Plant Depressants: Tranquilizers and Opiates Flashcards

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1
Q

What is the small evergreen shrub discussed in the heart and circulatory system?

A

Indian Snakeroot.

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2
Q

What does the Indian snakeroot species contain?

A

Resperine, which revolutionized the treatment of chronic psychoses (especially schizophrenia) and moderate to severe hypertension.

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3
Q

When did European and American pharmaceutical companies begin marketing resperine to treat schizophrenia, hypertension, and a tranquillizing agent for treating mild to moderate anxiety?

A

1953.

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4
Q

When was resperine discouraged as a tranquillizing agent due to adverse side effects of fatigue and deep depression?

A

1956 (US Food and Drug Administration).

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5
Q

What is resperine classified as?

A

A phenothiazines.

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6
Q

What is the small shrub (3m in height), and native to the South Pacific Islands called?

A

Kava.

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7
Q

What does Kava exist as?

A

Only a cultigen-does not occur in the wild.

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8
Q

What does Kava consist of?

A

Numerous sterile polyploid cultivars of variable Biochemistry-nearly 250 types are recognized on Vanuatu alone.

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9
Q

Where and when was plant first domesticated?

A

Vanuatu about 3000 years ago.

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10
Q

From Vanuatu, where was Kava taken?

A

Kava was taken westward to New Guinea and parts of Micronesia and eastward to Fiji and Polynesia.

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11
Q

Why must the Kava plant be propagated colonially?

A

Because the cultivars are sterile.

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12
Q

What plant is of great religious and ceremonial significance to South Pacific islands?

A

Kava.

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13
Q

What is Kava used for in regard to communicating?

A

Kava is used for communicating with ancestors and the Gods.

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14
Q

How is Kava used socially?

A

To relax the body and mind.

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15
Q

How is Kava used medicinally?

A

To induce sleep, relieve pain, and treat anxiety and insomnia.
Sometimes even to treat rheumatism, menstrual problems, venereal diseases and tuberculosis.

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16
Q

Which part of Kava contains the active principles?

A

Root stock.

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17
Q

How was rootstock prepared?

A

1) The chewing method, root broken down into small fragment, and chewed into soft mass, and mixed with cold water or coconut milk, strained then drunk a few hours later.
2) The grating method, the root is grated and macerated in cold water or coconut milk, then filtered and drank.

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18
Q

Of chewing and grating methods, which one is said to have stronger narcotic and depressant affects?

A

Chewing.

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19
Q

Which of chewing and grating is used to treat the sick and convalescent?

A

Grating.

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20
Q

What is the pharmacology makeup of Kava?

A

Made up of 18 related compounds known as kavalactones (kavain), as well as other secondary products.

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21
Q

What do the kavalactones do?

A

They have muscle-relaxing and antispasmodic effects.

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22
Q

What are the medical symptoms of drinking Kava?

A

Mild muscle paralysis (in lower limbs), and increase force but decreased rapidity of heartbeat.

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23
Q

How does Kava demonstrate its affects?

A

It will first stimulate and then depress respiration. Unlike other depressants such as alcohol, it does not impair alertness significantly.

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24
Q

What are the affects of whole extracts of Kava?

A

Hypnotic-sedative, analgesic, and psychotropic affects.

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25
Q

What do small doses of kava produce?

A

Small does are relatively benign, producing a euphoric state of tranquility and friendliness lasting for a short period.

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26
Q

What do high doses of kava produce?

A

They produce a stronger hypnotic effects and may effect muscle coordination and lead to visual distortion (pupil enlargement).

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27
Q

What is kava recommended for in treatment of?

A

Will treat non-psychotic anxiety symptoms such as nervous tension, stress, agitation and insomnia.

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28
Q

What is kava as affective as in regard to treating non-psychotic anxiety?

A

Synthetic depressants but with fewer side effects.

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29
Q

What will constant and heavy kava use result in?

A

Scaly skin eruptions, which are alleviated by abstinence.

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30
Q

Why should alcohol and kava not be taken together?

A

Due to the fact that they are both depressants and their effects will be additive-full concentration activities should be avoided if they are taking both.

