drugs exam 3
preferences and success rate with quitting smoking
90% self help/cold turkey but less than 10% success PP page 35 for rest of chart
nicotine was first isolated in
1821 constitute about 5% of the weight of dry tobacco leaves
schizophrenia diagnosis
2+ of the following, each present for a significant portion of time during a 1 month period (or less if successfully treated). At least one of these should include 1-3 6 diagnostic symptoms- delusion, hallucinations, disorganized speech, disorganized or catatonic behavior, negative symptoms (blunted emotions), cognitive deficits
electronic cigs/vaping
2003 Chinese pharmacist Hon Lik vaping=using e-cigs e-cigs dont contain tobacco, they do or do not contain nicotine they are likely safer than tobacco cigs but the long term health effects are unknown questionable if it helps quit smoking 2019- a vaping resting lung injury epidemic January 2020- FDA bans mint and fruit flavored vaping products but exempts menthol and tobacco
tobacco was first encountered by Europeans when
Columbus reached the West Indies; they quickly took this habit up
in the 1600s
England commercialized tobacco growing in the Virginia colony
caffeine use disorder
ICD-10 is the 10th revision of the international statistical classification of diseases and related health problems, a medical classification list by the World Health Org (WHO) caffeine addiction was added to the ICD-10 AMA DSM-5 (2013) does not include the diagnosis of a caffeine use disorder, but describes caffeine withdrawal, but the DSM-5 lists caffeine use disorder in the emerging models section after the manual many neuroscientist / clinicians think there is not enough evidence to support caffeine addiction
PCP and ketamine mechanism of action
PCP and ketamine are noncompetitive antagonists at NMDA receptors- ionotropic receptors for the excitatory neurotransmitter glutamate the pcp/ketamine binding site is inside the receptor's ion channel, separate from the site at which glutamate or NMDA binds blockade of NMDA receptors in the cerebral cortex and hippocampus probably contributes to the cognitive deficits produced by the drugs NMDA receptors are associated with learning and memory
PCP and Ketamine behavioral effects
PCP is a dissociative drug- feelings of detachment, dissociate from the environment and self, vertigo or floating sensation, numbness, and a dreamlike state all subjects exhibited cognitive disorganization- difficulty in maintaining concentration or focus, deficiencies in abstract thinking and halting speech affective reactions include apathy, loneliness, negativism or hostility, or alternatively euphoria ketamine- low doses yield reactions similar to those of PCP doses in the anesthetic range produce a dissociated state with many subjective effects reported. this state is called the K-Hole and can be either spiritually uplifting or terrifying effects of PCP have been compared with the symptoms of schizophrenia, presumably accounting for the waning of the drug's popularity ketamine is currently used to model schizophrenia in animal research studies experiences of ketamine chart page 37
pharmacokinetics of PCP and ketamine
PCP is generally obtained in powdered or pill form and can be taken orally, intranasally, injected, or applied to tobacco and weed cigs to smoke half life and duration of action of PCP is 7-48 hours ketamine can be injected or taken orally half life of ketamine is 2.5-3 hours, duration is less than 1 hour
source of caffeine and caffeine content chard
PP page 40
LSD
a synthetic compound based on fungal alkaloids first synthesized by Albert Hofmann in 1938 from ergot, a parasitic fungus on rye it was intensely studied during the 1960s, when researchers were beginning to appreciate that nerve cells communicate chemically by means of neurotransmitters there was tremendous excitement about the possibility of understanding human mental activity and behavior at a chemical and physiological level some researchers tried LSD as a tool in psychotherapy or psychoanalysis CIA investigated LSD as potential psychological weapon exploded in 1960s with the hippie culture 1965 law restricted research on LSD; recreational use was banned in 1967 very potent, a single dose in crystalline form is barely visible larger amounts representing many doses are dissolved in water, then droplets containing single-dose units are applied to a sheet of paper (blotter) and dried; paper is then divided into individual squares or tabs
nicotine route of administration- smoking
a typical cig contains 6-11 mg of nicotine, though no more than 1-3 mg actually reachers the smoker's bloodstream amount available depends on the smokers behavior (numbers of puffs and length of each puff) during smoking nicotine, tar and carbon monoxide are released- tar contributes to the taste and smell of cigarette smoke
