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83 Cards in this Set

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Where is Cocaine Derived, and where is it produced?
Cocaine is derived from the leaves of the Coca Shrub, and it grows in the rainforests of the Bolivian and Peruvian andes.
What are the different forms of Cocaine?
Coca leaves (chewed)
Cocaine hydrochloride (snorted, IV, or Injected)
Free base (smoked)
Crack (smoked)
What 3 Neurotransmitters does Cocaine have an effect on?
Dopamine, norepinephrine, and Serotonin
What effects does Cocaine have on Dopamine, Norepinephrine, and Serotonin.
Cocaine greatly enhances the activity of dopamine and to a lesser extent NE.
Cocaine serves as agonist of serotonin when binding to serotonin receptors.
How Does Cocaine cross the barriers of the body? Which barriers can it cross efficiently?
Rapid brain penetration in the BBB, Concentration in brain far exceeds cocaine concentrations in plasma. Redistribution after brain penetration, drug is rapidly redistributed to the other tissues, and the placental barrier is crossed with ease, cocaine levels in the unborn = others
How is Cocaine metabolized?
Metabolized by the liver and plasma enzyes, slower removal fro the brain (can be detected there 8 hours after use)
The larger interaction between coke and alcohol, cocaine remains as benzolylegonone in the bloodstream much longer, increases blood pressure and heart rate, and has a 18-25 increased risk for imminent death.
What are the Acute Physiological affects of Coke?
Increased alertness
Motor hyperactivity
Vasoconstriction hypertension, and increased body teperature
Shift of blood from internal organs to muscles; increased glucose availability
Suppression of appetite
Suppression of Fatigue
What are the Psychological Affects of Coke? Starting from immediately after taken to hours later.
Immediate Effects (30 minutes)
imediate euphoria
enhanced self-consciousness and sense of power
mental alertness and good mood
2. Next 1-1.5 Hours
Milder Euphoria and Anxiety
3. Last phase
Increased anxiety and desire to take more coke (even at expense of food intake)
What are the Acute Psychological Effects that last throughout after Cocaine Use?
Psychological: Increased talkativeness, feel pressure to talk, high pace of speech, sometimes incoherent - racing thoughts
What are the Chronic Physiological Effects of long term coke use?
Progressive loss of coordination, tremors, seizures, and sexual unarousal, cardio complications, nasal and pulmonary complications, and gastro-intestinal complications - may occur with one-time use.
What are the Chronic Psychological Effects?
Anxiety, Sleep deprivation, Suspiciousness and paranoia, a toxic paranoid psychosis, interpersonal conflicts.
What are the Three Stages of Withdrawl?
The Crash
24-48 hours after stopped, the initial abstinence phase, depression, agitation, suicidal thoughts and fatigue
Withdrawl
1-10 weeks, mood swings, cravings, anhedonia, and obsession with drug seeking
Extinction
Normal pleasure returns, ocassional cravings, cues trigger cravings, mood swings
What are the nicknames for Dextroaphetaines (d-amphetamine)?
Dexies, caddalics, black beauties.
What is the less potent form of Methamphetaine?
Levoaphetamine, or l-ampheamine
What are the Street names for Methamphetaine?
Meth, Speed, Tina, Crank, little whites, Crystal Meth, and quill
What are the Nicknaes for Smokable Methaphetamine - freebase?
Ice, Crystal, LA, LA Glass, Quartx, Christy, Christina, Tina
What are the Street names for methcathione?
(designer drug, synthesized in a lab) khat, cat, and goob.
What neurotransmitters does Meth have an effect on?
Causes the release of dopamine and NE from the terminals, and causes the stimulation of the dopamine receptors.
What are the 4 different ways to absorb Meth? Which type of Meth produces the largest effect?
Snorting, Oral, Intrevenous, and Smoking
Free-base, extreely rapid absorption, more rapid than IV and more intense
What are the Acute Effects of Meth?
Similar to Cocaine
8-24 Hours, increased sympathetic autonomic activity, euphoria and invincibility
Describe the different Meth effects as they occur in High, Low, or Moderate Doses?
Low: Psychomotor stimulation and increased alertness
Moderate: respiration stimulated, decreased appetite, agitation
High doses: psychosis, severe anorexia
What are the Chronic Effects of Meth? How high is the relapse?
