Block 2: Drugs Of Abuse: Marijuana And Hallucinogens

Front 1

north Africa, Middle east
dried resinous exudate of the flowering tops

Back 1

hashish

Front 2

Far East
dried resinous extract of tops

Back 2

charas

Front 3

Asia, Caribbean
dried leaves, flowering shoots with relatively low cannabinoid content

Back 3

bhang

Front 4

Caribbean
resinous mass of smaller leaves and flowers

Back 4

ganja

Front 5

USA- any part or extract of plant producing a pharmacological effect

Back 5

marijuana, Mary Jane, pot, grass, weed, joint, reefer

Front 6

Colombian marijuana with a high THC content

Back 6

bo

Front 7

What are the pharmacologically active components of marijuana known as?

Back 7

cannabinoids

Front 8

What is the principal psychoactive component of marijuana?

Back 8

tetrahydrocannabinol (THC)
aka dronabinol (generic name)

Front 9

How do cannabinol and cannabidiol relate to tetrahydrocannabinol?

Back 9

less potent cannabinoids with no psychoactive effect; they are plant precursors or products of THC metabolism in plant

Front 10

What synthetic analogue of THC has anti-emetic properties?

Back 10

nabilone

Front 11

What synthetic analogue of THC has analgesic properties?

Back 11

nantradol

Front 12

What is the THC content of an average joint?

Back 12

10-50 mg

Front 13

What has faster absorption- smoking or oral ingestion?

Back 13

smoking, duh :)

Front 14

How is marijuana distributed after smoking?

Back 14

peak plasma levels in 10-30 minutes --> redistribution into adipose tissue (t1/2 45 min) --> gradual metabolism and elimination (t1/2 4 days)
Recovery takes 3-5 hrs

Front 15

Can THC cross the placental barrier? Is it found in human milk?

Back 15

yes to both

Front 16

What is the major metabolite of THC?

Back 16

11-hydroxy-THC
very potent

Front 17

What is the principal bioactive species after oral administration of marijuana?

Back 17

11-OH-THC, after first pass through liver

Front 18

How much of total administered THC dose is excreted in urine and feces within 5 days?

Back 18

80%

Front 19

Feces excretion of marijuana?

Back 19

THC
11-OH-THC
inactive metabolites

Front 20

Urine excretion of marijuana?

Back 20

9-COOH metabolites
appear 20-30 min after smoking, 2-3 hrs after eating, detectable for 24 hrs

Front 21

What happens to the remaining 20% of ingested THC?

Back 21

exreted very slowly over days to weeks
THC in blood or urine higher than its 9-COOH metabolites provide presumptive evidence of recent intoxication

Front 22

What are the effects of smoking one marijuana cigarette (in order)?

Back 22

tachycardia w/p change in BP --> euphoria/high --> relaxation and sedation --> psychomotor impairment --> dry mouth, hunger, peripheral vasodilation (red eyes), bronchodilation

Front 23

What can higher doses of THC cause?

Back 23

confused, disorganized thinking; hallucinations, delusions
euphoria--> anxiety, panic, paranoia
more common after oral administration

Front 24

What does activation of the THC receptors do?

Back 24

cannabinoid receptors (CB1 in CNS and CB2 in periphery) are 7-transmembrane G-protein coupled receptors --> inhibit adenylyl cyclase

Front 25

What is the consequence of many CB1 receptors in hippocampus and cortex, and striatum and nucleus accumbens?

Back 25

well placed to influence memory, cognition, motor function, and reinforcement

Front 26

What is anandamide (arachidonyl-ethanolamide)

Back 26

endogenous lipid with affinity for CB receptors-
also activates vanilloid receptors in bladder and may cause bladder hyperreflexia (fixed w/ antagonist capsazepine)

ananda= eternal bliss (sanskrit)

Front 27

What is arachidonyl-glycerol?

Back 27

another CB receptor ligand found in hippocampus --> extinction of learned memories, particularly fearful memories

Front 28

3 possible therapeutic uses of THC (dronabinol) and related drugs?

Back 28

1. reduce intra-ocular pressure in glaucoma
2. tx chemotherapeutic drug - induced vomiting
3. pain relief

Front 29

Advantages of medical marijuana?