hallucinogenic drugs physiological effects
activate the sympathetic nervous system- pupil dilation, small increases in heart rate, bp, and blood temp; dizziness, nausea, and vomiting are more likely after consumption of peyote or mushrooms
caffeine physiological effects
acute caffeine intake leads to several physiological (sympathomimetic) effects- increased BP, increased respiratory rate, and enhanced water excretion (diuresis)
pathology = study of disease
addresses the following components of disease- cause/etiology, mechanisms of development (pathogenesis), structural alternations of cells, tissues, and organs, functional alterations of cells, tissues, and organs (pathophysiology), and the consequences of changes (clinical symptoms)
2014 farm bill
allowed to cultivate industrial hemp for research purposes
PCP and ketamine abuse
although PCP is less popular, users have developed dangerous combos known as fry, wet, or illy, in which tobacco or weed cigs are dipped in a liquid containing PCP and embalming fluid and then smoked use of ketamine has been growing because of the drug's popularity within the dance scene; abuse dates back many years by people in the medical or veterinarian professions and by some intellectuals who favored it as a mind-expanding drug int he tradition of LSD
ketamine brain damage
among many changes recorded in neuron structure and function, repeated administration of high doses of ketamine caused apoptotic cell death in developed brains of rats and monkeys this is some concern because ketamine is a recommended anesthetic agent for pediatric procedures
hallucinogenic drugs behavioral effects
an led trip can be divided into 4 phases- onset, plateau, peak, and come down users experience vivid visual hallucinations, a slowing of the subjective sense of time, feelings of depersonalization, strong emotional reactions, and a disruption of logical thought a hallucinogenic trip may be experienced as mystical and spiritually enlightening or disturbing and frightening whether the user has a good or bad trip depends on the dose and individual and social factors; one cannot predict in advance the outcome of an LSD trip researchers make use of the altered states of consciousness (ASC) rating scale or the hallucinogen rating scale (on page 18)
cannabinoids tolerance and dependence
animals exposed to THC or other CB1 agonists develop tolerance to the behavioral and physiological effects of these compounds it appears to involve a combination of desensitization and down-regulation of CB1 receptors
stimulant effect
antagonism of adenosine also promises release of dopamine, norepinephrine, and acetylcholine, which is responsible for caffeine's stimulant effects
cognition in nicotine
because acetylcholine plays an important role in aspects of cognitive functioning, several studies have examined effects of nicotine on cognitive function abstinent smokers given nicotine show enhanced performance on many kinds of cognitive and motor tasks some benefits for Alzheimer's disease- nicotinic receptor agonists high smoking rates in people with schizophrenia may be an attempt to self medicate their cognitive deficits
nicotine use disorder treatment
behavioral interventions include anti-smoking appeals in the media, surgeon generals health warnings on packages, and high taxes on tobacco products individual or group counseling programs can be successful, particularly if they provide social support and or training in coping skills most common pharmacological intervention is nicotine replacement nicotine relieves withdrawal symptoms and is delivered in safer ways than smoking- gum and lozenges, transdermal patch, nasal spray and inhalers the nasal spray and inhaler require a doctors prescription, whereas nicotine patches, gum, and lozenges can be obtained over the counter bupropion (zyban)- initially developed as an antidepressant; antismoking properties of this are thought to be related to its actions as a dopamine uptake inhibitor and a weak antagonist at nicotinic cholinergic receptors varenicline (chantix)- is a partial agonist at high affinity nicotinic receptors expressed in the VTA and other brain areas; reduces nicotine cravings and withdrawal symptoms
marijuana elimination
blood THC levels decline rapidly after smoking marijuana, but complete elimination from the body is much slower because of persistence in fat tissues half life varies from few hours to 3-4 days the gradual movement of THC metabolites back out of fat stores means that urine screening tests can detect them more than 2 weeks after a single marijuana use
PCP and ketamine reinforcement
both are highly reinforcing, as shown by drug self-administration and have high abuse potential both activate midbrain DA cell firing and stimulate DA release, particularly in the prefrontal cortex
