Test 1 PSYC 345A Flashcards
Define Psychoactive Drug (3 pts)
- non- nutritive chemical
- alters normal biochemical rxns in NS
- affects behavior, cognitive functioning, emotional reactions
Alchohol in cold?
BAD! Bc alchohol causes vasodiilation, does not help survive cold temp
T/F: half the world regularly consumes caffeine?
F : MORE than half of the world consumes caffeine
T/F: Termination of long term use from heroin can be more life threatening that termination from alchohol?
FALSE : abrupt alchohol termination is more life threatening - can actually cause seizures and illness
T/F Continued use of ANY drug leads to addiction?
FALSE
T/F Ecstacy use can cause ppl to bleed to death?
T - can cause blood clotting issues and bleeding to death - like blood ebola. not dose dependent (rare)
can you be intoxitated on caffiene?
TRUE - manic state, increased HR
T/F - with Salvia intoxication, feel sensory distortion, like being twisted and pulled (Salvia Winds?)
True
Physiologically, is LSD a toxic drug?
No, not toxic. Few physiological effects. only toxicity with hallucinations/delusions/unsafe actions
is marijuana more potent today?
YES - due to farming
T/F in low doses, THC has similar effects to alchohol or barbituates
T - relaxation
do majority of alchoholics get cirrhosis of liver?
NO - this is a very late stage effect
does smoking marijuana cause impotence in males?
No
does alchohol pep you up?
NO - it is a depressant, it only feels peppy bc it relieves anxiety and causes disinhibition. release of dopamine.
does heroin relieve diarrhea?
yes, chronic users often deal w constipation
T/F nicotine triggers vomiting?
true, in chemoreceptors area
methamphetamine lasts longer than coke?
T
methamphetamine abuse and picking ?
causing tweaking, repetitive behavior. feeling or insects in the skin. try to pick them out.
Drug names and classifications (5 kinds of names)
code name, chemical name, generic name, trade/brand names, slang name
Drug code name?
- > 2 letters/numbers used when being developed by pharma company
- SKF1475
- Lilly 110140
- given to newly developed substance during research
- more $, more secrecy
Drug Chemical Name?
complete molecular description according to specific chemistry rules
- shows where parts of molecule joins
Generic Drug Name?
legal , official, non-proprietary name (non-owned name)
Diazepam, fluoxetine, duloxetine
typically cited in research, more widely known
conventions - for local anesthetics, - many end with -aine … this has been used as local anesthetic
Benzodiazapanes - all anti anxiety same ending
- not owned - bears some resemblance to chemical name. you might see unoficcial generic names
- such as SKF 10,045 if not yet develped
Trade Drug Name?
Brand name (registered trademark), proprietary, the OWNED and patented name. protected name.
example
- Valium is the trade name for diazepam
- Prozac (fluoxetine)
Often a simplification of generic name - ex: sudafed is simple of pseudoephedrine
- Haldol is trade name for haloperidol
Trade name is always capitalized (generic is not capital)
** often different formulation between different drugs of same generic.
sometime can change effects
patent expires 5-6 years
Slang names? Street names?
Heroin - H, quartz
Cocaine - blow, ice crystals,
Esctasy - is MDMA
Drug Classification Problems and Issues
- not easily classified by site of action …. never restricted to only one functional or anatomical division of brain. Alch effects cerebral cortex, pons…
- not easily classified according to NT interactions - many interfere w one another
- not easily class by behavioral effects
3 types of Sedative hypnotics / CNS depressants
- Alcohol - ethyl alcohol
- Barbiturates - 4 types
- Non- barbiturate hypnotics
4 Types of Barbiturates
- Long acting - phenobarbital - 6 hrs, sleeping pill, long flight anxiety …
- intermediate acting - amobarbital - 4 hrs
- short acting - secobarbital - 1-1.5 hrs, sleep onset, bad news …
- ultra short acting - thiopental - 15-30 mins, must be constantly administered
choosing barbituates vs benzodiazepines?
- genetic variability
- ppl see Benzo as safer … an overdose on barbituates will more likely cause LOC that benzo. easier to overdose on barbituates (since the barbituates interacts with GABA)
benzo has an extra step and has to get through the GABA pathway… someone w suicidal ideation may be safer with benzo
equally effective in TREATING deprression
Anti Anxiety Agents/ Benzodiazpines (3 action lengths)
for anx and sleep
long acting, diasapam
intermediate - lorazapam
short- triasolam
Psychomotor and CNS Stimulants (4 types)
amhetamines, cocaine, nicotine, caffiene
Anti-psychotic agents
haloperidal
antidepressants (5 types)
sometimes in stimulant category?