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31
Q

What toxicity has been reported by those taking kava as a dietary supplement?

A

Liver toxicity.

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32
Q

What has this liver toxicity led to in regard to kava?

A

It has been banned in some European countries and in Canada, a stop sale order was issued in 2002-but not enforced and kava can be legally purchased.

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33
Q

Why is the liver toxicity of kava controversial?

A

Because it may be do to adulteration of parts other than the roots or using ethanol rather than traditional water extraction in the preparation of some kava dietary supplements.

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34
Q

What is a robust annual plant, part of the poppy or papaveraceae family?

A

The opium poppy.

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35
Q

Where is the opium poppy native to?

A

Southwest Asia.

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36
Q

Where and when was the opium poppy first domesticated?

A

Western Mediterranean region about 6000 years ago.

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37
Q

Opium poppy is considered the worlds oldest known _____?

A

Narcotic.

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38
Q

Why is the opium poppy considered the oldest known narcotic?

A

Because of the reference to the “joy plant” in Sumerian medical clay tablets. (Yet people think they were referring to non-narcotics).

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39
Q

Where was the opium poppy used in ancient times?

A

The Mycenaean funerary rites (1500-1100 BCE) in Greece and on the islands of Crete and Cyprus.

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40
Q

Where is there earlier evidence of opium poppy use than Greece?

A

Burial chambers in Spain dated to approximately 4500 years ago contain numerous opium poppy capsules.

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41
Q

What were the early mycenaean opium cults centred around?

A

The worship of the fertility goddess, which likely inspired later images of the Greek goddess Persephone holding opium poppies.

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42
Q

Where and when was the first direct evidence of the opium poppy found?

A

3500 year old ivory pipes and other opium smoking equipment on the Mediterranean Islands of Cyprus and Crete.

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43
Q

What did Dioscorides mean by mekonion, and opos?

A

1) The ground whole opium plant.

2) The latex from opium capsules.

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44
Q

How was the opium poppy used medicinally and who was this summarized by?

A

Summarized by Roman Galen and was used as a cure for poisoning venomous bites and to treat chronic headache vertigo, deafness, epilepsy, and loss of sight or voice.

45
Q

What spread opium use to the Arabian peninsula and later to India and China?

A

The ascendancy of Islamic medicine in the 8th century.

46
Q

How was opium poppy used medicinally in Islamic medicine?

A

As a pain reliever, but this use was apparently unknown in Medieval Europe.

47
Q

Who (1493-1541) popularized opium use in Renaissance Europe?

A

Paracelsus.

48
Q

What did Paracelsus develop?

A

He developed laudanum, a tincture of opium in 10% ethanol (alcohol) recommended for pain relief and general euphoria.

49
Q

Who championed the use of opium after nothing its remarkable ability to relieve pain and suffering?

A

Thomas Sydenham (1624-1689), a 17th century pioneer of English medicine.

50
Q

When did opium use for pain relief become very popular in Europe?

A

18th century.

51
Q

When did opium become an integral (and entirely legal) part of daily life in Europe?

A

19th century.

52
Q

What were non-alcoholic opium based syrups developed for?

A

To soothe crying infants, as cough remedies and for treating diarrhea and dysentery.

53
Q

What is an example of this non-alcoholic based syrup?

A

Godfrey’s Coridal, popular patent medicine. It was a mixture of opium, molasses and sassafras.

54
Q

When were the addictive properties of opium known?

A

By mid-1800s.

55
Q

Who described the addictive and euphoric effects of opium in Confessions of an Opium Eater (1821)?

A

Englishman Thomas De Quincey (1785-1859) who had used laudanum since the age of 20 to alleviate toothache pain.

56
Q

Where was it estimated that 1 in 400 persons are addicted to opium in 1900s?

A

North America-US.

57
Q

Who introduced the opium poppy to India and China about 1000 years ago?

A

Arabic traders.

58
Q

What did the Chinese develop a habit for?

A

Smoking a mixture of tobacco and opium.

59
Q

What did the last Ming emperor (1628-1644) forbid the use of resulting in increased amounts of opium in the traditional smoking mixture?

