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133 Cards in this Set
- Front
- Back
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metabolic pathway of cannibis?
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CBD (cannabindiol) → THC → Cannabinol (CBN)
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Normal percentage of THC in a non-genetically altered plant?
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1%
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Percentage of THC in genetically altered plants?
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4-6%
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Smoking vs injection with cannabis?
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It is very lipid soluble. Not a large difference between the two. Except that there will be lower plasma levels when you smoke vs an IV.
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Effects of taking cannabis orally?
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Duration of action is longer
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What class of drug is cannabis?
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Psychomimetic
Mood altering CNS depressant |
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Central effects of Cannabis?
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•Time passing slowly (little concept of time)
•Decrease in short term memory •Feel confident (performance does not reflect confidence) •Impaired motor coordination oDecrease in ability to drive a car and make reasonable judgments •Catalepsy (decreased pain) •Analgesia •Antiemetic (decreases vomiting and nausea) •Increase appetite |
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Peripheral effects of cannabis?
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•Increased heart rate
•Vasodilatation •Decreased intraocular pressure •Bronchodilation |
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What are the cannabinoid receptors?
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CB1
CB2 |
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What is the CB1 receptor?
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A g-protein coupled receptor.Linked to inhibition of adenylcyclase, also coupled to potassium channels and it activates potassium channels. Which will lead to a decrease in neurotransmitter release.
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The CB1 Receptor has a similar mechanism to?
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Opioids
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There is a high concentration of CB1 receptors where?
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In the basal ganglia
Hippocampus Cerebellum Substantia Nigra Mesolimbic DA pathway VTA |
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Unwanted side effects of cannabis?
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Drowsiness
Dizziness Dry Mouth Dysphoria, unpleasant response Hallucinations (only sensory) Psychotic Reaction |
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What is Anandamide?
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Endogenous cannabinoid NT
No risk of overdose No respiratory depression, or cardiovascular problems Used for chemotherapy |
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What is Anandamide synthesized from?
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Arachidonic Acid
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Anandamide antagonists
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Opposite effects of THC
Inc in locomotor activity Inc in short term memory Inc in NT release Reduce intraocular pressure and bronchial pain |
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What is dronabinol?
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Synthetic cannabinoid
Used for cancer Taken orally Doesnt have a short half life Problem with first pass metabolism (metabolites are active) |
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Do chronic marijuana users exhibit flashbacks?
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Only those who had also used LSD
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Chronic users exhibit...
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Inhibition of sweating and an increase in internal temperature
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Long term effects of chronic THC use in males
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Decrease in serum testosterone
Decrease in length of sperm tail Decrease in spermatogenesis |
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Long term effects of chronic THC use in females
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Anovulatory cycles
Decrease in FSH and LH |
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Adverse effects of chronic THC use
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Apathy
Impairment of of judgement Poor concentration Short term memory loss Loss of interest in appearance Loss of interest in your goals (Amotivational syndrome) |
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Can detect plasma levels of THC after how long?
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10 minutes
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THC subjective effect
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20-30 minutes
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THC lasts how long?
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2-3 hours
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THC effects on nursing mother?
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Concentrated in milk
Could impair motor development |
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Tolerance to THC
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Does develop in the case of increased temperature and increased HR. Experienced users also exhibit less perceptual and motor impairments
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Withdrawal symptoms
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Irritability
Restlessness Nervousness Decrease in appetite Insomnia Relatively mild and lasts for about a week |
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Is THC addicting?
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Yes, mesolimbic pathway involved
Large concentrations of CB1 receptors in hippocampus and basal ganglia |
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Most drugs use what metabolic pathway to remove the drug from the system?
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P450
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What is the primary enzyme that removes the drugs from the system?
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Cyp3A4
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Antiretroviral and Benzos
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If you are taking antiretroviral for HIV and also taking benzos benzo concentration will increase, and the risk of reaching a lethal level is higher.
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Some examples of types of Heroin
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chinese no.4
Brown sugar- caffeine and barbs (soluble) |
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How to identify a heroin addict
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ritualized (candle lighting)
Constipation burnt spoon, aluminum foil Track Marks Disoriented, tics, mood fluctuations Pinpoint pupils Lack of hygiene |
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Heroin crosses the BBB in...