Crase is similar to Cocaine, 6-18 weeks, increased appetite and need for sleep, decreased energy, and weight gain.
Depression, Cravings, and paranoia, craving's may persist through withdrawal but do not develop as a result of withdrawal (Meth has the highest relapse rate)
What are Narcotics?
General term referring to opiate related drugs. Referred to as opiates because of their association with opium. Have significant abuse potential but also important clinical value.
Which drugs fall into the Narcotics category: Straight Opium?
Morphine
Codeine
thebaine
Which drugs fall into the Narcotics category: Opiate Derivatives?
Heroin
Percodan
OxyContin
Hydodan (Vicodin)
Which drugs fall into the Narcotics category: Synthetic Opiates?
Methadone
Demerol

Synthetics were attempts to discover opiates without the abuse potential
What are the 4 types of interaction that Occur within Opiod Receptors? Describe each one.
1. Pure Agonism: drugs bind to receptors causing analgsia and euphoria
2. Partial agonism: bind to receptors but have low intrinsic activity resulting in only moderate analgesia; have celing effect
3. ixed agonists/antagonists: agonistic effect at one receptor and antagonistic on another
Pure Antagonism: drugs bind to a receptor but have no action. Also blocks agonists from occupying the sites.
What are the primary active ingredient in Opium?
Morphine
What is Morphine commonly prescribed for? What are the routes for administration and which are most effective?
Pain Management
Oral - absorbtion is slow and incomplete; time release form available
IV - care should be exercisedbecause of the possible respiratory depression and allergic reactions
Rectal Administration - gives adequate absorption; several fors of orphine are available in the suppository form - used for patients suffering from muscle wasting diseases
Spinal Administration - places drug at its site of action, thus avoiding its effects on higher CNS centers
How does Morphine cross the BBB? What is its halflife? Where is it metabolized?
Morphine crosses the BBB slowly, more water soluable than lipid soluable. Reaches all body tissues including the featus, the baby can go through withdrawl.
HL = 3-5 Hours
Liver metabolizes it, individuals with impaired kidney function tend to accumulate this metabolite and may become more sensitive to consequent morphine.
What is Codeine commonly prescribed for? What metabolizes it? Where do its side effects stem from?
Codeine: Perscribed for pain relief and cough suppression. 40% using pills eet criteria for dependence. Strongly associated with endogenous depression.
- Liver produced enzyme metabolizes codeine first into morphine
- Pain relief and euphoria are hypothesized to stem from morphine
What are Percodan and Oxycontin prescribed for?
Percodan: acute pain treatment
Oxycontin: chronic pain treatment (controlled release form: rapid tolerance, pain in cancer and musculo-skeletal problems)
Methadone Maintenance clinics in Pennslyvania and W Virginia claim what as their primary drug of abuse?
Oxycontin
How have efforts been made to change the formula and help it be less habit forming? (in Oxycontin). Why have manufacturers been slow to do this?
Adding opiod antagonist, slow to fix because these are larger sellers than Viagra.
What are slang words for Oxycontin? How is Oxycontin administered when abused> What are some of the problems and consequences associated with abuse?
Oxy, Poor mans heroin, OC.
Capsule is crushed which destroys the time-release coating, making an immediate rush. Oral, snorting or IV injections with water.
Can cause HIC, Hep C, STDS, and overdoses with lethality, suicides, and neglect with care.
What are some risk factors for Adolescents who start Oxycontin?
Earlier onset of abuse pattern compared to Heroin. RFs: parent's opiod use or dependence; sexual abuse, or exposure to violence
What is Heroin, how potent is it, and how does it pass through the body barriers?
Heroid is derived from Morphine.
It is a chemical derivitave that is 3X as potent as morphine
Very Rapidly penetrates the BBB due to increased lipid solubility and produces rapid rush when smoked and snorted.
Schedule 1 drug.
How is heroin administered, which for is most common? Why is it rapidly penetrable? How is it metabolized and excreted out of the body?
Heroin can be injected, soked, snorted, and taken orally; injection is most common
Fat soluable: which allows it to rapidly penetrate the BBB
Metabolism: First metabolized into monoacetlymorphine and morphine, and 2. metabolized into inactive metabolites and excreted 95% of drug is eliminated fro body with 30 minutes.