hemp was grown in colonial America,
but marijuana smoking came to the US with Mexican and carribean immigrants in the early 1990s
breathing and BP in caffeine
caffeine blocks adenosine receptors in the medulla vasomotor and respiratory centers, which leads to increase in respiratory rate and constriction of blood vessels
hallucinogenic drugs severe reactions
can cause serious problems for some users a user may have a bad trip with acute anxiety or panic it appears to be related to the individuals emotional state going into the trip as well as the external environment most severe reaction is a psychotic reaction; with few exceptions, prolonged psychotic episodes typically involve individuals who had already been diagnosed with a psychotic disorder or who had pre-psychotic symptoms before taking the drug flashbacks- re-experiencing the hallucinations some time after the drug has stopped; if they occur for a long time, the individual is considered to be suffering from hallucinogen persisting perception disorder (HPPD), which seems to be rare
marijuana mechanisms of action
cannabinoid receptor in the CNS was identified in 1988 receptors occur in many brain areas localization of cannabinoid receptors in these areas in consistent with the behavioral effects of these compounds on locomotor activity, coordination, and memory endogenous neurotransmitter-like substance that acts on the receptors are the endocannabinoids 2 main endocannabinoids have been found- anandamide and 2-AG; they are retrograde messengers that carry information in the opposite direction form normal (postsynaptic to presynaptic) cannabis similar to endocannabinoids binds to cannabinoids receptors located presynaptically on the nerve terminal. they are metabotropic: they work via G proteins to inhibit presynaptic voltage-sensitive Ca2+ channels and open K+ channels; as a result, cannabinoids decrease neurotransmitter release from the terminal
caffeine chronic use
chronic caffeine use does lead to tolerance for some of the subjective effects and ability to disrupt sleep, as well as tolerance to the cardiovascular and respiratory effects of the drug they may exhibit no trouble sleeping after consuming coffee right before bedtime withdrawal can include- headache and fatigue if they miss their morning cup of coffee, impaired concentration and psychomotor performance, and mild anxiety or depression people may develop an intense craving for coffee if they try to stop drinking it withdrawal symptoms can occur in individuals who consume as little as 100 mg a day symptoms dissipate after a few days despite its ability to produce physical dependence, caffeine does not meet the criteria necessary to be considered addictive
nicotine acute tolerance
cig smokers undergo this during the course of the day it dissipates during the night and mid withdrawal occurs the 1st cig in the morning is the strongest effect
nicotine use disorder
cig smoking- 70-75% of current smokers in the US would like the quit, and bout 40-45% of daily smokers actually attempt to quit each year. however, addiction to nicotine is powerful and success rate is very low 2 aspects of nicotine addiction- biomedical (abstinence syndrome, reinforcing properties), and sociocultural
leaves of tobacco plants
contain 80-85% water curing is the process that brings out the aroma and flavor of each variety of tobacco, after this cycle there is essentially no water left the actual nicotine content of the cured tobacco lead may reach as much as 6.17%
ketamine potential therapeutic uses
depression- march 2019 the US FDA approved Spravato (esketamine) nasal spray for the treatment of depression in adults who have tried other antidepressant medicines but have not benefitted from them (treatment resistant depression) chronic pain- it may be useful an non-opioid analgesic agent for a variety of chronic pain conditions
psycholytic therapy
drug induced psycholysis, meaning psychic loosening or opening
tobacco smoke initially used by Maya
during religious ceremonies, rituals, and medicinal practices they passed on the custom of smoking to almost every other Indian group in North and South America
cannabinoids acute behavioral effects
effects of cannabinoid use vary depending on dose, frequency of use, characteristics of the user, and the setting in which use occurs subjective and behavioral effects can be separated into 4 stages- buzz, high, stoned, and come down high is associated with feelings of euphoria and exhilaration, and a sense of disinhibition relaxation is the most commonly reported effect of being stoned it can sometimes produce transient psychotic symptoms such as depersonalization, derealization, agitation, and paranoia; expectation also plays a role in what effects the drug will produce, as shown by placebo studies affects cognitive functions and psychomotor performance; decreased performance for a variety of verbal, spatial, time estimation, and reaction time tasks have been noted; appears to interfere with all aspects of memory processing can affect psychomotor functioning under demanding task conditions, such as driving; use of cannabis with to without alcohol is a risk factor in automobile accidents
