg/kg

25
Q

ADME for cocaine?

A

A=absorbed by all MM–highly lipid soluble
D=crosses BBB and alveolar capillary
M=hydrolyzed by plasma and hepatic esterase and is methylated in liver
E=unchanged (10-20%) and metabolites in urine

26
Q

MOA of cocaine?

A

CNS stimulant and sympathomimetic, blocks reuptake of norepinephrine, dopamine and serotonin, increases catecholamine release, sensitizes sympathetic effector cells to catecholamines, direct effect on myocardium

27
Q

Clinical signs of cocaine toxicosis?

A

V+, hypersalivation, mydriasis, hyperactivity, tremors, convulsive seizures, hyperthermia, tachycardia, tachypnea

28
Q

Lesions seen in cocaine toxicosis?

A

myocardial degeneration, subendocardial and epicardial hemorrhage, pericardial effusion, pulmonary hemorrhage

29
Q

Laboratory diagnosis of cocaine toxicosis?

A

elevated CK, systemic acidosis, detected in serum, plasma, urine, stomach contents

30
Q

Differential diagnosis for cocaine toxicosis?

A

CNS stimulants–> amphetamines, strychnine, metaldehyde, methylxanthines, pseudoephedrine, organophosphate and carbamate insecticides, chlorinated hydrocarbon insecticides, permethrin in cats

31
Q

Treatment for cocaine toxicosis?

A

emesis in animals not showing clinical signs, gastric lavage w/ activated charcoal, diazepam IV for seizures–also barbiturates or phenothiazines, beta blockers to control tachyarrhythmias, sodium bicarb IV or LRS for metabolic acidosis, IV fluids, body temp should be monitored

32
Q

Prognosis of cocaine toxicosis?

A

depends on severity of condition

33
Q

Why is it important to not induce vomiting in an animal showing clinical signs due to cocaine toxicosis?

A

may precipitate seizures

34
Q

Uses of marijuana?

A

treatment of nausea associated w/ anticancer chemotherapy in patients who fail to respond to conventional antiemetics, treatment of anorexia associated w/ weight loss in AIDS patients, glaucoma and MS, recreational drug

35
Q

Sources of marijuana toxicosis?

A

ingestion of loose marijuana, cannibis plant, cookies, brownies or cigarettes containing marijuana–inhalation–secondhand smoke

36
Q

Street names for marijuana?

A

weed, grass, pot, puff, hemp, MaryJane, MJ

37
Q

Name of marijuana plant?

A

Cannabis sativa–contains THC (tetrahydrocannibinol) and CBD (cannabidiol).

38
Q

Amount of THC is determined by?

A

amount of THC in a sample decreases w/ time–hashish refers to dried resin from flower tops and contains 10% THC–hashish oil contains up to 20% THC–sinsemilla is seedless marjiuana which contains about 5% THC

39
Q

What animals are most frequently poisoned by marijuana?

A

dogs–cats are also susceptible

40
Q

Oral MLD dose for THC in the dog is greater than ___kg/mg.

A

3 mg/kg–1000 times the behaviorally effective dose in dogs!

41
Q

ADME of marijuana toxicosis?

A

A=readily orally (increased by fatty meal) and by inhalation–THC highly lipid soluble
D=binds to plasma proteins, widely including CNS and fatty tissue
M=to several metabolites including an active metabolite which is more potent than THC and cross the BBB
E=mainly in bile and feces–enterohepatic recirculation and also in urine (10-15%)

42
Q

What percentage of THC is bound to plasma proteins?

A

97-99%

43
Q

T/F Half life is prolonged to 25-30 hrs due to redistribution from the adipose tissue.

A

TRUE

44
Q

T/F Elimination is complete within 2 days.

A

FALSE 5 days!

45
Q

MOA of marijuana?

A

2 cannabinoid receptors have been identified–CB1 widely distributed in the brain and has the cannabinoid effects on memory, perception and the control of movement. both CB1 and CB2 are found in the immune cells.

46
Q

Clinical signs of marijuana toxicosis?

A

V+, CNS depression, ataxia, incoordination, tremor, weakness, mydriasis and hypothermia, rare seizures, hyperexcitability, brady/tachycardia, hyperthermia, apprehension

47
Q

Chemical analysis of marijuana toxicosis?

A

detected in urine for several days following acute exposure–stomach contents and other specimens can be used for analysis

48
Q

Diagnosis of marijuana toxicosis?

A

mainly hx and clinical signs, chem analysis, human urine tests are not effective in dogs

49
Q

Differential diagnosis for marijuana toxicosis?

A

CNS depressants–>opioids, LSD, PCP, tranquilizers, ethylene glycol, propylene glycol, alcohols, macrolide antiparasitics, muscle relaxants and hallucinogenic mushrooms (Psilocybin mushrooms)

50
Q

Treatment for marijuana toxicosis?

A

emesis, repeated doses of activated charcoal and a cathartic, symptomatic/supportive tx–>fluids, O2, diazepam for CNS stimulation, monitor temp

51
Q

T/F Signs of marijuana toxicosis usually resolve spontaneously without treatment.

A

TRUE

52
Q

Why is induction of emesis usually not effective in animals with marijuana toxicosis?

A

bc of antiemetic effect of THC

53
Q

Recovery from marijuana toxicosis can take how long?

A

24 hrs to several days

54
Q

Prognosis for marijuana toxicosis?

A

Cannabinoids have a wide safety margin so unlikely to be fatal

Tox Final Exam (9 decks)

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