Excreted through urine and bile
What are the immediate effects of Heroin? Use with IV causes what reaction? How long does the rush last? To whom could the reaction be unpleasant?
Heroin produces an immediate reaction with IV use that can resemble an orgasm. It can also produce a rush or flash that lasts for 3-4 hours, followed by muscle relazation and decline of sex desire. First timers could be unpleasant because of the nausea and vomiting caused by the stimulation of the reflex centers in the medulla.
What are the Physiological Effects of Heroin?
Reduces sensitivity of respiratory centers in medulla to the levels of CO2
Respiratory depression, one of the major risk factors in relation to death
Blood pressure is lowered as well
May cause sudden release of histamine in the bloodstream, intense itching of the entire body and reddening of eyes can happen, can also cause Constipation.
What Chronic Effects does Heroin have on the body?
Tolerance develops rapidly to analgesia and euphoria, not to GI effects, if the doses are high tolerance effects will be way more dramatic.
How can an unfamiliar environment cause an overdose to Heroin?
Unstable levels some abusers develop tolerance can depend on the environmental setting; when the drug is taken in unfamiliar environments in the same dose, an overdose can occur.
What are the Withdrawal Symptoms to Heroin? How long can they last?
Craving more Heroin is the first sign of withdrawl, begins 4-6 hours after last dose and peaks over the next 36-72 hours.
5-10 days later, increased blood pressure, diarrhea, chilliness, and gooseflesh, spontaneous orgasms, pain and irritability, depression and anxiety.
Serious shysiological dependence develops and withdrawl syptos are so unpleasant that a person continues to administer heroin without experiencing euphoria in order to avoid withdrawal symptoms. These symptoms can last for up to 6 months.
Heroin is not physically toxic, yet it can result in overdoses. What are the circumstances that can lead to overdoses in Heroin?
Overdoses can lead to: STDs, HIV, liver damage from hepatitis, and there is a possibility from death when used in:
Unfamiliar environments
Mixing with other drugs
Allergic Reactions - resulting from massive release of histamines
How is Heroin Detoxified? What are the programs used to get it out of the system?
Gradual reduction of the level of herion synthetic opiates sych as methadone are administered initially to replace it, doses of the drugs are decreased over a period of two weeks.

There is Detox that involves Naloxone and Clondine administered in combination, nalozone blocks opiod receptors and clondine inhibits hypersensitive norepinephrine neurons that become hyperactive when heroin is withdrawn - complete in 6 hours.
What is Methadone Maintenance? How is it beneficial? What are its successes?
1. helps avoid criminal involvement
2. Oral administration
3. Prevents heroin cravings

Stopped injections 71% of former heroin abusers who stayed inclinic for 1 year or more
Decline in drug associated probles fro 80% to 17-28
Reduction in criminal behavior from more than 20% to less than 10%.
What are some of the drawbacks of the Methadone Maintenance?
Increases the use of alcohol and cocaine abuse, does not treat drug abuse problem, person stays vulnerable to the abuse of other drugs, like cocaine and alcohol.
What is Demerol? How is it similar to Morphine? Why would you get Demorol? How does it differ from morephine side effects? How is the tolerance different?>
Demerol is a synthetic derivative that is also Schedule 2. It is very addictive and can be substituted for orphine or heroin addicts as it is widely used for prescribed pain. Differs from morphine with excitatory CNS effects, such as tremors, delirium, and convulsions. Tolerance develops more rapidly than morphine.
What makes a drug an Hallucinogen?
Disruption of interaction of nerve cells and Serotonin, after thought, feeling, and perception. People see images, hear sounds, feel sensations that see real but don't know how to exist. Trips can occur for 12 hours.
What is the History behind LSD? How is it taken? Is it addictive?
Manufactured fro lysergic acid, found on fungus that grows on rye and other grounds. Can be taken in tablets, capsules, liquid, and absorbent paper. Also addictive, does not produce compulsive drug seeking behavior - can be stopped.
Who are the Harvard Two and what do they have to do with LSD?
The H2 are Timothy Leary and Ram Dass, they did an experiment to see how comfortable taking LSD was in different environments.