nicotine metabolism, withdrawal and tolerance
elimination half life of nicotine is around 2 hours. to avoid withdrawal symptoms, smoking must occur repeatedly throughout the day frequent smoking leads to ever-increasing peak levels of nicotine during the day, since each dose builds on the residual nicotine from the previous one, but tolerance also builds
therapeutic uses of cannabinoids- appetite stimulation
endocannabinoids have additionally been shown to play a significant role in hunger and eating behavior endocannabinoids enhance the incentive motivational properties of food and food-mediated reward CB1 receptor antagonists reduce food consumption in animals and human subjects CB1 antagonist may be useful in treating obesity Dronabinal (Marinol)- a synthetic form of THC, schedule 3 drug; FDA approved for use as an appetite stimulant in AIDS patients suffering from anorexia-cachexia (wasting syndrome); used to treat nausea and emesis in cancer chemotherapy patients
dmt
found in several plants indigenous to south america native tribes make hallucinogenic snuffs from plants containing these compounds, and also a drink called ayahuasca in the US, people occasionally brew a homemade version of ayahuasca, but more typically DMT is sold in powdered form and is smoked DMT is usually devoid of psychoactivity when taken orally, but this is not the case when people drink ayahuasca (a brew with a source of monoamine oxidase inhibitor MAOI) DMT has the shortest of all hallucinogens duration of action= businessman's trip
mescaline
found in several species of cactus like peyote the crown of this small cactus is cut off and dried to form a mescal button or peyote button peyote buttons can be eaten raw or cooked, or the mescaline can be extracted and consumed as a powder peyote cactus is native to the US southwest and northern mexico Peyote has been used for thousands of years by native Americans for religious and healing rituals aldous Huxley tried mescaline in 1953 and described his experience in 2 books that helped spawn a rise in hallucinogenic drug use in the 1960s
caffeine high doses/OD
greatest health risks occur with high doses caffeinism (1000 mg or more a day) is characterized by restlessness, nervousness, insomnia, tachycardia, and GI upset it can be difficult to distinguish from a primary anxiety disorder more than 10 g can be lethal (about 75-100 cups of coffee or a tablespoon of powdered caffeine supplements)
hallucinogenic drugs dependence
hallucinogens do not have high abuse potential; there are no withdrawal symptoms and they are not effective reinforcers dependence does occur in small number of users, especially if exposed at an early age
caffeine mechanisms of actions
has several biochemical effects, but only blockade of A1 and A2a receptors for adenosine has effects that operate at doses around in a cup of coffee caffeine=antagonist of adenosine receptors adenosine in the brain has neurotransmitter-like function and has been proposed as a key modulatory in inducing drowsiness and sleep in addition to blocking adenosine receptors, caffeine blocks GABAa receptors and stimulates CA2+ release all these effects require higher doses, even into the toxic range
marijuana ingredients
hemp also contains 70 unique compounds knows as cannabinoids, plus more than 400 other identified compounds the psychoactive compounds (tetrahydrocannabinol- THC) accounts for the use of cannabis as a drug marijuana potency (in terms of THC content) varies widely, depending on the genetic strain of the plant and growing conditions potency can be increased by preventing pollination and seed production by the female plants. this marijuana is called sinsemilla (without seeds) THC was identified as the major active ingredient in 1964 burning marijuana causes the THC to vaporize and enter the smokers lungs in small particles effective dose and latency to onset of effects are influenced by the amount and potency of the plant used, and patterns of smoking (like breathhold duration)
cannabis (hemp) plant
high THC content- marijuana, recreational use low THC content (less than .3%)- industrial hemp
graphic warning labels
in June 2011, the FDA ordered the use of nine rotating warnings to cover 50% of cig packs with such images as diseased lungs and a cadaver lying on an autopsy table 5 tobacco companies, including RJ Reynolds Tobacco and Lorillard Tobacco (2nd and 3rd biggest cig makers) filed a law suit claiming the mandate violated their 1st amendment rights US district judge Richard Leon ruled for cig companies in 2 lawsuits against the FDA
