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Drugs Flashcards

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1
Q

What is the ICD 10 definition of dependence syndrome?

A

a cluster of physiological, behavioural and cognitive phenomena in which the use of a substance or a class of substances takes on a much higher priority for a given individual than other behaviours that once had greater value

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2
Q

What is a central descriptive characteristic of dependence syndrome (ICD10)?

A

the desire (often strong, or overpowering) to take the psychoactive drugs (may/not have been prescribed), alcohol or tobacco.

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3
Q

What is the misuse of drugs act?

A

An act providing the legal framework for control of drugs according to potential for misuse.
Details requirements for prescription, safe custody and record-keeping.
Classifies drugs and penalties for supply & possession offences, allowing premises to be used for drug production.

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4
Q

List the class A drugs.

A 
Major opiates
cocaine, crack
LSD
injectable amphetamines
magic mushrooms
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5
Q

List the class B drugs.

A 
cannabis
oral amphetamines
ritalin 
pholocodeine
mephedrone (bubbles)
synthetic cannabinoids
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6
Q

List the class C drugs.

A

Tranquilisers (including benzodiazepines)
some painkillers (buprenorphine, dextropropoxyphene)
gamma hydroxybutyrate (GHB)
Ketamine

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7
Q

Jail time for dealing and possession of class A drugs?

A

dealing: up to life
possession: up to 7 years

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8
Q

Jail time for dealing and possession of class B drugs?

A

dealing: up to 14y
possession: up to 5y

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9
Q

Jail time for dealing and possession of class C drugs?

A

dealing: up to 14y
possession: up to 2y

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10
Q

According to the misuse of drugs regulations, which drugs are prohibited without a H.O. licence?

A

Schedule 1: prohibited without H.O licence

LSD, cannabis, opium, ecstasy

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11
Q

According to the misuse of drugs regulations, which drugs have controlled prescribing, custody and registers?

A

Schedule 2: controlled prescribing, custody and registers.

Heroin, methadone, cocaine, amphetamine

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12
Q

According to the misuse of drugs regulations, which drugs are schedule 3?

A

barbiturates, pentazocine

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13
Q

According to the misuse of drugs regulations, which drugs are schedule 4?

A

benzodiazepines

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14
Q

According to the misuse of drugs regulations, which drugs are schedule 5 (contain small amounts of CD)?

A

Schedule 5: contain small amounts of controlled drugs

co-proxamol, co-codamol

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15
Q

Drug use in Scotland per head is amongst the highest in the world - which drug is used most?

A

4% of Scots use Cocaine (highest)

  1. 5% use ecstasy
  2. 5% smoke or inject heroin
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16
Q

how many more times likely are drug users likely to die than general population?

A

users 12x more likely to due than gen population

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17
Q

Which drug is the commonest single use drug in Scotland?

A

heroin is commonest single drug

but poly use is normal

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18
Q

the majority of drug deaths are in people from which ethnic and socioeconomic background?

A

mostly white males from deprived areas

common to have had alcohol, or psychiatric problems within 6m prior to death
1/3 in contact with drug treatment service at time of death

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19
Q

in terms of value for money (VFM), which is cheaper, drugs or alcohol?

A

drugs are cheaper in terms of VFM/hr of effect

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20
Q

what is the active compound in cannabis?

A

THC = tetra-hydro-cannabinol

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21
Q

what is hash?

A

cannabis resin (blocks in clingfilm)

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22
Q

Acute physical effects of cannabis

A 
Dry mouth
Dilated pupils 
red eyes
tachycardia, HTN
postural HTN
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23
Q

Chronic effects of cannabis

A 
psychosis - schizophrenia 
A-motivational syndrome
Reduced sperm count
Reduced fertility (F)
Bronchitis + emphysema 
Lung cancer?
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24
Q