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20 seconds
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Pharmacology of heroin
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Hydrolyzed into morphine and then acts on opiate receptors which will inhibit release of GABA
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Tolerance builds to....
(in heroin) |
Constipation
Nausea and vomiting |
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Withdrawal of heroin..
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Begins in 8-12 hrs after last use
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What are some heroin treatment plans?
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1) Residential Rehabilitation (similar to AA) If they complete it relapse is unlikely.
2) Opioid Maintenance Therapies (ex: methadone competes for the same receptor so they dont feel the withdrawal symptoms and it has a long half life of 24 hours, another example is suboxone) |
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Oxycontin
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AKA Hillbilly Heroin
Schedule II drug Opioid Receptor Agonist |
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What receptor is oxycontin acting on?
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Mu1 receptor- when you remove receptor you dont get euphoric effect
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Addiction and abuse of Oxycontin
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Pain mills
Pain Clinics (dispensing drs) Drs not good at predicting drug seeking behaviors Purdue Pharma-unconventional methods of promoting drug, coupon program, employee bonuses |
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Method of stopping abuse of oxycontin?
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Oxyneo (tamper proof)
Stopped 160 mg pill production |
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How to produce opium?
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Make incision in capsule of plant, let white latex ooze out. Let dry for a day or 2. Scrape off.
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Opium through the ages
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Sumerians- "Joy plant"
Ancient egyptians - sedative and analgesic for surgery Greece- Odyssey Marcus Aurelius Islamic Empire India China 17th century-started smoking opium with tobacco India-monopoly on opium production Opium wars |
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is the smoke of marijuana carcinogenic?
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4x more tar than tobacco smoke
Has not been linked with tobacco related cancers Promotes inflammation |
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Cognitive Function of long term marijuana use
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Heavy users scored poorly
No irreversible mental deficits Why did smokers remain impaired for weeks? 1. THC still in system 2. Withdrawal effect |
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Mental illness and long term marijuana use
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If used before 18, it will accelerate development of schizophrenia
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What is sufism?
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A doctrine of islam which has the goal of unifying with god through different spiritual states (marijuana culture)
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what was the rastafari movement?
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1930s in Jamaica
Marcus Garvey Popularized weed culture (bob marley) |
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Phenylcyclidine and ketamine are what type of drug?
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Dissociative Anesthetic
Psycotomimetic |
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Principal reason for interest in phenylcyclidine (PCP)?
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Produces a range of symptoms that mirrors schizophrenia
Was also used a general anesthetic. But was discontinued since patients could remember the surgery and had post surgery hallucinations |
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Ketamine reason for interest?
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Very short acting
Anesthetic Go down and come back up very quickly |
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What are the positive signs of schizophrenia that PCP produces?
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1) Hallucinations (sensory and auditory)
2) Delusions 3) Thought broadcasting (believe their thoughts in their head can be heard by everybody) 4) Thought insertion (believe others are putting thoughts in their head) Become paranoid. 5) Dysfunctional/illogical thought pattern |
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Negative signs of schizophrenia which can be produced by PCP?
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1) Depression
2) Social withdrawal |
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Mechanism of action of PCP?
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non competitive antagonist of NMDA class of glutamate receptors. Thought to bind at site inside the channel pore. Use dependent the channel has to be open and has to be stimulated.
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What other channels can PCP block?
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1) Voltage dependent sodium channels
2) K+ channels 3) Ach Nicotinic receptor 4) Antagonist at the sigma receptor |
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What the metabolic deficits seen in schizophrenia seen at the receptor level?
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Lower nicotinic receptor
Increase DA in limbic system Compromised K channel |
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Effects of PCP
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1.upregulating cyclic AMP and probably the signal transduction pathway through D1 receptor.
2.Decrease testosterone and sperm count. 3.Increase endocrine effect |
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Gammahydroxybutarate was originally studied for ...
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anesthetic purposes
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What type of drug class is GHB?