caffeine behavioral effects
in lab animals, low doses have stimulant effects, but high doses show reduced activity people inject caffeine mostly for its stimulation and fatigue-reducing effects at high doses humans experience feelings of tension and anxiety in controlled studies for regular caffeine users, humans report positive subjective effects such as enhanced vigor and ability to concentrate recent research suggests this is not just due to allocation of withdrawal symptoms, both caffeine consumes and non consumers benefitted from the caffeine treatment research has shown some benefit of caffeine to athletic performance possible mechanisms include increased force of muscle contraction, enhanced arousal and alertness, and reduced pain perception
cannabinoids reinforcement
in one study, marijuana users could discriminate THC containing weed cigs from placebos with no THC, and all subjects preferred the weed with THC when given a choice animal studies have also demonstrated reinforcing properties- lever pressing by squirrel monkeys for THC stopped when placebos were used mechanisms of reinforcing- activation of the mesolimbic dopamine system (VTA to NAcc); interactions between the cannabinoid and opioid systems may play a role in cannabinoid reward and reinforcement; opioid agonists enhance cannabinoid self-administration and opioid antagonists have the opposite effect
marijuana chronic behavioral effects
in young people, amount of cannabis use is inversely related to educational performance some research supports the hypothesis that heavy cannabis use leads to persistent cognitive deficits, impairing school performance alternatively, poor school performance and rejection of mainstream values such as educational achievement may increase cannabis use can also result in aimlessness, decreased motivation, lack of planning, and decreased productivity- amotivational syndrome heavy cannabis use over a long period may lead to impaired executive functioning for at least 2-3 weeks following a cessation of use some data suggest that heavy, long time users may continue to show impairment in decision making, planning, and concept formation it might negatively affect the prefrontal cortex imaging studies suggest that chronic marijuana use is associated with several kinda of abnormalities in the brain several studies have found a significant relationship between early heavy marijuana smoking and increased risk for later development of psychotic disorders such as schizophrenia
cannabinoids acute physiological effects
increased blood flow to the skin and flushing, increased heart rate, increased hunger
nicotine metabolism/excretion
is metabolized to cotinine by the liver enzyme cytochrome _450 2A6 (CYP2A6) cotinine and other nicotine metabolites are excreted mainly in the urine
PCP was developed in 1950s as an anesthetic
it did not result in respiratory depression, as with barbiturates, but it produced unusual characteristics and sometimes severe reactions clinical use stopped in 1965 PCP became an illicit street drug with names such as angel dust and hog popularity never rivaled that of weed or cocaine or heroin, and PCP use declined to a rather low level schedule 2 drug
nicotine poisoning
it is a toxic substance that can be fatal at high doses (LD50 is about 40-60 mg) such dose can not be reached via inhalation a large number of poisonings occur among children who eat tobacco contact with tobacco in the field (green tobacco sickness) or insecticides that contain nicotine however, 2 protections against death- quick first pass metabolism through liver, and activation of vomiting center
ketamine was developed as a safer alternative to PCP, being less potent and shorter-acting
it is a valuable anesthetic for certain procedures, particularly in children and also used by veterinarians it is currently marketed as a prescription medication under the trade names Ketalar, Ketaset, and Vetalar schedule 3 drug illicit ketamine usually comes from diversion or theft of medical or veterinary material and is sold on the street as "K" "special K" or "cat valium"
in 1937, the marijuana tax act instituted a national registration and taxation system aimed at discouraging all use of cannabis
it was overturned in 1969 largely destroyed hemp industry United States department of agriculture lifted the tax on hemp cultivation during wwII
nicotine chronic tolerance
long-term exposure to nicotine causes this, superimposed on the acute within a day tolerance in one study, a high dose of nicotine elicited an aversive reaction with some symptoms of mild nicotine toxicity in nonsmokers but no such reaction in smokers
2018 farm bill
made industrial hemp legal CBD (cannabidiol) oil production
tobacco for burning
