Module 3 Continued

Front 1

classification of cannabis

Back 1

• legal - CNS depressant, euphoriant, hallucinogen
• pharmacological - narcotic, controlled substance, Schedule II

Front 2

CB1 receptors

Back 2

• located in the brain, THC not a very effective agonist, but produces a response because of the high number of available receptors
• cerebral cortex - mediate the distortions of time, colour, sound, and taste; mediate decrease in cognitive function and concentration
• hippocampus - memory change and learning
• none located in brain stem= non-lethal

Front 3

CB2 receptors

Back 3

• only found outside CNS
• not involved in the psychotomimetic effects of THC
• may be involved in inflammation
• binding THC to these receptors on lymphocytes is believed to be responsible for immunosuppressive properties of THC

Front 4

short-term effects of marijuana

Back 4

• relaxation and drowsiness, euphoria, impaired motor coordination
• increasing dose can cause pseudo-hallucinations
• increased heart rate and blood flow to extremities, postural hypertension
• increased appetite, dry mouth and throat
• reduced testosterone in males, disruption of ovarian cycle in females

Front 5

long-term effects of marijuana: psychological

Back 5

• occasional low dose - no effects
• high doses - loss of short-term memory, lack of concentration, loss of ability in abstract thinking
• amotivational syndrome - mental slowing, loss of memory, loss of ambitions, emotional flatness
• permanent use - unknown

Front 6

long-term effects of marijuana: cardiovascular

Back 6

• usually reversible
• effects on heart rate and BP become and issue to those with heart disease

Front 7

long-term effects of marijuana: respiratory

Back 7

• smoked - bronchitis, asthma, sore throat, chronic irritation of and damage to membranes of respiratory tract
• higher concentrations of tars and carcinogens in marijuana smoke than tobacco smoke - holding in inhale enhances absorption
• incidence of lung cancer and chronic obstructive pulmonary disease increase long-term

Front 8

long-term effects of marijuana: fertility

Back 8

• males - decreased sperm count
• females - THC freely crosses placenta and can cause developmental delays: cognitive effects, impulsiveness, hyperactivity

Front 9

pros of vaporizing

Back 9

• potentially produces smaller amounts of toxic substances
• may decrease negative respiratory effects associated with smoking
• discrete consumption

Front 10

dronabinal and nabilone

Back 10

• synthetic THC derivatives
• more selective at treating nausea than marijuana
• good for those undergoing cancer treatment

Front 11

tolerance to cannabis

Back 11

• develops to the psychoactive properties of THC, cardiovascular system, impairment of performance, and cognitive function

Front 12

dependence of cannabis

Back 12

• can occur with high-dose use
• termination - mild withdrawal syndrome - sleep disturbances, irritability, loss of appetite, nervousness
• low dependence liability

Front 13

treatment for addiction

Back 13

• no approved pharmacological treatments
• dronabinal has been tried as replacement THC therapy with some promise

Front 14

opiate

Back 14

• narcotic analgesic obtained from the opium poppy

• morphine and codeine

Front 15

opioid

Back 15

• any natural synthetic substance which exerts actions of the body similar to those induced by morphine and that are antagonized by the drug naloxone
• substances structurally related to morphine
• synthetic drugs with structures different from morphine
• endogenous brain peptides that exert analgesic actions

Front 16

opioid receptors

Back 16

• located in the CNS and peripheral nervous system
• also present in GI tract - responsible for constipation by opiates

Front 17

Mu receptor

Back 17

• present in all structures of the brain and spinal cord
• block pain pathways in spinal cord and brain
• responsible for morphine-mediated depression of respiration in brain stem
• involved in abuse behaviour
• difficult to obtain drugs with separation between the 2 responses - same receptor responsible for both effects

Front 18

kappa receptor

Back 18

• involved in analgesia, dysphoria, and myosis (pin-point pupils)

Front 19

delta receptor

Back 19

• involved in analgesia at the level of the spinal cord and brain

• may modulate the emotional response to opioids

Front 20

opioid MOA

Back 20

1. reduced presynaptic release of chemical transmitters that are mobilized by brain impulses
2. blockade of postsynaptic effect of these transmitters
3. activation of descending inhibitory pathways to block pain input
4. reduced emotional reaction to pain by acting on limbic areas of the brain

Front 21

short-term effects: morphine

Back 21

• may be taken orally as a tablet or smoked, sniffed, or injected
• usually taken alone but may be combined with meth and cocaine

Front 22

short-term effects: heroin

Back 22

• produced synthetically from morphine, more potent but not more efficacious
• rapidly converted to morphine in the body
• sometimes combined with meth or cocaine
• concentration in a street sample can vary from 3-20%

Front 23

analgesia

Back 23

• short-term effect
• opioid-produced feeling of indifference to pain, reducing intensity and reaction
• limited by respiratory depression

Front 24

sedation and hypnosis

Back 24

• short-term effect

• produced by morphine, not as intense as that produced by CNS depressants

• all opioids produce sedation

Front 25

additional short-term effects of opioids

Back 25

• suppression of cough centre by suppression of medulla
• respiratory depression - depressed in brain stem - usually cause of death in overdose
• response to respiratory drive by carbon dioxide is blunted by mu and delta receptors
• myosis - pupil constriction by CNS
• irregular heart rate at high doses, low body temp, cold clammy skin

Front 26

endocrine effects of opioids

Back 26

• reduced release of the hormone responsible for regulating the release of sex hormone from hypothalamus = reduction in testosterone, estrogen, and progesterone
• drop in libido in men, menstrual irregularities in women

Front 27

long-term effects of opioids

Back 27

• no marked physiological deterioration or psychological impairment
• mood instability, pupil constriction, constipation, reduced libido, menstrual irregularities, respiratory impairment

Front 28

therapeutic uses

Back 28

• relief of severe pain
• treatment of diarrhea - OTC drug that does not cause dependence
• cough suppression - better alternatives with lower dependence liability than opioids available

Front 29

abuse potential of opioids

Back 29

• powerful euphoric and analgesic effects
• highest abuse potential drug of class = heroin

Front 30

inherent harmfulness of opioids

Back 30

• low to moderate doses - not very high for morphine or heroin
• high doses - life threatening - unknown dose in street samples, can OD more easily

Front 31

treatment of overdose on opioids

Back 31

• opioid antagonists and support of respiration and vitals
• naloxone - primary OD antagonist
• naltrexone - antagonist used to treat alcohol dependence

Front 32

neonates

Back 32

• opioid-dependent mothers
• increased risk of premature birth and low birth weight
• infant will undergo abrupt termination of drug supply = withdrawal

Front 33

methadone

Back 33

• treatment of opioid dependence
• synthetic opioid that is effective by oral administration
• long half-life
• low abuse potential
• slowly reduce dose overtime