Who created LSD and Why?
Chemist Albert Hofmann, working at the Sandoz Corporation pharmaceutical laboratory in Switzerland, first synthesized LSD in 1938. He was conducting research on possible medical applications of various lysergic acid compounds derived from ergot, a fungus that develops on rye grass.
What are the Physical Effects of LSD? When do they occur?
30-90 minutes after taking it: The physical effects include dilated pupils, higher body temperature, increased heart rate and blood pressure, sweating, loss of appetite, sleeplessness, dry mouth, and tremors. Sensations may seem to "cross over" for the user, giving the feeling of hearing colors and seeing sounds. Flashbacks are also known to occur.
What is Peyote? What is the Active Ingredient in Peyote?
Peyote is used in religious rights in the Southwestern united states, its active ingredient is Mescaline. It causes Visual Hallucinations, it is eaten by the buttons on the top of the cactus that are dried out and then soaked in water or chewed.
What is Psilocybin? Where are they found and how are they consumed?
Mushrooms or Shrooms that are consumed in the Southern United Stated orally. Effects are below:
As pure chemicals at doses of 10 to 20 mg, these hallucinogens produce muscle relaxation, dilation of pupils, vivid visual and auditory distortions, and emotional disturbances.
Who was Leary and what was the Good Friday Experiment?
Leary used to treat personality disorders and psychological counseling patients with mushrooms.
What is MDMA? What are its effects and what are some nicknames for it?
Excacty, XTC, Ada, hug, beans, and luvedrug. This is taken as a pill, and can be addictive, many report dependence or abuse. All report withdrawl symptoms.
- Produces nausea, chills, sweating, teeth clenching, uscle craping, blurred vision, and can contain substances besides XTC, which makes it very dangerous.
What NT does MDMA have a primary effect on, and what occurs with respect of the NT on the brain?
Has a very large effect on Serotonin. During MDMA use it damages Serotonin reuptake, and can cause degeneration of the serotonin nerve terminals.
Which areas of the Brain are affected by XTC?
The Neocortex, The hypothalamus, The hippocampus, The aygdala, and The basal ganglia
What are the accute effects of MDMA?
Heightened Preceptions, Stimulation, Reduced Appetite, and Elevated Mood, also causes cloudded thinking, Hypertheria, jaw clenchine, and distirbed behavior. It also causes Memory Impairment.
What are the Long Term and Life-Threatening effects of Ecstasy?
Brain Chemistry Changes: Serotonin reduced, Serotonin metabolites are reduced, and the structure changes, the transporters are reduced, and the terminals degenerate. It also causes hyperthermia, arrhythmias and renal failure.
What are the Miscellaneous Hallucinogens are what are they scheduled as?
Phencyclidine (PCP) and Ketamine (Jet, Super Acid, and Special K)
PCP is S2 and Ketamine is S3
What is and what are the names of the Date Rape Drugs?
Any drug used to assist in the commission of a sexual assualt. Examples: Flunitrazepam, Rohypnol, and Restoril.
What is Rohypnol? What is its method of ingestion? Why is it so effective as a date rape drug>
Eaten in Pill form and easily dissolvable in ethanol or alcohol.
Very easy to find in the US
Produces Amnesia
Incapacitates its victims and prevents resisting sexual assault.
What is Nicotine?
Found in Cigarette smoke, Toxic and dependence producing drug found in tobacco, commonly used in insecticides and pesticides. A few drops of pure nicotine would kill a healthy adult.
How does Nicotine make you feel?
Increases your mood
Improves Concentration
Makes you more alert
Antidepressant Action
Calms you down
What NTs does Nicotine have an effect on in the body?
Nicotine has an effect on Acetylcholine, it activates certain ACH receptors, resulting in increases in BP and HR, and causing the release of adrenaline.
Also increases the levels of secreting neurons.
What are the Negative Effects of Nicotine? It increases your risk for what diseases> How many people does it Kill>
Increased Risk for: Heart attack, heart disease, stroke, vascular disease, aneurysm and cancer.
Kills more people than alcohol, cocaine, heroin, hoicide, scuicide, car accidents, fire and AIDs combined.