made into cigars, cigarettes, or pipe tobacco
tobacco snuff
made my grinding dried tobacco leaves to a very fine powder
in 1970
marijuana and THC became a schedule 1 illegal drug
cannabis probably originated in China
medical and religious use can be traced to ancient china, India, and the Middle East spreading to the arab world napoleons soldiers brought it to France from Egypt. it became popular with French writers and artists
therapeutic uses of cannabinoids
medical marijuana many states now permit legal use, but clinical studies of its efficacy have shown mixed results smoked marijuana has the potential for adverse health effects and abuse; most researchers favor development of cannabinoid-based drugs instead addiction- some evidence that it might reduce addiction and ODs caused by other drugs anxiety- was shown to relieve anxiety, depression in animal studies galucoma- number of years ago, Jamaican researchers also prepared eye drops from cannabis extracts (trade name Canasol) for the purpose of reducing ocular pressure in glaucoma patients. However, Canasol was never licensed by the FDA for legal marketing in US
cannabis use disorder treatment
most cannabis users do not become dependent and do not seek treatment outpatient programs involves cognitive-behavioral therapy, relapse prevention training, and or motivational enhancement therapy, but patients are very vulnerable to relapse some research on medication to relieve withdrawal symptoms have been done
hallucinogenic drugs tolerance
most hallucinogens (except DMT) produce rapid tolerance with repeated use a likely mechanism is down-regulation of 5-HT2A receptors, which has been demonstrated in rats
psilocybin
mushrooms is several different genera produce alkaloids with hallucinogenic properties and are found in many places around the world the dried mushrooms may be eaten raw or cooked or made into tea the main compounds are psilocybin and related psilocin after injection, psilocybin is converted to psilocin, that actual psychoactive agent hallucinogenic mushroom use also goes back thousands of years in several parts of the world they were used by the mayan and aztec civilizations in religious rituals the Spanish suppressed mushroom eating int he conquered Aztecs but could not wipe it out completely in 1955, gordon Wasson participated in a mushroom eating ritual in Oaxaca Mexico led by a mazatec shaman; his experiences were described in a Life magazine article in 1957 Timothy Leary and Richard Alpert at Harvard experiments with psilocybin and LSD and helped to popularize the drug; the Harvard psychedelic drug research center
nicotine is a potent
neurotoxin with particular specificity to insects, therefore nicotine was widely used as an insecticide
Nesbitt's Paradox
nicotine appears to cause an arousal in most studies. however, most smokers report that they smoke because smoking a cig relaxes them nicotine changes from stimulant to sedative with increase of dose
nicotine behavioral effects
nicotine is both a stimulant and relaxant tp separate the effects of nicotine from behavioral aspects of smoking, subjects are given pure nicotine through injection, skin patches, or gum in smokers- nicotine produces a calm or relaxed state In non-smokers- tends to elicit heightened tension or arousal, along with lightheadedness, dizziness, and even nausea
nicotine reinforcement
nicotine on its own is reinforcing: humans and other animals will self administer nicotine the mesolimbic DA pathway from the VTA to the nucleus accumbuss (NAcc) plays a key role in reinforcement- lesioning the dopaminergic innervation of NAcc significantly attenuates nicotine self-administration high affinity nicotinic receptors in the VTA stimulate firing of DA neurons, increasing DA release in the NAcc research in this area usually involves nicotine, but one study showed the same result when rates were inhaling cig smoke
nicotine physiological effects
nicotine receptors are abundant in the autonomic nervous system smoking can activate both sympathetic and parasympathetic systems, causing a wide range of physiological effects, including tachycardia and elevated blood pressure this can increase risk of cardiovascular disease reduces appetite and increases metabolic rate, resulting in weight loss smokers in general weigh less than non smokers, quitting usually results in weight gain
caffeine pharmakinetics
normally consumed orally in beverages 18-175 mg per cup of coffee it is completely absorbed from the GI tract in 30 to 60 mins because caffeine is both water and lipid soluble, it readily crosses the BBB absorbed by the small intestine within 45 mins of ingestion. peak blood concentration is reached within 1-2 hours caffeine is converted to a variety of metabolites by the CYP450 in the liver average plasma half life is about 4 hours (3-7 hours) people who drink coffee repeatedly over the course of the day experience dreadfully rising plasma caffeine concentrations in humans, appx 95% of caffeine metabolites are eliminated through the urine
