SOC 204 Drugs & SocietyChapter 11 StimulantsGoldberg

Do you agree with the use of medication for ADD/ADHD?

A. YesB. NoC. I’m not sure

YesNo

I’m not s

ure

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Questions for Discussion 6List three benefits or risks of

using stimulant medication to treat ADD/ADHD

Do the benefits or risks change when prescribing to children?

Back up your points with research

Historically, cocaine was used as a local anesthetic.

A. TrueB. False

True

False

19%

81%

StimulantsModify (stimulate) a person’s

◦Activity level◦Mood◦Central nervous system

Increased heart rate Increased respiration Increased blood pressure Dilated pupils

https://www.youtube.com/watch?v=R3GYI-Kpf5M

History of Cocaine

Bush that grows in the Andes Natives chewed the leaves for

endurance

Cocoa wineCoca-ColaPatent medicines

Cocaine accounts for more ER visits than any other illegal drug.

A. TrueB. False

True

False

40%

60%

HistoryLocal anesthesia:

Dr. W. S. HalstedEarly psychiatric

uses:Sigmund Freud

Used to alleviate fatigue, depression, opiate addiction

Later opposed this use

Legal Control46 states passed laws to regulate

cocaine between 1887 and 1914Negative publicity about cocaine

influenced the passage of the 1914 Harrison Act

Anti-Drug Abuse Acts of 1986 and 1988

The majority of powder cocaine users who enter treatment are white, and the majority of crack cocaine users who enter treatment are black.

A. TrueB. False

True

False

44%

56%

Forms of CocaineProcessing 500 kilograms of coca

leaves yields 1 kilogram of cocaine

Coca pasteCocaine hydrochlorideFreebaseCrack or rock

Mechanism of ActionCocaine blocks reuptake of

dopamine, serotonin, and norepinephrine

The depressant effects of alcohol reduce the stimulating effects of cocaine, making serious side effects less likely to occur.

A. TrueB. False

True

False

100%

0%

Administration/EliminationRoutes:

◦Topical, snorting, IV, smokingCocaine is metabolized by

enzymes in the blood and liver

Cocaine has a half-life of about one hour

Major metabolites (detected by drug screens) have a half-life of eight hours

Benefits/ConcernsAnesthetic

properties Acute toxicityDamage to nasal

septumParanoid psychosisDamage to heart

muscleDependenceSome withdrawalUse during

pregnancy

AmphetaminesAncient Chinese used ephedraChemical version in 1932 –

amphetamineUsed in WWII to fight fatigue1960’sTighter control

After Mexico, the largest producer of methamphetamine is Canada, because pseudoephedrine is not regulated there.

A. TrueB. False

True

False

60%

40%

PharmacologyChemical structure is similar to

catecholamine neurotransmitters (adrenaline, noradrenaline)

Methamphetamine and amphetamine both cross blood brain barrier

Increases activity of monoamine neurotransmitters by stimulating their release (dopamine, norepinephrine, serotonin)

Absorption/EliminationPeak effects

◦1.5 hours oral◦5-20 min snorting◦5-10 min smoking

Half-life is 5-12 hoursRapid tolerance

Boys are more than twice as likely as girls to be identified with ADHD.

A. TrueB. False

True

False

19%

81%

BenefitsDepressionWeight controlNarcolepsyADD/ADHDConcentrationAthletics

ADHD is limited to teenagers and children. Very few adults have this disorder.

A. TrueB. False

True

False

84%

16%

RisksAcute behavioral

toxicityHigh doses may

destroy catecholamine neurons

ContaminantsParanoid psychosisNo withdrawalPowerful

psychological dependence

Methamphetamine

Ritalin, AdderallMost commonly

prescribed drugs for ADHD

Ritalin and other stimulants enhance the functioning of the reticular activating system, which helps children focus attention and filter out extraneous stimuli

Side effects include insomnia, weight loss, headaches, irritability, nausea, and dizziness

Videos

Caffeine Humor◦http://

www.youtube.com/watch?v=TqFRP5lXTmE

Do you think of Caffeine as a Drug?

A. YesB. NoC. Not sure

YesNo

Not sure

54%

15%

31%

Why or why not?

CaffeineSources of caffeine

Coffee Tea Soda Chocolate Energy drinks Over-the-counter medications

NoDoz Vivarin Anacin Excedrin Midol Diurex

What do you consider an acceptable level of caffeine intake?

A. NoneB. One beverage a

dayC. 2-5 beverages a

dayD. Any level is ok

None

One bevera

ge a day

2-5 beverage

s a day

Any level is

ok

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PharmacologyPeak blood levels reached 30

minutes after oral intakeHalf-life is about 3 hoursLow-grade tolerance does

develop

Mechanism of Action200 mg

◦ Increased arousal◦ Mood-elevating effects

500 mg◦ Increased heart rate & respiration◦ Paradoxical effect on blood vessels: dilation◦ Constriction of blood vessels in the brain =

headache relief◦ Increased basal metabolic rate (10%) in chronic

usersWorks on the neurotransmitter adenosine

(inhibitory)◦ Blocks receptors

Effects

Behavioral◦ Stimulation◦ Headache◦ Hyperactivity◦ Does not sober one up

Concerns◦ Panic attacks◦ 1980s thought to have a link

to cancer, since disproven◦ Reproduction◦ Heart disease (large

amounts)◦ Caffeinism

Should there be an age limit on caffeine consumption?

A. YesB. No

YesNo

0%0%

ConsiderationsWhat age?

◦ Infants◦ Toddlers◦ School age◦ Teenage

What products?◦ Energy drinks◦ Soda◦ Coffee ◦ Tea/iced tea◦ Hot chocolate◦ Chocolate

VideosYour brain on coffee

◦http://www.youtube.com/watch?v=hbuCmO8Bwhs&noredirect=1

◦http://www.youtube.com/watch?v=gfntvRGwpvs

Children and Caffeine◦http://guardianlv.com/2014/02/caffein

e-is-a-drug-for-kids-video/

Wrap-up

How much caffeine do you consume?

1981 FDA: limit of 6 mg of caffeine per ounce◦No labeling

required

Item Amount of Item Amount of Caffeine

Jolt soft drink 12 ounces 71.2 mg

Mountain Dew 12 ounces 55.0 mg

Coca-Cola 12 ounces 34.0 mg

Diet Coke 12 ounces 45.0 mg

Pepsi 12 ounces 38.0 mg

7-Up 12 ounces 0 mg

Brewed coffee (drip method)

5 ounces 115 mg

Espresso 1 shot 64 mg

Tea 5 ounces 40 mg

Iced tea 12 ounces 70 mg

Dark chocolate 1 ounce 20 mg

Milk chocolate 1 ounce 6 mg

Cocoa beverage 5 ounces 4 mg

Chocolate milk beverage

8 ounces 5 mg

Cold relief medication 1 tablet 30 mg

Midol 1 tablet 32 mg

Excedrin 1 tablet 65 mg

Monster Energy Drink 16 ounces 160 mg

Red Bull 8 ounces 60 mg

Under what circumstances should a person consider reducing caffeine intake?A. When they are

cranky without itB. When they have

health complications

C. When they obsess about it

D. Can’t think of a time I’d give it up! W

hen they a

re cranky

w...

When th

ey have health

...

When th

ey obse

ss about it

Can’t think of a

time I’d g.

..

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