A

Tobacco.

60
Q

When was the cultivation and use of opium in China made illegal but not strictly reinforced?

A

1729.

61
Q

Who reintroduced opium into China from neighbouring colonial India in 1781?

A

The British.

62
Q

Who held a virtual monopoly on the global trade in opium in 1830s, in which most opium was produced in India?

A

The British East India Company.

China was a huge potential market but remained illegal to transport or sell opium there.

63
Q

What was done to overcome the fact that it was illegal to transport and sell opium in China?

A

Public auctions were held and large quantities of opium self to the owners of British and American merchant ships. These ships were used to smuggle opium into china, mainly at the port of Canton.

64
Q

How was this smuggling of opium highly lucrative?

A

In 1838 alone, 2.5million kg of opium was smuggled into China, representing over half of Chinese imports.

65
Q

Who was the trade profitable for?

A

The BEIC, which supplied the raw opium, the British and American merchants, who benefited from its transport to Chine, and the middlemen at canton, who smuggled and distributed the opium within China.

66
Q

How did the illegal opium trade affect China?

A

It was a huge drain on the Chinese economy, profitable commodities such as tea were being traded for this highly addictive drug, and a heavily addicted population severely sapped productivity.

67
Q

Who and when did an individual start enforcing an Imperial edict banning the importation of opium (previously ignored)?

A

Lin Tse-Hsu in 1839.

68
Q

What did the acts of Lin on destroying all opium stocks from warehouses and ships in Canton?

A

It precipitated the First Opium War (1839-1841).

69
Q

How did the British play a role in the First opium war?

A

The British sent 10000 troops and the largest naval fleet in the world to Canton and other ports, crippling the Chinese economy.

70
Q

What ended this occupation?

A

An agreement that weakened the China government: the island port of Hong Kong was ceded and the British were granted broad trading rights with China.

71
Q

What were the affects of the second opium war (1856-1860)?

A

It provided more humiliation to China, and further weakened the Imperial government.

72
Q

When was it estimated that 1/4 of the Chinese population was addicted to opium, a tragedy of poverty and misery fuelled by the opium trade?

A

The 20th century.

73
Q

What ended the British-Indian opium trade in 1913?

A

Pressure from the Chinese government and British parliamentarians.

74
Q

Also during 1913, there was an anti-chines xenophobia was sweeping Europe, which increased recognition of the addictive properties of opium and ultimately resulted in _____?

A

Opium smoking being vilified.

75
Q

When did opium smoking in China continue until the installation of the Communist regime?

A

The late 1940s.

76
Q

How is opium produced?

A

1) Involves the use of a sharp knife to land the developing green fruit (capsule) shortly after the petals fall.
2) A milky sap exudes from these cuts for about 10 days, drying to a brown gummy substance known as raw opium.

77
Q

What does the collected raw opium contain?

A

At least 25 related opiate alkaloids, the most important being morphine, noscapine, papaverine, and thebaine.

78
Q

How do these alkaloids exert their affects?

A

On the receptors of the CNS, reducing brain arousal to painful stimulation and thereby decreasing the awareness of pain.

They also depress respiratory and heart rates and impart digestion by decreasing the secession of digestive juices and slowing the passage of food.

79
Q

What did this decreasing the secession of digestive juices and slowing the passage of food lead to?

A

The development of paregoric, a tincture of opium and camphor used to treat diarrhea.

80
Q

What are some of the other affects of opium?

A

Reduced sexual desire, suppression of feelings of tension, anxiety, depression, and panic resulting in a feeling of total satisfaction.

81
Q

What is the most common opiate alkaloid of raw opium?

A

Morphine.

82
Q

What is morphine?

A

A powerful and effective analgesic, hypnotic, and narcotic that was first chemically isolated in 1803.

83
Q

What is unique about pure morphine?

A

It is isolated from opium, and absorbed easily. It was in general used as a powerful painkiller by 1830s.

84
Q

What development in 1853 allowed for rapid pain relief by injection of morphine directly into the bloodstream?

A

The hypodermic needle.

85
Q

How does the pain relieving affect work?