- elevate and stabilize mood
older ones are tri and MAO
1. Tricyclic antidepressants - imipramine
2. Monoamine oxidase (MAO) inibitors; tranylcypromine
3. Selective Serotonin Reuptake Inhibitors (SRRIs): fluoxeti
4. Second Generation Aytpical Antidepressants: buproprio (when treatment resistant, go back to tricyclin)
5. Dual Action: Serzan
** will not give high to someone without depression
Antimanic drugs?
- Anti-manics
- Lithium
some prophylactic effects, can prevent future issues.
old and cheap… now is used to augment effects of antidepressants
Hallucinogens/Psychotomimetics/Psychedelics? 5 examples
1. Anticholinergic psychedelics: atropine
2. Norepinephrine psychedelics: mescaline C.
3. Serotonin Psychedelics: LSD
4. Psychedelic anesthetics: PCP
5. THC (for some ppl, can cause hallucinations)
sometime categorized according to NT that they effect the levels of … many psychedelics often effect serotonin
Anesthetics/Analgesics (4 types)
reduces pain
1. Opiates: morphine, heroin, Demerol
2. Inhalants: ether
3. Psychedelic anesthetics
4. THC
Neurological Drugs
antiepileptic drugs - dilantin
why is advil a non-narcotic anaesthetic?
- non addictive
Narcotic means SLEEP PRODUCING …and DEPENDENCY PRODUCING … potential for abuse
Drug Classification - Problems and Issues
Not easily classified according to site of action -
action of drug not restricted to one functional or
anatomical division of brain
* Not easily classified according to NT interactions -
many drugs interfere with more than one NT and NT
have more than one effect themselves
* Not easily classified according to behavioral effects -
different responses seen as function of different
doses
5 FIVE SCHEDULES OF CONTROLLED SUBSTANCES IN THE COMPREHENSIVE ABUSE PREVENTION AND CONTROL ACT - why we have this???
- Reflect abuse potential of the drugs (could they be addictive?)
- Reflect the degree of control exercised over storage
and dispensing of the drugs - Schedule 1-5 -
1-2, high potential to become dependent
schedule 1 are more strictly controlled (dispensing and storage) - 6-8 for plants as well
- schedule 9 regulated the equipment used to make drugs.
schedule 1 vs schedule 5 drugs? differentiate?
Schedule 1 - in US heroin. not widely accepted. ppl are given morphine instead…. in Canada, cocaine and meth. stored in vaults.
- opiates are often schedule 1 drugs (tramadol)
- schedule 1 is highly controlled, harder to get prescriptions.
Schedule 2 in US - morphine, methadone, cannabis
Schedule 3 - accepted medical use, less danger. moderate control. prescription reg is not as strict. long acting barbituates, amphetamines, riddalen,
- can be harmful if ppl step outside of regular use
Schedule 4 - can get renewals without needing to go back to doctor…
Schedule 5 - cough prescription medications
schedules 6-8?
controls precursors, plants, how much plant one can purchase. you can only purchase so much sage!
schedule 9 is about controlling devices used to make medications
Canadian Categories N, J, G, F
- Schedule N
– Narcotic Drugs - high potential to become dependent - BUT have accepted medical use with strict limitations
- Schedule J
– Considered illegal (j for jail) - not widespread accepted medical use (marijuana, used to be a J)
- LSD and mushrooms are schedule J
- Schedule G
– Controlled drugs - some regulations over prescriptions - pharmacists have close records
- amphetamines, barbituates
- Schedule F
– Drugs treating wide variety of illnesses requiring
physician supervision - can call in for a renewal, does not need to see person
- antidepressants, antihypertensives…
Influence at site of action - what would impact this?
- drugs only work at specific sites of actions
- ex, if you throw up, or swallow drug thats meant to be administered a different way .
how a drug is administered will affect: (3 pts)
– whether it gets to site of action
– how fast it gets to site of action
– how much gets to site of action
Oral administration of drugs
mouth, swallow or consume… most common.