Back 29

low cost; good individualized control of dose; reduced pain and nausea; improved appetite; less wasting disease

Front 30

Disadvantages of medical marijuana?

Back 30

potential long term toxicity from inhalation of combustion products; chronic toxicity of marijuana; lack of quality control; potential for diversion to illegal market

Front 31

Can you get craving after THC withdrawal?

Back 31

yes, after heavy use

Front 32

Sx associated with chronic marijuana use?

Back 32

bronchitis, asthma
suppressed immunity
dec secretion of gonadotropins and sex steroids
amotivational syndrome

Front 33

Where does LSD come from?

Back 33

the lab, its synthetic and was first made in 1943 by Hoffman

Front 34

How long can LSD last and how potent is it?

Back 34

up to 12 hrs; very potent 20-25 ug may produce threshold effects

Front 35

effects of LSD?

Back 35

somatic (1-2 hrs)
perceptual (2-6 hrs)
affective

Front 36

What are the somatic effects of LSD?

Back 36

dizziness, pupil dilatation, weakness, tremor, nausea, parasthesias

Front 37

What are the perceptual effects of LSD?

Back 37

blurred vision, difficulty focusing, altered awarness of shape and color, micropsia, macropsia, hallucinations

Front 38

What are the affective symptoms of LSD?

Back 38

elation, euphoria or dysphoria, depression, fear, paranoia, panic (2-5 hrs), mood swings, after 6 hrs - detachment

Front 39

LSD MOA?

Back 39

partial agonist at 5-HT receptors; effects reversed by 5-HT and D2 antagonists

Front 40

Does tolerance, or dependence occur with LSD?

Back 40

tolerance yes
dependence no

Front 41

What two drugs are related to LSD and come from mushrooms?

Back 41

psilocybin
AND
psilocin, dimethyltryptamine, bufotenin

(psiocybe = type of mushroom
dimethyltryptamine = DMT
bufo = genus of toad)

Front 42

What is ecstasy?

Back 42

MDMA
5-methoxy-3,4 methylene dioxyamphetamine
a "rave" drug

Front 43

What drug related to ecstasy is found in peyote cactus

Back 43

mescaline
(3,4,5 trimethoxy-beta-ethylamine)

Front 44

What are DOM ("STP") and DOET related to?

Back 44

ecstasy

Front 45

How do mescaline and DOM differ from LSD

Back 45

more LSD-like effects, but with less or little stimulation- there is cross-tolerance

Front 46

Does MDMA cause less or more marked hallucinogenic state than does LSD?

Back 46

less but are mildly stimulating

Front 47

What causes a transition from amphetamine like stimulation to LSD like hallucination?

Back 47

increasing substituents on aromatic ring of amphetamines

Front 48

What group of patients are very sensitive to anticholinergic delirium?

Back 48

elderly patients

Front 49

Are phenothiazines (atropine like) indicated in tx of anticholinergic delirium?

Back 49

no

Front 50

This drug gives good analgesia, amnesia, poor muscle relaxation, and 40% of pt's have dysphoric reax and some develop violent psychotic state?

Back 50

PCP

Front 51

this drug is related to PCP and is used as animal anesthetic?

Back 51

ketamine

Front 52

PCP MOA?

Back 52

NMDA receptor Ca channel blocker --> non- competitive NMDA antagonist

Front 53

acute actions of PCP in low doses

Back 53

15-20 mg doses orally or smoking --> intoxicated in 2-5 minutes --> blank stare, catatonic muscular rigidity, confusion, drowsiness, hypersalivation, sweating lasting up to 24 hrs

Front 54

acute actions of PCP in high doses

Back 54

stuporous, comatose state for 4-6 hrs, bizarre, unpredicatable aggressive behavior, paranoid psychoses, convulsive episodes, hypertensive crisis

Front 55

chronic use effects of PCP

Back 55

persistent difficulty in thinking, memory deficits, speech impairment, occasionally for a year or more after drug use ceases

Front 56

What does PCP do in schizophrenics?

Back 56

intensifies psychotic behavior

Front 57

How do you tx PCP overdose

Back 57

symptomatic
avoid exacerbating paranoia (don't try to talk down)
tx convulsions with diazepam; hypertension with hydralazine; psychosis with haloperidol