Withdrawal symptoms for cannabis

A 
irritability
mood change
restlessness
loss of appetite
weight loss 
insomnia
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25
what class of drug is valium?
valium = diazepam = benzo = class C
26
acute effects of benzodiazepines
``` anxiolytic, relaxation impaired memory paradoxical aggression uncharacteristic criminal behaviour uncontrollable emotions 'hangover' dizziness sedation, incoordination sexual dysfunction weight gain hypotension + coma w/ high dose ```
27
chronic effects of benzodiazepines
chronic intoxication tolerance psychological and physical dependence
28
withdrawal effects of benzodiazepines
``` anxiety, insomnia sweating, headache tremor, nausea disordered perceptions hypersensitivity to stimuli psychosis convulsions ```
29
full names for MDA and MDMA
``` MDA = methylene-dioxy-amphetamine MDMA = 3,4, methylene-dioxy-methamphetamine ```
30
acute psychological effects of amphetamines
``` Euphoria, friendly Heightened awareness and concentration Increased energy Irritability, restlessness Irrational behaviour, confusion Hallucinations, delusions, paranoia Psychosis ```
31
acute physical effects of amphetamines
``` Tachycardia, HTN, tachypnoea Loss of appetite Dilated pupils, brisk reflexes Dry mouth, blurred vision, dizziness Sweating, flushing or pallor Teeth-grinding, repetitive actions Pyrexia, dehydration ```
32
Acute adverse reactions from amphetamines
``` arrhythmia stroke (intra-cerebral or sub-arachnoid haemorrhage) hyper-pyrexia DIC Acute paranoid psychosis ```
33
chronic effects of amphetamines
``` Aggression, fatigue, insomnia Anorexia, malnutrition, weight loss Diarrhoea and vomiting Cardiomyopathy Chronic paranoid psychosis Depression, schizophrenia ```
34
Alternative names for mephedrone and class type
aka. bubbles, plant food 4-methylo-meth-cathinone (MMCAT) ``` similar to XTC and cocaine Made class B in 2010 ```
35
acute effects of mephedrone
``` tachycardia, HTN insomnia, anorexia Bruxism Nystagmus Blue/cold extremities (vasoconstriction) Pain in chest, throat, nose Nosebleeds if snorted ```
36
Withdrawal effects of mephderone
unpleasant come down with sleep disturbance paranoia depression SUICIDE
37
cocaine is detectable in which samples?
blood, urine, nasal, hair and saliva (everywhere)
38
acute effects of cocaine
``` Euphoria Formication (insects under skin) Irritability, confusion Hallucinations, paranoia, depression Tachycardia, HTN, tachypnoea Dilated pupils Increased mental excitement Hyper-pyrexia ```
39
Chronic effects of cocaine (general)
``` chest pains, muscle spasm weight loss perforated nasal septum "crack keratitis" of eyes erosion of tooth enamel "crack callus" of fingers male impotence, female orgasm problems ```
40
Chronic effects of cocaine on the heart
premature atherosclerosis, CAT, MI Acute contraction band necrosis (catecholamine stress) Chronic scarring (cardiomyopathy) Fatal arrhythmia
41
Chronic effects of cocaine on the brain
Haemorrhage (intra-cerebral or SA) | Infarction - arterial spasm
42
Withdrawal effects of cocaine
``` Intense psychological craving irritability, depression muscle pains, tremor hunger exhaustion, prolonged sleep ```
43
Full name of LSD and time until peak effects
Lysergic acid Diethytlamide a semi-synthetic hallucinogen effects within 1hr, peak at 4hr eliminated at 12hrs
44
you cannot become dependent on LSD - true or false
tolerance develops but not dependence
45
hallucinations with LSD are visual - true or false
trick Q - hallucinations are visual and auditory distorted perception of time, distance and speed
46
what are some chronic effects of LSD
tolerance abortion in pregnant women anxiety, psychosis flashbacks
47
constricted pupils, relief of anxiety, N&V, inability to concentrate and suppressed cough reflex = which drug class?
opiates also decreased HR and RR
48
chronic effects of opiates
``` tolerance dependence constipation loss of libido complications of IV injection ```
49
withdrawal signs from opiates
``` OPPOSITE SIGNS OF OPIATE INTOXICATION dilated pupils, raised HR and BP lacrimation, yawning cold clammy skin, gooseflesh loud bowel sounds N/V/D ```
50
Timing of opiate withdrawal
Commences after 8-15hrs Peaks at 36-48hrs Subsides over 5-10 days
51
metabolism of heroin
diacetylmorphine aka. diamorphine > 6-MAM > morphine > M3G (inactive) or M6G (active)
52
new heroin addicts are more likely to die from over dose than older addicts - true or false
false older addicts most at risk morphine levels at death are no different to those in living addicts i.e. not a huge dose required to kill
53
presence of 6-MAM in toxicology samples from a drugs death tells you what?
6-MAM indicates rapid death from heroin overdose | 6-MAM hasn't yet turned to morphine
54
M3G and M6G in toxicology tells you that the death was how long ago?
M3G and M6G is seen if death is some hours after injection
55
IV abuse of oral drugs -> ?
lung and liver granulomas due to e.g. gelatinous capsule content, tablet filler etc.
56
Person with pulmonary scarring and granulomas, which microscopy investigation might indicate IVDU?
birefringement in polarised light of foreign body granulomas suggests IVDU
57
what substances are being referred to when "cocktail effect" is mentioned re. heroin death?
diazepam, methadone, alcohol and heroin
58
why is it difficult to quantify the 'lethal level' form PM toxicology?
``` inter-individual variation tolerance cocktail effect active metabolites sampling site PM redistribution ```
59
Which drugs cause sexual dysfunction of some form?
benzodiazepines - sexual dysfunction chronic effects of cocaine - male impotence and female orgasm problems chronic use of opiates - loss of libido
60
Which drugs cause reproductive issues?
cannabis - reduced sperm count and female fertility | LSD causes abortion in pregnant females
61
which drugs cause paradoxical aggression and uncharacteristic criminal behaviour?
benzodiazepines
62
Which drugs can cause brain haemorrhage as an adverse effect?
cocaine and amphetamines can cause intra-cerebral or subarachnoid haemorrhages
63
alcohol potentiates the effects of benzodiazepines - true or false
true
64
how long until withdrawal symptoms for benzos set in?
2-3 days

Forensic medicine (10 decks)

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