- any pills tabs capsules
- some absorbed thru lining of stomach -> bloodstream
- best way is thru small intestine - best absorption
cross concentration gradient, enters bloodstream
- technically includes chewing tobacco, absorbed thru buccal membrane of mouth.
- intrarectal admin - suppositories in the rectum
- stomach contents
IF full stomach, drug can get stuck there w food… stuck in intestine. slowly absorbed on full stomach. - drug form
drugs in pill or tab form take longer to be absorbed to bloodstream … gel or liquid gets to bloodstream faster. - longer drugs stay in stomach, less likely they are in active form once they get to intestines. stomach enzymes and acid biodegrade the drug.
- lipid solubility of drug
how readily drug dissolved to fatty tissue - cell walls are made of large protein molecules. increased lipid solubility means they can move thru more easily … other rely on portal or holes. more lip sol, more rapid absorb
*** heroin is more potent than morphine because heroin is more lipid soluble.
more drugs gets to site of action
most efficient absorption in intestines… taking a drug with a meal slows its absorption … intestinal walls lined with capillaries
- lipid bilayers - olive oil test to see lipid solubility or drugs (vs H2o)
pros cons of oral administration?
- Advantages:
– generally safest, cheapest, and most convenient
“safe” because we can get the drug OUT of system - induce vomiting or pumping system. prevent too much from getting to site of action - Disadvantages:
1. slow absorption - like reversing the effects of another drug… (thing naloxone)
2. delayed feedback - ppl have expectation of when they’ll “feel it” - wait and not feel effect yet, then they take more. accidental overdose.
- common with PCP - angel dust. ppl use the same way as theyd use LSD. is it NOT as potent at LSD … so theyll take more, and it created toxic side effects. doing PCP as sniff or smoke is more popular.
3. variability of absorption - gut health stuff? not feeling well when they take it?
4. irritating substances - fillers can be irritating to stomach, get nausea with pill.
Absorption method of drug administration
- through skin or membrane into bloodstream
- positioning drug against skin, inserting into
rectum, snorting it into nasal cavity, placing
under tongue or against cheek - drugs found in plans may be chewed on and release liquid that absorbed in mucus membranes of mouth.
- patch
- nitroglycerine - under the tongue
- cocaine, rub on gums
- snuff tobacco
advantages / disadvantages of absorption?
- Advantages include:
1. Useful alternative to oral route - helpful when unconscious and cannot swallow
- if frequent vomiting
- Disadvantages include:
1. Irritation of skin or membranes - Variable absorption
- need to hold in mouth for a while
rectal suppositories? may not stay in proper position
Inhalation administration
- by breathing (rich capillary density in lungs)
- absorption occurs in lungs
- Two types
1. smoking dried material - with smoking, other substances come with … tary, hydrocarbons, other chemicals from burning process. carbon monoxide… toxic bc it blocks O2 carrying ability.
- vaporous inhalation
VAPROUS - nitrous oxide.. used as anisthetic and in dentistry (as well as recreationally)
- rags soaked in solvent
- sniffing paint thinner? sniffing solvent
Huffing or bagging from container
smoking CRACK not cocaine
VAPOUROUS INHALATION adv / disavg
contact of gas with moist surface of lungs, dissolve and diffuse into blood. diff between smoke and gases is that the drug in the smoke particles will not re-vaporize after it is dissolved in the blood and cannot be exhaled.
- Advantages:
1. Extremely fast absorption - to bloodstream bc straight to lungs (many capillaries) - can be controlled with precision - reason used for anesthesia
- Disadvantages:
1. Effect c/be limited to time drug being
inhaled
2. Lung and throat irritation with chronic use
3. Risk of brain damage with chronic use, with accompanying cognitive impairments (in abusive/ rec fashion) - most common is attention and memory difficulties
** depends on individual susceptibility!!
** hard to eliminate substance once its administered
Sniffing gasoline can cause immediate death from someone who is genetically susceptible
Nitros Oxide in dental procedures?
- could be used recreationally
- case of dentist who chronically used NO, personality changes (became inappropriate, manic…)
** temporary!
** with legit dental procedures, its given 50/50 with O2
what is PARENTERAL ADMINISTRATION?
