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Drug Abuse. Self administration of drug or drugs in manner not in accord with accepted medical or social patterns. Drug Abuse. Psychological Dependenc (Habituation) addiction. Drug necessary to maintain user’s sense of well-being Physical Dependence, dependence - PowerPoint PPT Presentation
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Self administration of drug or drugs in manner not in accord
with accepted medical or social patterns
Psychological Dependenc (Habituation) addiction. Drug necessary to maintain user’s sense of
well-being Physical Dependence, dependence
Physical symptoms if intake is reduced
Addiction Compulsive, relapsing drug use
despite negative consequences, at times triggered by cravings. Includes
Tolerance (dose has to be progressively increased to maintain rewarding or analgesic effect)
Psychological dependence Physical dependence Compulsive use
Mesolinbic dopamine system is the prime target of addictive drugs.
The system originates in the ventral tegmental area (VTA).
Drug of abuse are rewarding and reinforcing.
Drugs that activate G Protein-Coupled Receptors
Opioids Cannabinoids γ-hydroxybutyric acid (GHB) LSD, mescaline Drugs that bind to ionotropic receptors
and ion channels Nicotine Alcohol Benzodiazepines Phencyclidine, ketamine
Drugs that bind to transporters of Biogenic Amines
Cocaine Amphetamine Ectasy
OPIATESOPIATES
Opiates are drugs that are derived from the Poppy Opiates are drugs that are derived from the Poppy Plant and are Central Nervous System (CNS) Plant and are Central Nervous System (CNS) depressants.depressants.
The most common opiates are:The most common opiates are:OpiumOpiumHeroinHeroinMorphineMorphineCodeineCodeine
Opiates are known by several different names:Opiates are known by several different names: SmackSmack SmackSmack ChivaChiva ChivaChiva
MorfMorf MorfMorf HH HH
SoapiumSoapium SoapiumSoapium FlowerFlower FlowerFlower
PoppyPoppy PoppyPoppy HazelHazel HazelHazel
Examples Opium Morphine Heroin Codeine
Oxycodone (Percodan)
Meperidine (Demerol)
Propoxyphene (Darvon)
Talwin Fentanyl
Acts on μ, κ and delta opioid receptors
Effects Analgesia CNS depression
Euphoria Drowsiness Apathy
Antidiarrheal action Antitussitive action
Nausea/VomitingNausea/Vomiting
ConstipationConstipation
Itchy SkinItchy Skin
SleepinessSleepiness
Loss of Sex DriveLoss of Sex Drive
Altered Mental ProcessAltered Mental Process Absence of StressAbsence of Stress
Overdose/DeathOverdose/Death Impaired VisionImpaired Vision
Collapsed VeinsCollapsed Veins
Menstrual IrregularitiesMenstrual Irregularities
Liver DamageLiver Damage
Kidney DamageKidney Damage
Lung DamageLung Damage
Brain DamageBrain Damage
Immune System Immune System DamageDamage
Overdose Mild to
Moderate Lethargy Pinpoint pupils Bradycardia Hypotension Decreased
bowel sounds Flaccid muscles
SevereSevere Respiratory depressionRespiratory depression ComaComa AspirationAspiration Seizures with certain Seizures with certain
compounds (meperidine, compounds (meperidine, propoxyphene, tramadol)propoxyphene, tramadol)
Overdose Management Naloxone
Treatment of opioid addiction Long acting opioids
Withdrawal Insomnia Restlessness Irritability Anorexia Tremors Back, extremity
pain
Watery eyes Yawning Rhinorrhea Sneezing Diarrhea Diaphoresis
Resembles Severe Influenza
Marijuana (Tetrahydrocannabinol (THC) Endogenous cannabinoids (Anandamide) Act on CB1 receptors, presynaptically and
inhibit the release of glutammate or GABALeading to disinhibition of dopamine neurons.Onset of effects: within minutes Effects: Euphoria, relaxation, visual
distortions, drowsiness, diminished coordination and memory impairment.
LSD Mescaline Psilocybin
Produce altered/enhanced sensation Increased dose does not intensify
effect Mechanism of action Act on 5HT2A receptor------G proteins
------ IP3 ---intracellular calcium-------- increase glutamate release.
Signs and symptoms Anxiety, excitement Nausea, vomiting Tachycardia, tachypnea
Moderate Intoxication Tachycardia Mydriasis Diaphoresis Short attention span Tremor Hypertension Hyperreflexia Fever
Life-threatening toxicity (rare) Seizures Severe hyperthermia Hypertension, arrhythmias Agitated Diaphoretic, hyperreflexic Untreated hyperthermia can lead to
hypotension, coagulopathy, rhabdomyolysis and multiple organ failure
Nicotine Smoking of tobacco through different
routes. Agonist of nicotinic acetylcholine receptor
(nAChR),role in cognitive processes. Rewarding effect of nicotine requires
involvement of VTA in which (nAChR) are expressed on dopamine neurons.
Nicotine withdrawal : irritability, sleep problems.
Slowly absorbable form of nicotine. Cytisine, varenicline (partial agonists) Act by occupying nAChRs on dopamine
neurons of the VTA. Bupropion + behavioural therapy
Anxiolytic and sleep medications Abused for their EUPHORIC effects GABAA receptors on interneurons,
disinhibition of mesolimbic dopamine system-----rewarding effects.
Withdrawal symptoms include Irritability, insomnia, photophobia,
depression, muscle cramps and even seizures.
General anesthetic Non-competitive antagonism of NMDA
receptor. Increased blood pressure, impaired
memory function & visual alterations. ‘Club drugs’ and sold as ‘angel dust’
Street names Angel dust Peace Pill Hog Krystal Animal tranquilizer
Used as veterinary anesthetic
Examples Nitrates , ketones , aliphatic and
aromatic hydrocarbons Gases (freon, halon fire extinguishing
agent) Metallic paints Sniffing Huffing Bagging
Examples Cocaine Amphetamines
Benzedrine (bennies) Dexedrine (dexies, copilots) Methamphetamine (ice, black beauties)
Ephedrine Caffeine Ritalin
Cocaine local anesthetic used to treat depression Block of dopamine transporter, by
increasing conc in nucleus accumbens Increased risk of intracranial haemorrhage,
ischemic stroke, myocardial infarction and seizures.
Produce euphoria hyperactivity alertness sense of enhanced energy anorexia
Overdose signs/symptoms Euphoria, restlessness, agitation, anxiety Paranoia, irritability, delirium, psychosis Muscle tremors, rigidity Seizures, coma Nausea, vomiting, chills, sweating, headache Elevated body temperature Tachycardia, hypertension Ventricular arrhythmias
Withdrawal Drowsiness Profound depression (“cocaine blues”) Increased appetite Abdominal cramps, diarrhea, nausea Headache
Include derivatives of amphetamine related compound methylene-dioxymethaamphetamine (MDMA)
Increases extracellular concentration of serotinin
Long term cognitive impairement in heavy users of MDMA.
Withdrawal lead to depression
Transdermal nicotine patches for smoking
Baclofen is a GABAB receptor agonist Rimonabant is inverse agonist of CB1
receptors