tobacco for chewing
one to three high quality leaves are braided and twisted into a rope while green and then are cured in the same manner as other tobacco
therapeutic uses of cannabinoids- pain treatment
pain perception- transgenic mice that lack CB1 and CB2 receptors demonstrate hyperalgesia (increased pain sensitivity) clinical evidence for cannabinoids as analgesics has not been convincing Nabiximols (Sativex)- cannabis extract, approved in the UK in 2010 to treat pain and spasticity in multiple sclerosis patients (not yet approved in US)
psychedelic therapy
patient was given a high dose of LSD in hopes of gaining insight into his or her problems
cigarettes began to be used in Europe in the mid nineteenth century
popularity in USA exploded over the next 30 years new methods of curing tobacco leaves that improved flavor invention of the cigarette machine, which increased production dramatically
caffeine therapeutic uses
potentiates analgesic properties of aspirin and acetaminophen. it is included in some OTC pain medication anacin- aspirin + caffeine excedrin= aspirin + paracetamol + caffeine effective in treatment of apnea in premature newborns. caffeine can normalize breathing
marijuana preparation
produced from flowering hemp (cannabis sativa) a mixture of dried and crumbled leaves, small stems, and flowering tops hemp seeds have been used for oil and bird food it can be consumed orally, as in cookies or brownies, but is usually smoked in rolled cigs knows as joints, various kinda of pipes, or in hollowed-out cigars called blunts hashish is a cannabis derivative that can be smoked or eaten; it can refer to a relatively pure resin preparation with very high cannabinoid content or a solvent extract of leaves or resin hash oil is an alcohol extract. a drop is placed on a tobacco or marijuana cig
hallucinogens are
psychedelic drugs primary action is to produce hallucinations by altering cognition and perception mescaline, psilocybin, dimethyltryptamine (DMT), lysergic acid diethylamide (LSD) all hallucinogens are schedule 1 drugs
pharmacokinetics of hallucinogenic drugs
psychedelic effects generally begin 30-90 mins after ingestion, an LSD trip canals 6-12 hours effects of smoked DMT are felt within seconds, peak over a few mins, and are gone within an hour the different hallucinogens vary widely in potency, ranging from LSD as the most potent to mescaline as the least route of administration and potency chart pp page 15
nicotine absorption
readily passes through the absorbent surface of the lungs to the bloodstream first reaches the brain in about 7 seconds which is appx twice as fast as when the drug is administered intravenously it is absorbed to a lesser extent through the mouth and nostrils when tobacco is chewed or snorted as snuff
Phencyclidine (PCP) and ketamine
related compounds "dissociative anesthetics"
WWII and cigarettes
sales at an all time high included in soldier's C-Rations companies sent millions to the soldiers for free so when they came home the companies would have a steady stream of loyal customers 1971- television ads for cigs taken off air in US AMA because tobacco was now a health hazard, cause for cancer, and other respiratory and circulatory diseases
hallucinogenic drugs mechanism of action
serotonin receptors in the cortex are believed to be particularly important in the action of hallucinogens a neuroimaging study found that 5-HT2A (serotonin) receptor antagonists block psilocybin induced visual illusions and hallucinations hallucinogens activate serotonin receptors on prefrontal cortical pyramidal neurons and increase their excitation; this disrupts the normal functioning of glutamatergic networks in the prefrontal cortex
marijuana administration and absorption
smoking- quickest way to absorb the THC with blood levels peaking between 9-10 minutes into a smoke session; THC is easily absorbed by the lungs and blood plasma levels rise quickly edibles- thought to yield peak THC blood levels within 1-5 hours post injection; poor absorption results in low and variable plasma levels, probably due to degradation in the stomach and first pass metabolism
nicotine abstinence
studies show that the abstinence syndrome is relatively short, with most symptoms gone by 4 weeks, and nicotine gum prevents most symptoms withdrawal symptoms- decreased heart rate, increased eating, inability to concentrate, aggression, depression, anxiety, sleep disruption, cravings
DSM-5 other hallucinogen use disorder
