Pharmacology of drug abuse Flashcards
what are the 7 classes of drugs Abuse ?
1) Opoids – morphine and codeine etc
2) Sedative/Hypnotics
3) CNS stimulants
4) Cocaine
5) Cannabis
6) Hallucinogens
7) MISCELLANEOUS
what is Abstince syndrome ?
a term used to describe the signs and symptoms that occur on withdrawal of a drug in a dependent person
what is dependance ?
a state characterized by signs and symptoms frequently the opposite of those caused by a drug, when its withdrawn from chronic use or when the dose is abruptly lowered
mechanism of Dependance :
1- Drugs of abuse induce amplified dopamine release and activate the same synaptic adaptations as natural re-inforcers.
2- increase glutamate receptors
3- increased structural protein expression
4- increased dendritic spine size
what can induce relapse to drug-taking behavior ?
- Stress ( by increasing release of dopamine)
2. Exposure to drug-related sensory cues ( increased release of Glutamate and it receptor
what is the mechanism of action of cocaine ?
inhibits dopamine reuptake transporters (DAT), resulting in increased synaptic dopamine levels and increased postsynaptic dopamine receptor activation at synapses in the Nucleus accumbens
what is the consequences of increased postsynaptic dopamine receptor ?
result in D2 autoreceptor activation, which decreases dopamine synthesis
what is the mechanism of action of Amphetamine ?
- release of endogenous catecholamine from nerve endings
- inhibit neurotransmitter reuptake into vesicles
these combined actions cause neurotransmitter concentrations to increase in the synaptic cleft. - DAT expression increases (thus reduce dopamine synthesis )
what are the initial symptoms of Amphetamine overuse?
mood elevation and euphoria, increased energy and alertness & with time stereotyped behavior emerges, including hyperirritability, jumpiness, grinding and rashing of the teeth, touching and picking of the face and extremities, suspicious
what are the S&S of Cocaine acute intoxication ?
Hyperfunction, high BP, tachycardia, pupillary dilation, motor unrest, sweating and chills, convulsion
what are the S&S of Cocaine chronic intoxication ?
paranoid psychosis similar to paranoid schizophrenia, High risk for arrhythmia and CVS diseases
Vasoconstriction results in tissue necrosis (with intranasal use)
treatment of addiction :
- benzodiazepines, e.g. Diazepam in acute cases.
what drugs are not recommended In acute cases?
antipsychotic drugs: e.g. Chlorpromazine or Haloperidol;
barbiturates and diazepam
what is the treatment for chronic abusers ?
Desipramine (tricyclic antidepressants)
what mood stabilizers is effective in case of Euphoria?
Lithium
what are some examples of Hallucinogens ?
Lysergic acid diethyl amide (LSD) , dimethyltryptamine (DMT), and diethyltryptamine (DET), psilocybin, psilocin
what is the mechanism of action of Hallucinogens ?
repression of central serotonin neuronal activity, and/or reduction in serotonin increases hallucinogenic potency of LSD.
what are the effects of LSD ?
Euphoric or dysphoric “trips”
tolerance and dependance of hallucinogens :
No intense physical dependence no withdrawal symptoms
what is the prominent feature of hallucinogens?
Changes in sensory perception (Time sense is lost)
what is the treatment for the psychotic and visual hallucinations episodes ?
phenothiazines
what is the treatment For psychotic episodes which last from several days to several months and resembles schizophrenia ?
Large doses of chlorpromazine
treatment for Acute hallucinogens intoxication :
Relaxing room is the only needed treatment.
what is PCP mechanism of action ?
non- competitive antagonist at NMDA-glutamate receptor and Inhibits dopamine uptake and enhances dopamine release
what are the physical S&S of PCP intoxication ?
rotatory nystagmus , Ataxia ,rigidity, motor restlessness, nystagmus and repetitive movements
what are the other S&S of PCP intoxication ?
- Violent behavior (most common)
- Large doses causes bizarre sensations (walking on clouds)
- visual hallucination
treatment of PCP intoxication :
- blood pressure normalization
- for seizure ( Diazepam )
what class of drugs are contraindicated for people taking PCP ?
Antipsychotic are contraindicated because
hypertension might ensue
(only in case of agitation )
what are the S&S of SMALL doses CANNABIS intoxication ?
euphoria, relaxation, sleepiness if alone .
Impaired memory, mental task performance is impeded. This latter effect is called ‘temporal disintegration’.
what are the S&S of HIGHER doses CANNABIS intoxication ?
abstract thinking is affected, illusions and color hallucination occur. Psychotic reactions can manifest
Personalization and paranoid feelings may predominate and euphoria is converted to anxiety and panic feelings.
what are the some commercial names for synthetic cannabinoids
Spice and K2
what is synthetic cannabinoid ?
a structurally diverse class of synthetic substances that bind to cannabinoid receptors in our body, and create a similar type of high that naturally occurring cannabinoids (marijuana) produce
examples of the synthetic cannabinoids compounds:
JWH-018
what are the effects of these synthetic cannabinoids ?
impaired driving incidents, attempted suicides, and emergency department visits.
Anxiety
panic attack
mood swings
what are inhalants ?
breathable chemical vapors or gases that produce psychoactive (mind-altering) effects when abused or misused. These include volatile organic solvents, fuel gases, nitrites, and anesthetic gases.
what other inhaled drugs that not considered inhalants ?
Heroin, cocaine, and methamphetamine
what is the action of Nitrates ?
it dilate and relax blood vessels
Used primarily as sexual enhancers (causes priapism)
what is the most common form of drug abuse in young age group?
Inhalants often among first drugs that young children use
what are Club drugs ?
are naturally occurring metabolite of GABA. they are strong CNS depressant
who’s using club drugs the most ?
Bodybuilders-Growth hormone releasing effects
what does club drugs mainly used for ?
to improve athletic performance and Drug-facilitated sexual assault .
what are the examples of club drugs ?
- GHB
- Rohypnol
- Flunitrazepam
what is the most fetal side effect of GHB ?
Profound CNS and respiratory depression.
Bradycardia and hypotension .
what is given in case of benzodiazepines intoxication ?
FLUMAZENIL