- by injection (hypodermic syringe)
- drug is dissolved or suspended in a liquid (normally saline, water, or vinegar)
- the liquid is called the vehicle
- THC requires oil as vehicle - lipid soluble drug in oil wehicle slows rate of absorption
three (4) types
* intravenous (vein)
* intramuscular (butt, thigh)
* subcutaneous (into fatty tissue under skin)
* intraperitoneal
SUBCUTANEOUS INJECTION adv / disadv?
may be called subQ
Advantages:
1. easiest of all injection techniques
- with venous, can be hard to find vein or too much scarring
usually under skin of arm or thigh, sometimes hand or wrist used for self administer rec drugs (heroin), skin popping
Disadvantages:
1. slower absorption than IM or IV
2. risk of skin irritation or deterioration
- unclean needle? skin unclean? with routine injection of drugs youll see notable skin abscesses and lesions.
- risk of blood borne diseases
** skin lesions are a major injury treated by street docs
INTRAMUSCULAR INJECTION adv/disadv??
inserted into muscle, bolus left there. most common in deltoid, glute max… absorb thru capillaries within hour
* Advantages:
1. quicker to do than IV (dont have to find vein)
2. faster absorption than SC
- Disadvantages:
1. slower absorption than IV (15s for IV drug to get into site of action in vein)
2. risk of piercing vein by accident - tear vein, OR cause it to get to site of action VERY quick (too quick…) - this could be a problem bc IM drugs are meant to be administered this way
INTRAVENOUS INJECTION ( adv and disadv? )
into vein, direct to bloodstream. “mainlining” - must find a vein close to surface (usually inside of elbow). opposite of blood test procedure.
* Advantages:
1. faster absorption than SC or IM (person administering can be quite sure it gives patient effects right away.
2. immediacy of effects (15 sec)
3. allows for accurate dosages
- Disadvantages:
1. immediacy of effects c/be lethal (NO WAY for drug to be recalled)
2. drugs cannot be recalled
3. requires sterile conditions; unsterile conditions seen with street use leading to development and spread of infectious
diseases - when done too freq, vein can collapse
*** the needle can often take up a little blood and spread to the other person
would probably be helpful for EMS to have naloxone in lower dose to give IV .. faster act
Insite - Safe injection site… what is this?
- Opened in 2003 @ DTES vancouver… , first in North America
(lots of controversy…) - Hours of Operation: 7 days/week, 18 hrs/day
- Staff: 2 registered nurses, on-site manager,
counselor, doctor on call - Provides:
– 12 seat injection room
– “Chill Room”
– Clean injecting equipment
– Medical attention in case of overdose
– Access to, or referral to other health care services (some treatment of skin lesions here) - some sites do drug testing too
$$$ to run - approx $500,000/year
http://www.vch.ca/locations-services/result?res_id=964
* also safe inhalation sites now too.
FIX movie key ideas
- the cost of bringing ambulances to respond to OD and dealing with long term health issues and jails is LOTS more $ than safe injection sites.
- separate the users from dealer - “the user is sick, the dealer is evil” says mayor.
https://www.canadawildproductions.com/film/fix/
they use frankfurt as a model of somewhere safe injection sites have worked.
- safe injection sites offer a pathway into methadone programs, medical help, other counselling programs …
- shows protests against a safe injection site in chinatown… does not want it in city. “force them to abstain” … opposing protests.
- Ann Livingston - didn’t use VANDU money, but created a drop in centre to support the problem. creates her own safe injection site with her own $. https://www.abundantcommunity.com/author/annlivingston/
- some sites offer drug checking
- at this time, lot of the controversy abt supporting the mayors plan , plan for task force. ( reluctant…) voted in favor, after months of demonstrations, they are going through the programs for drug users
dean gets through 8 days of detox
Aims of Insite?
- Decrease public injection drug use
– Up to 1000 injections per day (many less injection on the street!)
** early 2020 state 3000 per day - Decrease unsafe disposal of syringes in
public spaces
– CMJ: decreased drug litter on street (this worked!) - Decrease overdoses
– Overdoses common, but no deaths (in Insite) - Decrease Infectious Disease Risk
– 70% reported less syringe sharing (The Lancet;
Marshall et al, 2007))
– 2009 Stats showed 8% reported needle sharing in Vancouver vs 29% in Victoria (CARBC research study) - Vic didnt have site at this time)
– Incidence of HIV/AIDS dropped by over half (BC Centre for Excellence HIV/AIDS
– Estimated 20-30 new cases of HIV/AIDS
prevented yearly (Des Jarlais et al, 2008) - Improve Access to Healthcare Services
– # of abcess treatments = 3, 130 (Vancouver Coastal Health, 2009)
– 1 in 5 accessed detox centers
– Onsite: 30 bed detox facility - more ppl accessing this
** money saving studies! treating HIV aids
Current stats on Safe Consumption Sites? 2017-19
> 35,000 Canadians accessing.