the "other" in the title distinguishes the hallucinogens causing the disorder from "phencyclidine use disorder" and "cannabis use disorder" drugs in this category are mescaline, MDMA/ectasy, psilocybin or psilocin, DMT and LSD; various other plant compounds with hallucinogenic effects are also included unlike many other substance use disorders, withdrawal symptoms are rare symptoms of other hallucinogen use page 25
nicotine use disorder- cig smoking
the amount of cig smoking in the US has varied over the past 100 years smoking increased dramatically up to the 1960s. declines since then are related to the surgeon general's report on health consequences, antismoking ads, high cig taxes, and societal disapproval of smoking
nicotine is an oily water soluble substance
the colorless liquid changes color to yellow and brown on contact with air or slowly with light
cig smoking- health effects
the deleterious health effects stem from carbon monoxide from burning tobacco, tar, and nicotine nicotine enters the smokers lungs on tiny particles called tar, a complex mixture of chemicals, some of which are known to be carcinogenic other chemicals that can be found- ammonia (found in toilet cleaners), acetone (found in nail varnish remover), cadmium (a highly poisonous metal used in batteries), naphthalene (used in moth balls), cyanide (used in gas chambers), and formaldehyde (use to preserve dead bodies) smoking is a major cause of illness and premature death cig smoking is the major preventable cause of death among americans increases the risk for many life threatening illnesses like cancer, cardiovascular disease, and respiratory disease
energy drinks
the increased popularity of energy drinks may result in more caffeinism overconsumption of energy drinks can have serious health effects, including- agitation, tremors, seizures, damage to the liver and kidneys, GI distress, respiratory problems, cardiac arrhythmia, tachycardia, and even heart failure
Characteristics of schizophrenia
the most typical feature of schizophrenia is psychosis- severe distortions of reality, disturbances in perception, intellectual functioning, affect, motivation, social relationship, and motor behavior; relapsing episodes they can be so incapacitating that voluntary on involuntary hospitalization is required classification of mental disorders DSM-5 pg 4
major source of caffeine is coffee beans
the seeds of the plant Coffea Arabica also in tea, chocolate, etc. one of the most widely used drugs in the world
marijuana adverse health effects
theres re no reports of death from OD smoking weed can damage lungs; smoke contains tar, other carcinogens, carbon monoxide, etc. adverse cardiac effects? immune system suppression THC may affect reproductive functions- in women it can affect ovulation, in men regular smoking has been shown to decrease testosterone levels and sperm counts, animal work has demonstrated pregnancy failure, retarded embryonic development, and even fetal death with THC administration, smoking weed during pregnancy results in cognitive deficits, poor school achievement, and increased risk for tobacco and or weed use later in life
PCP and ketamine health effects
they should not be mixed with drugs that act as respiratory depressants like alcohol, valium, or opioids chronic use of either can produce many negative effects like- urological problems like bladder pain and incontinence, deficits in memory and other cognitive functions, and gray and white matter abnormalities in chronic ketamine users
mixing alcohol and energy drinks
though subjects may feel less intoxicated, alcohol related impairment of psychomotor performance is still present (weed awake drunk)
caffeine reinforcement
until recently it was thought that caffeine does not increase dopamine level in the nucleus accumbens 2002- in freely moving rats caffeine preferentially increase extracellular levels of dopamine in the NAcc these effects could be reproduced by the administration of a selective adenosine A1 receptor antagonist but not by a selective adenosine A2A receptor antagonist
cannabis use disorder
weed typically begins in a adolescence and peaks during young adulthood if an individual has not yet tried weed by his or her mid 20s, he or she is unlikely to begin at a later stage risk of dependence is related to drug use patterns. people who progress to daily use have a 10-20% probability of becoming dependent dependence is manifested as a difficulty in stopping ones use, a craving for marijuana, and unpleasant withdrawal symptoms; irritability, increased anxiety, depressed mood, sleep disturbances, heightened aggression, and decreased appetite (similar symptoms to nicotine withdrawal)
nicotine mechanisms of action
works by activating nicotinic cholinergic receptors (nAChRs), one of the 2 subtypes of acetylcholine receptor they are ionotropic receptors made up of 5 subunits high-affinity nAChRs are found in many parts of the brain, neuro muscular junctions, and in he ganglia of the autonomic nervous system
