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People and Illness Lectures > Illicit Drugs Toxidromes > Flashcards

Illicit Drugs Toxidromes Flashcards

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1
Q

list some effects of alcohol

A
  • Wernicke-Korsakoff syndrome
  • Peripheral neuropathy
  • Cerebellar degeneration
  • Myopathy
  • Cognitive decline
  • Seizures
  • Withdrawal effects
  • Injury / intracranial haemorrhage
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2
Q

which transmitter gives euphoria/pleasure drinking alcohol

A

Dopamine, Opioids

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3
Q

which transmitter gives anxiolysis/ataxia

A

Increased GABA

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4
Q

which transmitter gives sedation/amnesia

A

increased GABA + decreased NMDA

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5
Q

triad of serotonin syndrome

A
  • Altered mental status – Agitation / confusion / seizures
  • Autonomic changes - Hyperthermia, diaphoresis, diarrhoea, tachycardia, hypertension, salivation
  • Neuromuscular effects - Myoclonus, clonus, hyperreflexia, tremor, rigidity
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6
Q

when are Hallucinations common

A

serotonergic activation

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7
Q

stimulants cause stimulation of adrenergic activity. what are the symptoms of this

A
  • Tachycardia
  • Hypertension

  • Risk of arrhythmia
  • Sweaty
  • 
Hallucination

  • Agitation
  • 
Dilated pupils
  • Elevated temperature
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8
Q

which receptor causes you to feel euphoria/pleasure

A

Dopamine, Opioids

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9
Q

which receptor causes you to feel sedation/amnesia

A

increased GABA + decreased NMDA

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10
Q

which receptor causes you to feel anxiolysis/ataxia

A

increased GABA

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11
Q

how do stimulants cause stroke

A

Mostly haemorrhagic

Soon after use – within 3 hours

More common if underlying pre-disposition

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12
Q

full name for MDMA

A

3,4 methylenedioxymethamphetamine

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13
Q

how does MDMA work

A

Blocks 5-HT, NE reuptake

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14
Q

symptoms of MDMA

A

Thermoregulatory problems, hallucinations, CV complications

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15
Q

what is mephedrone

A

4-methylmethcathinone (4-MMC) or 4-methylephedrone

bath salts, M-cat, plant food, drone

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16
Q

methadone is a substitute for what

A

4-methoxy

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17
Q

what is the structure of mephedrone

A

A substituted cathinone = Phenethylamine core with an alkyl group attached to the alpha carbon and a ketone group to the beta carbon

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18
Q
  • Enhance transmission at the catecholaminergic /dopaminergic / serotonergic synapses
  • Increase behavioural and motor activity I
  • ncrease alertness / disruption of sleep
  • Euphoria
  • Confidence Central and peripheral sympathomimetic effects
  • Side effects of anxiety, insomnia and irritability
A

The stimulants

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19
Q

how does cocaine work

A
  • Rapid BBB penetration – high brain concentrations
  • Half-life in plasma = 30-90 minutes (longer PD action)
  • Blocks DA, NE & 5-HT re-uptake

  • Exerts inhibitory effect on postsynaptic dopamine receptors
  • Blocks the presynaptic transporter protein for DA
  • Dopaminergic pleasure effect
  • Noradrenergic excess (readiness)
20
Q

how do Amphetamines

A
  • Enhance release of DA &amp
  • NE from pre-synaptic terminals
  • Dopaminergic pleasure effect
  • Noradrenergic excess (readiness)
  • Detectable for 48 hours in urine
21
Q

list a few additional stimulants

A
  • Ephedrine Pseudoephridrine
  • Phenylpropanolamine
  • Ephedra alkaloids
  • Methylphenidate (Ritalin) MDMA
  • Reports of all things described in previous slides with these drugs
22
Q

how do Stimulants cause vasospasm / sticky blood

A

Mediated by alpha-adrenergic stimulation

Platelet aggregation is increased

Evidence for accelerated atherosclerosis

23
Q

symptoms of opaites

A
  • Pinpoint pupils
  • Respiratory depression
  • Bradycardia
  • Hypotension
  • Hypothermia
  • Pulmonary edema
  • Seizures
24
Q

symptoms of sedatives and hypotonic

A
  • Ataxia
  • Blurred vision
  • Coma
  • Confusion
  • Delirium
  • Sedation
  • Pupils likely to be normal
  • Causes include anticonvulsants, benzodiazepines, GHB, ethanol.
25
Q

Acute neurological problems with sedatives

A

Typically these are INDIRECT Coma Compressive nerve palsies Anoxic brain injury Complications of injection Embolic infarction Infective endocarditis Abscesses Discitis Meningitis HIV related illness

26
Q

how do opaites work

A

Sedation: upside down n receptors


Dysphoria: k receptors / reduces GABA release (increases dopamine)

27
Q

how does GHB work

A

Dysphoria (stimulates dopamine release)

Sedation (GABA receptor activation)

Muscle twitching

28
Q

main systems targeted by the hallucinogens

A
  1. Serotoninergic (5-HT systems)
  2. Noradrenergic (NE systems)
  3. Cholinergic (ACh systems)
  4. Miscellaneous — phencyclidine / ketamine
29
Q

sypmtoms of cholinergic drugs

A
  • Defecation
  • Urination
  • Miosis (small pupils)
  • Bronchoconstriction
  • Bradycardia
  • Emesis Lacrimation
  • Salivation
30
Q

Neurologic effects of hallucinogens

A
  • Rare reports of stroke
  • 
Toxic psychosis

  • Dangerous behaviour

  • Wernicke’s type syndrome – Angel dust
31
Q

active component of Marijuana

A

THC

32
Q

how does cannabis work

A
  • Agonist at cannabinoid receptors – G protein linked receptors
  • Alters mood
  • 
Increases dopamine release
  • 
Modulates opiod receptors
33
Q

which act do legal highs try and bypass

A

Misuse of Drugs Act

34
Q

list some legal highs

A
  • benzodiazepine analogues (etizolam)
  • synthetic opioids hallucinogenic drugs (methoxetamine synthetic cannabinoids like 5F-AKB-48)
35
Q

when were legal highs banned

A

2010

36
Q

acute effects of organic solvents

A

Lightheadedness / Hallucinations

37
Q

list some organic solvents

A

Toluene / hexane / benzene

38
Q

prolonged use effect of organic solvents

A
  • Cognitive impairment
  • Diplopia / ataxia / nystagmus
  • Coma Peripheral neuropathies
39
Q
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Q
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People and Illness Lectures (16 decks)

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