Novel psychoactive substances part 1 & 2

Question 1

Mephadrone

• effects?
• negative effects?

Answer 1

-re-uptake inhibition of serotonin, noradrenaline and dopamine
also encourages dopamine release
stimulant & empathogenic

-sympathetic NS: fast, irregular heartbeat, in BP, mydriasis, chest pain, agitation, sweating, headaches, insomnia
jaw clenching, nausea, vomiting, paranoia, hallucinations, susceptibility to ladybirds

Question 2

What factors must be considered when classifying NPS?

Answer 2

variability between people, non-drug effects, metabolism
drugs active in more than 1 group
stimulant/sedative
Ketamine
Hallucinogens

Question 3

give the 7 general classes of NSPs?

Answer 3

stimulants
Empathogens
Psychedelics
Dissociatives
cannabinoids
Depressants 
Opioids

Question 4

Empathogens

• effects?
• exmaples of illegal counterparts?
• risks?

Answer 4

-emotional opens and relatedness
empathy and sympathy

-cocaine, amphetamines

-cardiac and psychosis
sympathetic toxidrome

Question 5

Sympathetic toxidrome

-typical presentation? (11)

Answer 5

-agitation
confusion
anxiety
vomiting
abdo pain
seizures
hallucinations or delusions
chest pain
Palpitations 
Dyspnoea 
serotonin syndrome

-

Question 6

What is serotonin syndrome?

Answer 6

agitation/restlessness, hyper-reflexia, tremor, myoclonus, sweating, diarrhoea, shivering, ataxia, fever, confusion, hypomania, confusion

Question 7

Methiopropamine

-what is it?

Answer 7

• a structural analogue for methamphetamine

norepinephrine and dopamine reuptake inhibitor

Question 8

What receptor do cannaboids act on?

• why are they dangerous?
• risks?

Answer 8

the THC receptors,

• they can be up to 800 times more potent
• psychosis, agitation, CV probs,

Question 9

Action of depressant NSPs?

• effects?
• risks?

Answer 9

decreased NT levels that activate GABA/opiod receptors and inhibit glutaminergic/catecholaminergic

• inc sociability, enhance mood
• dec resp rate, HR = LOC

Question 10

Opioids

-give 2 examples

Answer 10

-AH-7921 ACMD & acetylfentanyl

Question 11

Hallucinogens

• effect?
• risks?
• example?

Answer 11

-affect
perception,

-illusions/hallucinations, synasthesia, tachyphylaxis, sympathomimetic activity,
psychotic symptoms

-green beans

Question 12

Ketamine

• effect?
• risks?
• NPS example?

Answer 12

-detached from reality, derealisation, depersonalisation, dissociation, hallucinations

-stimulates BP and Pulse
ketamine bladder

-Methoxphenidine

Question 13

NPS specific problems?

Answer 13

• potency
• knowledge re. effects – esuperman (PMMA vs MDMA)
• non-homogenous
• evade standard drug tests

Question 14

Treatment?

Answer 14

psychological intervention
detox & sustained change
stepped care

Question 15

investigations?

Answer 15

urine toxicology
need to know OTC stuff they’re taking
find out what the patient thinks they took and then can look for it
immunoassay analysis

Question 16

Advise to patients r.e. NPS?

Answer 16

Always take a test dose e.g a dab or half a pill and wait at least 2 hours before taking more
Avoid mixing with other drugs including alcohol
Tell someone you are with what you have taken
If going to sleep, sleep on your side
Seek help if you need to and be honest about what you have taken to emergency services
Tolerance, functional and metabolic
Non-drug factors and overdose