- 66% male, 33% female, 1% not specified.
-25% age 25-31
4 membranes for drug distribution?
– Cell membranes
– Capillary walls
– Blood-brain barrier
– Placenta
Cell Membrane drug distribution?
Cell Membrane: a bi-lipid layer embedded with large protein molecules
- fat soluble drugs absorb quite well in the body
BUT Large amounts of highly lipid soluble drugs
tend to accumulate outside CNS. as drug moves thru bloodstream, the fatty tissue acts as a sponge and takes up the drug.
- for ex,
cocaine, can get reverse tolerance. w repeated use, the regular dose might cause convulsions.
the pH of intestinal lining is 50 % ionization, at ph5 meets acid curve.
most bases like morphine are poorly absorbed when taken orally, but absorption depends on pKa (for ex, caffeine is a base with a pKa of 0.5, ionization curve drops off quick at very low pH - therefore is almost entirely non-ionised at pHs in digestive system … therefore is well absorbed orally.
GUY FELICELLA
https://www.ted.com/talks/guy_felicella_i_died_six_times_let_s_stop_the_stigma_of_harm_reduction
Capillaries for distribution?
Tiny Blood Vessels with walls formed by a single layer of tightly packed cells - drug molecules can fit thru the capillary pores. BUT if the drug bonds to a protein molecule, it becomes too big to move through the capillary and it gets excreted.
- * Exiting of drug molecules also affected by rate of blood flow
Blood Brain Barrier
a feature of the physical structure of the brain capillaries. much smaller pores than other capillaries in the body.
- FEWER pores in brain capillaries as well
often a fatty sheath (lipid layer) surrounding this as well.
- not much of a barrier for highly lipid soluble drugs
- some drugs may be actively transported across
Placenta Barrier?
- Network of blood vessels and pools of maternal blood into which fetal capillaries protrude
- active transport of nutrients, can get rid of waste. can bring drugs to the embryo/fetus
- Drug concentration can reach 75-100% of mothers within 5 min of admin
- Some drugs can have harmful effects on developing fetus
- similar to blood brain barrier. highly lipid soluble substances cross more easily
- ** drug concentration in the blood of fetus usually reached 75-100% of that o mother within 5 mins - offers little protection to fetus
DRUG ELIMINATION?
- Small amounts of some drugs will be eliminated through body secretions i.e., sweat, saliva, breast milk (non-metabolized methamphetamine in sweat )
- Some drugs may be excreted in feces and bile
- Some drugs will be eliminated through the lungs (sometimes unchanged, alchohol eliminated in breath)
- Most drugs leave the body in the urine
- excretion organs: the liver and kidneys work together to elininate drugs (dynamic duo!)
2 organs that do most elimination?
kidneys and liver
Liver and drugs?
located right under diaphragm
contains many enzymes - includes alcohol dehydrogenase - removes H from a molecule of alcohol and makes it acetaldehyde
enzyme biodegrade drugs, change structure, make less lipid soluble, more water soluble.
if more water soluble, when it reaches the kidneys, it will not be reabsorbed, will be eliminated
cytochrome 350 enzymes make them “drug metabolites” water soluble and excreteable
** chloral hydrate, psilocybin and THC are all more active after metabolism than original drugs
- metabolites are more likley to ionize - important w kidneys bc ionized molecules cannot be reabsorbed into blood
Kidneys and drugs?
Kidneys remove drug molecules/drug
metabolites from blood and by products of metabolism by liver enzymes … and send to ureter
filtering system physically removes certain substances from blood…
each kidney has millions of nephrons
** works by filtering everything out of blood then selectively reabsorbing what is required.
- nephron is long tube, one end us cup, Bowmans capsule, with a clump of capillaries inside called the glomerulus… other end empties into collecting tubules, to urinary bladder.
- of note: lots of capillarization of the glomerulus within nephron - these capillaries have porse for fluid in blood to flow through
- ## glomerulus filters fluid out of the blood into the nephron and capillary bed to reabsorb