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CNS depressant similar to GABA
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Can GHB cross the BBB?
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Yes, GABA cannot
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How does GHB affect Dopamine?
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At low doses it increases DA release. At high doses it decreases DA release.
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Effects of GHB in vitro?
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1) Inhibits impulse flow is mesolimbic system for 1 hr
2) Stimulates synthesis of DA through negative feedback 3) increases interneuronal DA levels 4) Increases level of Dopac in DA neurons |
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Therapeutic uses of GHB?
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1) Narcolepsy
2) Alcoholism (there is a cross tolerance by the end of the study they were having GHB withdrawals) 3) used to suppress heroin withdrawal 3) |
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Three things commonly used to treat narcolepsy?
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GHB, Anti-depressant, amphetamines
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how do GHB and antidepressants help narcolepsy?
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Disrupt sleep cycle
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Narcolepsy is associated with
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Changes in temperature and loss of muscle tone
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How does GHB target narcolepsy?
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1) Decreases latency to sleep
2) Does not alter REM sleep Disadvantage: duration of action is short, have to take it several times. |
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Peak Plasma levels are reached for GHB when...
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1-1.5 hrs after taking it
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Duration of GHB?
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3 hours
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Half life of GHB?
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35 minutes- 3 hours
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GHB is metabolized by what system?
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P450
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in the 90's GHB was used for...
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Body building
releases growth hormone |
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GHB is also known as the...
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date rape drug
With alcohol it produced rapid intoxication |
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treatment for GHB overdose..
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ventilation
wait for it to be metabolized |
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GHB effects
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Decrease in respiration
Decrease in HR Decrease in BP CNS depression |
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Can reverse CNS depression of GHB with..
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physostigmine
anticholinergic, blocks breakdown of aCh |
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LSD is a.... based on...
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Ergotalkaloid
Lysergic acid (naturally occurring) |
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Ergot alkaloids are used for...
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migraines
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What are symptoms of ergot poisoning?
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Mental disturbances
blood vessel constriction If its not treated it could lead to amputation |
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Who discovered LSD?
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Elbert Hoffman
was interested in 5HT receptors, and was looking at compounds for respiration. |
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What is the most potent mind altering drug known?
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LSD
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What dose do you need of LSD to get hallucinations?
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25 micrograms
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duration of LSD?
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6-12 hours
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The secret service used LSD for..
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truth syrup
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Median dose of LSD for adult?
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100 micrograms
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4 effects of LSD at receptor level
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1) decrease in enzyme activity for 5HT synthesis
2) decrease in 5HT extraneuronally 3) Increase in 5HT intraneuronally 4) Decrease in 5HT neuronal activity |
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LSD acts as an agonist on...
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5HT2A/C and 5HT1 receptors
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4 categories of hallucinogens
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1. LSD- indole
2. Phenylalkylamine- mescaline 3. Indol alkylamines (psilocybin) 4. MDMA in high doses |
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Define hallucination
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Visual, olfactory, tactile, auditory, or kinesthetic perception that occurs in the absence of external stimuli.
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Define illusion
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Distortion of external stimulus
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Will you get an hallucination with PCP?
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No
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LSD acts on what receptors?
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Partial agonist of 5HT2A
Agonist at D1 |
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What can compete with LSD at the 5HT2A receptor?
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Prozac (only partial block)
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LSD effects are dependent on...
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Personality
Mood Expectations Surroundings |
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Physiological effects of LSD?
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Inc BP
Inc HR Dizziness Tremors Loss of appetite Dry mouth Sweating nausea |
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LSD can produce...
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synesthesia
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LSD and cross tolerance
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Cross tolerance with psilocybin and mescalin
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LSD is a...
Psilocybin is a.. |
Indol
Phenethylamine |
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Does LSD exhibit cross tolerance with marijuana, amphetamine and PCP?
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NO
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What is candy flipping?
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MDMA+ LSD
MDMA- euphoria, good feelings LSD adds intensity and alters mental function MDMA makes it move faster |
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With MDMA you get release of...