A

It takes effect in 30 minutes and lasts for up to 12 hours.

86
Q

What was addiction to morphine deemed as?

A

“Soldiers Disease” and was first noted in American Civil War (1861-65) and the Franco-Prussian War (1870-71)

87
Q

Who and when boiled morphine with acetic acid to produce diacetylmorphine?

A

English pharmacist Alder Wright in 1874.

88
Q

When did the Bayer company begin commercial production of diacetylmorphine under the trade name “heroin”, marketing it as a harmless, nonaddictive substitute for morphine and codeine?

A

1898.

89
Q

When was habitual addiction to heroin first noted?

A

1905, and within few years heroin was recognized as the most additive of the opiates and banned.

90
Q

What makes the heroin more potent than morphine?

A

The addition of the two acetyl group increases lipid solubility.

91
Q

How soon does habituation of heroin occur?

A

Within 2 weeks and tolerance develops quickly. Increased doses are required to achieve the same euphoric affect.

Eventually the drug is taken not for the euphoric affect but to prevent the individual from feeling unwell.

92
Q

What is heroin withdrawal described as?

A

It is unpleasant; the initial four hours produce anxiety and craving for the drug and by the eighth hour, the patient is perspiring and yawning and has teary eyes and runny noise. By 12th hour, goose bumps on skin, muscle twitching, hot and cold flashes, aching bones and muscles and loss of appetite.
After 18-24th hours, insomnia, increased respiration and heart rates, nausea.
24-36 hours, vomiting, weight loss, withdrawn, curled up position.

93
Q

What is methadone?

A

A synthetic opiate first produced in Germany in 1939, is often administered to overcome heroin addiction.

94
Q

How is methadone effective?

A

Also addictive but less debilitating than heroin.
Taken orally or injected and does not appreciably depress heart and respiratory rates.
Less euphoric and narcotic and withdrawal symptoms are much less severe.

95
Q

What is codeine?

A

A semi-synthetic drug derived from morphine or thebaine. It is a mild analgesic with limited euphoric effects.

96
Q

What is codeine used for?

A

A cough suppressant and when combined with ASA, it will priced effective relief from arthritic pain, headaches, general muscle pains, and colds.

97
Q

Is Codeine addictive?

A

Codeine is potentially addictive and is a controlled substance in the US, in Canada however in low doses it is offered over the counter.

98
Q

What is oxycodone?

A

A semi-synthetic derived from thebaine, and used in control-release tablets to treat and manage moderate to severe pain.

99
Q

When is oxycodone used?

A

When “around the clock” pain relief is required-chronic arthritic and cancer patients.

100
Q

Is oxycodone addictive?

A

Like codeine, it is potentially addictive. It has actually become a problem in recent years leading to tightly controlling its distribution in Canada and other countries.

101
Q

Where is codeine, oxycodone and other medical opiate drugs synthesized from?

A

Semi-synthesized from raw opium produced legally in Turkey, India, France, Australia.

102
Q

What is fentanyl?

A

A potent synthetic opiate introduced into western medicine in the 1960s.

103
Q

By which year was fentanyl widely used as an effective analgesic and anaesthetic?

A

1990s.

104
Q

What is unique about fentanyl today?

A

It is the most common synthetic opiates used clinically today.

105
Q

How would one compare fentanyl to morphine?

A

Fentanyl is 50-100 times as potent as morphine, some analogues 500x more potent than morhpine.

106
Q

What are the fentanyl’s effective for?

A

Therapeutically useful pain-relievers, offering rapid pain relief for a relatively short period of time.

107
Q

What is the vast majority of global opium production?

A

Illicit with most occurring in Afghanistan and in Southeast Asia’s “Golden Triangle”, where Myanmar, Laos and Thailand meet.

108
Q

Where and when was opium banned during the last few years of the Taliban regime?

A

Afghanistan (1996-2001). But today Afghanistan is the major global source of illicit heroin.

109
Q

Where is the North American supply of heroin smuggled from?

A

Mexico and SA, leading some cocaine cartels to expand heroin production. As a result, opium poppy plantations have been established in Colombia, Mexico, and other Central and SA counties.