Leading Preventable death in the US
1200 People in America die every day from smoking
430,000 people die each year from smoking
What are the common symptoms from withdrawling from smoking?
Irritability, dysphoria, anxiety, frustration, poor concentration, increased appetite, and drug craving. The most difficult drug to stop using!
What three terms refer to tobacco smoke in the atmosphere as a result of burning cigarettes?
Environmental tobacco smoke, Sidestream Smoke, Secondary Smoke
What is the Titration Hypothesis? Give an example of the Titration Hypothesis?
Smokers with adjust their smoking of cigarettes so as to maintain a steady input of nicotine into the body.
ie. If you start smoking cigarettes of decreasing nicotine content, you will be more likely to smoke more.
Where do we find Caffine? What is found in Chocolate and Tea besides Caffine?
Caffine is found in coffee, tea, and chocolate and added in some brands of soft drinks.
Tea: theophyline
Chocolate: theobromine
Which beverages have the most caffeine per serving?
Instant Coffee, Energy Drinks, and Mountain Dew
How fast is caffeine metabolized into the body, and where is it metabolized?
caffeine is metabolized in the liver, some people can experience toxicity or intolerance to caffeine as plasma levels rise.
Distributed throughout the body and is completely absorbed in 90 minutes, plasma levels peak in 2 hours.
What are the CNS Affects and the Adverse CNS Affects to Caffeine?
CNS Effects: enhances alertness, causes arousal and dimiinishes fatigue
Adverse: insomnia, increase in tension, anxiety, and initiation of muscle twitches.
Over 500 mg.
Panic sensations, chills, nausea, and clumsiness
Extreme high doses,
Seizures, respiratory failure and death
What are the Cardiovascular Effects?
Low doses cuases heart activity to increase, decrease, or do nothing. High doses causes the rate of contraction of the heart to increase, minor vasodiation in most of the body, and cerebral blood vessels are vasoconstrictd. Can cause air passages to open and facilitate breathing.
What are the Acute effects of Caffine>
Alertness
Increases Performance: decreases boredom with repetetive tasks, improved performance,
Elevates Mood, mild euphoria and feelings of general well-being
Sleep affected - lengthens time to fall asleep and poor quality of sleep,
No sobering effect (unlike with Alcohol)
What is Caffeine Intoxication? How much has to be consumed? What occurs in severe cases?
Usually in excess of 250mg
Includes restlesness, nervousness, flushed face, tachycardia, or cardiac arrhythmia, can start at as little as 100mg.
More severe with 1g or more, muscle twitching, rambling flow of thought or speech, and psychomotor agitation. Infrequent users increased intake suffer from intoxication.
What are the Chronic Effects of Caffeine?
Tolerance develops easily - in a couple of weeks or earlier
More and ore coffee or soda is needed to maintain the same level of stimulation
Withdrawl:
headaches, negative mood and fatigue, can cease in a little less than a week
What is Caffeine dependence?
Physiological: Craving coffee because of its effects, sell, taste, and other people drinking it
Need caffeine as an eye=opener in the morning, experiences withdrawal when stopped.
What is Caffeine-Induced anxiety Disorder? What is Caffeine-Induced Sleep Disorder? What are other diseases caused by Caffeine?
Always ask patients complaining on anziety about their caffeine intake, may produce syptoms similar to generalized anziety disorder and panic attacks
SD: insonia or poor quality of sleep where a person does not feel rested in the morning
Other Disease:
Gastrointestinal diseases, heart diseases, fibrocystic breast disease
What are some potential benefits to drinking Caffeine?
Parkinsons disease : reduses the risk in men, the more caffeine the les the risk,
Helps with certain forms of cancer, oral, pharengeal, and esophageal
Helps lower risk of Type 2 Diabetes
Helps lower Liver cirrhosis - 2 cups per day lower risk by one-half after adjusting for sex, age, and alcohol use.
What are the potential health risks of caffeine?
Doubles risk for Heart Attacks (when you drink more than 6 cups a day)
Breast Disease
Link between caffeine consumption and formation of benign lumps in breasts
Increased incidence of osteoporosis and bone fractures is elderly men and women
Increased risk of low birth weight in newborns when mother consues caffeine during the first three months
Increased the risk of panic attacks in those individuals already suffering from a panic disorder