It is a... |
DA and 5HT
Phenethylamine |
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LSD
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5HT2A partial agonist
Indolamine Agonist for Dopamine D1 |
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LSD and MDMA neurotoxicity
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LSD activates D1 receptor
Dopamine will be taken up by 5HT neuron DA in 5HT neuron accounts for some of neurotoxicity |
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Neurotoxicity of MDMA
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Degeneration at nerve ending in raphe nuclei, CTX, striatum, hippocampus (in hippocampus you see anterograde amnesia)
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Effects of long term users of LSD
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1) Persistant psychosis
2) Hallucination Persisting Perception Disorder 3) Dramatic mood swings from severe depression to mania. |
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What is psychosis?
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Drug induced. Distortion or disorganization of a person's capacity to recognize reality, think rationally, or communicate.
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What is mescalin?
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Naturally occurring. Derived from a cactus. Acts on DA and NE. Do not appear to act on 5HT2A receptors. Maybe it is glutamate that is causing hallucinations
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What is hippy flipping?
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Psilocybin + LSD
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what is an opioid?
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Any substance, endogenous or synthetic that produces morphine like effects
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In the 1900s morphine was used...
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to soothe coughs and teething of babies and children
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Morphine effects on the CNS
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Both a stimulant (cats) and a depressant
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Is heroin lipid soluble?
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Yes. It gets into the brain very quickly and produces a rush within 5 seconds. Accompanied by warm rush of skin, dry mouth. Sometimes have itchiness (due to histamine response) and nausea
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Effects of Heroin
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Mental Cloudiness
Cardiac Function decreases Decreases Cardiac Output Decreases in BP Decrease in Respiration and heart rate |
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Effects of morphine
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Sedation
Changes in Mood Warmth Itching Nausea Dizziness Vascular system-orthostatic hypertension Constriction of pupils in animals where the drug is sedative (dilation in cats) |
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What is the reasoning for nausea caused by morphine?
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Stimulation of chemoreceptors in the trigger zone of the medulla oblongata
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Is morphine a good local anesthetic?
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No
Unlike Cocaine and Lidocaine |
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Physical dependence of morphine and heroin?
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Develops rapidly
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Withdrawn abruptly from morphine/heroin in rats...
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Increase in irritability
Weight loss Tremors Writhing Jumping Agression |
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Withdrawal of morphine/heroin in humans...
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Looks like bad flu
yawning Fever Sweating Piloerection Nausea Diarrhea Insomnia |
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Long term users of heroin and morphine are susceptible to...
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1) HIV/AIDS
2) Collapsed Veins 3) Hepatitis B and C 4) Absyss 5) Bacterial Infection 6) Infections of heart valves and lining of heart 7) Bronchorestriction (bad for asthma) 8) Decreases immune response |
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Half life of heroin
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3-6 hrs
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Heroin and morphine is metabolized by..
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glucoronadase
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Physiological pathway of morphine
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1) Acts on G-protein receptors
2) Inhibits adenylate cyclase 3) Decreases cAMP concentration intracellularly 4) promotes opening of potassium channel and 5) inhibits voltage gated calcium channels (reduces excitability) |
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Tolerance to opioids
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1) Physical and physiological
2) Develops to analgesia, nausea, euphoria, and respiratory depression |
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cross tolerance of opioids
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with other opioids that act at the same receptor
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Morphine and pain
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Will not effect phantom limb neuropathic pain or trigeminal neuralgia
2) Reduce affect associated with pain (dont care about the pain) 3) Produces powerful state of wellbeing |
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The euphoria associated with opioids is mediated through what receptor? As well as the analgesia and respiratory depression.
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The mu receptor
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GI and opioids
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Increases tone and decreases movement-constipation
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Naloxone
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Used for overdose, for respiratory depression and for addiction.
Problems: half life is 1-2 hrs and heroin will remain around for 6 hrs |
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Naltrexone
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More popular choice to treat heroin overdose and respiratory depression.
2) Problem-immediate and abrupt turn around which can cause seizures. 3) Used for addiction. If addict takes it, and then takes heroin they will not feel affects of heroin. |
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CB2 receptors are dense in the..
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lymphoid system in the periphery
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