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Psychiatry > Drug misuse > Flashcards

Drug misuse Flashcards

1
Q

Which drugs are classed as stimulants?

A
  • Cocaine [charlie]
  • Amphetamines [speed/whizz/billy]
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2
Q

Notable info about cocaine:

A
  • Most potent natural stimulant
  • Extracted from leaves of coca plant
  • First isolated in 1880s
  • Formerly used in eye nose and throat surgery
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3
Q

How is cocaine used?

A
  • Snorted
  • Coca leaves chewed or brewed
  • Cocaine hydrochloride is snorted or injected
  • Cocaine freebase or crack cocaine is smoked
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4
Q

What are the rates of taking effect for cocaine?

A
  • depends on dose and rate of entry to the brain
  • smoking - almost immediate
  • injecting - 15 to 30 secs
  • snorting - 3 to 5 mins
  • the effects of crack smoking are very intense but quickly over ( 15 mins)
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5
Q

What are the effects of cocaine?

A
  • stimulant and euphoriant
  • increased alertness and energy
  • increased confidence and impaired judgement
  • lessens appetite and desire for sleep
  • damage to nose and airways
  • convulsions with respiratory failure
  • cardiac arrhythmia’s and MI
  • hypertension and CVA
  • toxic confusion
  • paranoid psychosis
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6
Q

What are the withdrawal effects of cocaine?

A
  • Depression
  • Irritability
  • Agitation
  • Craving
  • Hyperphagia
  • Hypersomnia
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7
Q

What is the general chemical for speed? How is it taken? How much does it generally cost? What are the effects?

A
  • Generally amphetamine sulphate
  • Sniffed, swallowed or injected
  • Powder costs £10/g: ‘ice’ costs about £25/g
  • Effects similar to cocaine but longer lasting
  • Toxic confusion occasionally with convulsions and death
  • Amphetamine psychosis in heavy chronic use
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8
Q

Give some examples of opiates?

A
  • Opium
  • Morphine
  • Heroin (diamorphine)
  • Methadone
  • Codeine and dihydrocodeine
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9
Q

Is opium still smoked today?

A
  • Opium is still smoked today
  • The trade in opium was only regulated from the Hague Convention in 1911
  • Previously regulation was resisted by UK
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10
Q

Notable info about heroin?

A
  • First synthesised from morphine in 1874
  • Addictive potential unrecognised for years
  • Available as diamorphine or as diamorphine hydrochloride
  • May be presented as powder or as an almost tar like substance
  • Purity varies from 1%- 98% with average of 35% in US
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11
Q

Nicknames for heroin?

How is it taken?

Which is safest way to use heroin?

A
  • Also known as H ,gear, smack or brown
  • Taken by
    • Snorting
    • Smoking(chasing the dragon)
    • Injection
  • Smoking is safest, injecting the most dangerous method of use
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12
Q

What are some of the physiological effects of heroin?

A
  • Analgesia
  • Drowsiness and sleep
  • Mood change
  • Resp. depression
  • Cough reflex depression
  • Decreased sympathetic outflow
  • Pupillary constriction
  • Sensitization of labrynth
  • Lowered body temp
  • Constipation
  • Resp arrest with pulse
  • Pinpoint pupils unreactive to light
  • Bradycardia and hypotension
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13
Q

What is the high from opiates?

A

Intense but transient feeling of pleasure

  • “A rush”
  • Almost orgasmic
  • Physical and emotional anaesthetic
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14
Q

What are the side effects of opiates?

A
  • First time - nausea/vomiting and headache
  • Medium term
    • phlebitis
    • Anorexia
    • Constipation
  • Longer term
    • tolerance
    • Withdrawal
    • Social and health problems
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15
Q

What are the symptoms of opiate withdrawal syndrome?

A
  • craving
  • insomnia
  • yawning
  • muscle pain and cramps
  • increased salivary, nasal and lacrimal secretions
  • dilated pupils
  • piloerection (hence ‘cold turkey’)
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16
Q

What are the benefits of methadone maintenance?

A
  • decriminalises drug use
  • allows normalisation of lifestyle
  • reduces iv misuse
  • leakage on to the illicit market
17
Q

What is the chemical name for MDMA?

A

3,4-methylenedioxymethamphetamine

18
Q

How is MDMA taken and what does it cost?

A

almost always used orally ; £10-£15 /tab.

19
Q

What is the effect of MDMA?

A
  • relaxed euphoric state without hallucinations
  • half of all ‘ecstasy tabs.’ contain no MDMA
  • instead nil active , LSD, amphetamine , ketamine
  • likened to mixture of LSD and amphetamine
  • euphoria followed by feeling of calm
  • increased sociability
  • inability to distinguish between what is and isn’t desirable
  • effects after 20 mins lasting 2-4 hours
20
Q

What are side effects of MDMA?

A
  • Nausea and dry mouth
  • increased blood pressure and temperature
  • in clubs users risk dehydration
  • large doses can cause anxiety and panic
  • drug induced psychosis
  • ? liver and brain cell damage
21
Q

What are the effects to serotonin cells that has been proven in monkeys but not humans?

A
22
Q

Notable info about cannabis?

A
  • most commonly used illicit drug
  • tetrahydrocannabinol (THC) is the psychoactive agent
  • presented as marijuana , hashish (cannabis resin) or as hash oil (produced by extracting cannabinoids from plant material with a solvent)
  • skunk (sensimilla) has high THC content
23
Q

What is the cost of cannabis and how is it usually taken?

A
  • Usually sold by the ounce
  • £12-15 per eighth/oz for resin to £25 per eighth for marijuana
  • can be eaten but usually smoked ( joints spliffs or blunts)
  • Production becoming more professional - THC content from 1% in’74 to 5% in ‘94 ; THC content of sensimilla 17%
24
Q

What are the psychological effects of cannabis?

A
  • relaxing or stimulating, euphoriant , increases sociability and hilarity, increases appetite, changes in time perception, synaesthesia
  • in higher dose - anxiety , panic , persecutory ideation, hallucinatory activity
25
Q

What are ill effects of cannabis?

A
  • respiratory problems as with tobacco
  • toxic confusion
  • exacerbation of major mental illness
  • ? cannabis psychosis
26
Q

What are NPS drugs?

A

Novel psychoactive substances (legal highs)

27
Q

Give some examples of NPS drugs:

A

Spice

White china

Black mamba

28
Q

What consist of the family of drugs under anabolic steroids?

A
  • Family of drugs comprising testosterone and many synthetic analogues
29
Q

In which cases are anabolic steroids prescibed legitimately?

A
  • hypogonadism, muscular dystrophy, various anaemias, wasting in AIDS
30
Q

When are anabolic steroids used illicitaly?

A
  • Use rapidly expanded in sports requiring muscle mass and strength
  • Also used to enhance appearance -increase muscle mass and reduce body fat
  • Muscle hypertrophy from steroid use is particularly marked in the upper body in the pectoralis, deltoid, trapezius, and biceps
31
Q

What are side effects of anabolic steroids?

A
  • Skin – acne, stretch marks, baldness
  • Feminisation in males with hypogonadism and gynaecomastia (occasioning use of anti-oestrogens)
  • Virilisation in women including hirsutism, deep voice, clitoral enlargement, menstrual irregularities, hair thinning\
  • Cardiovascular – increased cholesterol and hypertension
  • Growth deficits due to premature closure of epiphyses
  • Liver Disease – cholestatic jaundice, liver tumours
32
Q

What are psychological effects of steroids?

A
  • Irritability and anger – ‘roid rage’
  • Hypomania and mania
  • Depression and suicidality on withdrawal

Psychiatry (24 decks)

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