Drug - PowerPoint Presentation

Slide1

Drug

Abuse 2Slide2

3.CNS Stimulants

Amphetamines

:

Amphetamines (

e.g.Amphetamine

, methamphetamine)are a group of synthetic, indirect-acting

sympathomimetic

drugs that cause the release of endogenous biogenic amines, such as dopamine

They are taken orally, sniffed

, smoked

or injected.

Amphetamines are

neurotoxic

& can cause tachycardia ,

dysrhythmias

& hypertensive crisis.

Withdrawal consists of

dysphoria

, drowsiness (in some cases, insomnia), and general irritability.

Khat

(Catha

edulis

) chewing leaves present in Yemen, Ethiopia & Somalia.

Khat

contains amphetamine-like agents (

cathine

&

cathinone

) with

psychostimulant

effects. It produces sense of well being, improvement of socialization, increase libido & increase work performance. It increases incidence of oral cancer. Slide3

Khat

leavesSlide4
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Cocaine

:

The prevalence of cocaine abuse has increased greatly over the past decades and now represents a major public health problem worldwide. Cocaine is highly addictive

Cocaine is an alkaloid found in the leaves of

E. coca.

It was used as a local anesthetic and to dilate pupils in ophthalmology

Cocaine blocks the uptake of dopamine,

noradrenaline

, and

serotonin.

Given IV or by sniffing: a rapid stimulating effects similar to amphetamine.

It causes toxic psychosis & ulceration of the nasal mucosa& Other serious side effects.Slide6
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Nicotine:

Nicotine is selective agonist of the nicotinic acetylcholine receptor .

In terms of numbers affected, addiction to nicotine exceeds all other forms of addiction.

Nicotine exposure occurs primarily through smoking of tobacco, which causes associated diseases that are responsible for many preventable deaths. The chronic use of chewing tobacco and snuff tobacco is also addicting.

Smoking-associated diseases

:include lung cancer, heart disease, atherosclerosis, laryngeal cancer, oral cancer,

oesophageal

cancer, COPD, intrauterine growth retardation & low birth weight. Slide9

Tolerance

: very quick perhaps due to desensitization of receptors.

withdrawal

syndrome

: craving

! increased

irritability, anxiety, impaired performance of psychomotor tasks, aggressiveness ,sleep disturbance

s

, headache and increased appetite.

highly addictive

with the very strong psychological component. Slide10

Treatment of nicotine dependence

Most smokers would like to quit but few succeed

Combination of psychological and pharmacological treatment achieve success rate about 25% (after 1 year)

.

Nicotine replacement therapy: Nicotine in patches (controlled release), chewing gums, nasal sprays several times daily (short effect)

Adjunct therapy

:

Bupropion

: an

antideprssant

that

reduces the severity of nicotine cravings and withdrawal symptoms .It

inhibits

the reuptake of dopamine and so increase dopamine activity in nucleus a

c

cumebens

.

Treatment course lasts for seven to twelve weeks

.

Clonidine

– rarely used due to the side-effects (hypotension, drowsiness…)

.Slide11

Cannabis

and Cannabinoids

Extracts of the hemp plant (

Cannabis

sativa,Canabis

indica

)

Cannabis mostly smoked produces a sensation of relaxation & well-being.

Cannabis contains chemicals called

cannabinoids

.One of these, delta-9-tetrahydrocannabinol (THC), is believed to be responsible for most of the characteristic psychoactive effects of cannabis.

Marijuana

: (

dried leaves and flower heads)

is one of the most frequently encountered illicit(illegal) drug worldwide.

Hashish

:

consists of the THC-rich resinous material of the cannabis plant, which is collected, dried, and then compressed into a variety of forms, such as balls, cakes

.

Their

CNS effects

are

combination of

psychotomimetic

& depressant effects

eg

: relaxation, well-being and euphoria ,uncontrolled laughing ,a feeling sharpened sensory awareness, with tastes, sounds and sights more intense and fantastic ,impairment of motor coordination (driving), impaired short-term memory and judgement, increased

appetite ,

analgesic effect

,antiemetic effect.Slide12
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Mechanism of action

is through

cannabinoid

(CB) receptors

(

CB

1

- brain ) highly abundant in: hippocampus (memory), cerebellum (loss of coordination), and

substantia

nigra

(motor disturbances), hypothalamus (appetite) and

mesoli

m

bic

dopaminergic

pathway (reward) and cortex.

The synthetic

9

-THC analog

dronabinol

is approved

cannabinoid

agonist currently marketed in the USA and some European

countries for the treatment of anorexia in AIDS patients, as well as for refractory nausea and vomiting of patients undergoing chemotherapy.

Nabilone

, an older

9

-THC analog used as an antiemetic and as an adjunct analgesic for neuropathic pain.

Tolerance and physical dependence occur only to a minor degree in heavy users

. Withdrawal

syndrome: weak and usually mild irritability, restlessness, confusion, sweating tremor and sleep disturbances.

Rimonabant

is selective CB1receptor blocker used as an anorectic anti-obesity drug It can opposite effects of

cannabinoids

.

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5.Hallucinogens

Hallucinogens are substances produce changes in perception, thought and mood.

Thoughts and perceptions tend to become distorted and dream-like, colours and sounds are more sharp

. Different kind of hallucinations (visual, auditory, tactile and olfactory) appear.

Thought

process tend to be illogical and disconnected

Lysergic acid diethylamide (

LSD

) is the most potent hallucinogen (agonist at 5-HT

2

receptors) .Others include:

Psilocybin,Mescaline

( agonists at 5-HT

2

receptors)

MDMA

(

Methylenedioxymethamphetamine

) (

Ecstasy

)called as "street" or "party" drug. It is an amphetamine derivative which acts mainly by inhibiting 5-HT uptake and has powerful

psychostimulant

effects typical of amphetamines, as well as

psychotomimetic

effects.

Phencyclidine called as “angel dust” and

ketamine

are

antagonists at NMDA(N-methyl-D-aspartic acid)-type glutamate receptors.Slide16
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6.Inhalants

Inhalants are a diverse group of substances that include volatile solvents, gases, and nitrites that are inhaled.

These substances are found in common household products like glues, lighter fluid, cleaning fluids, and paint products.

The chronic use of inhalants has been associated with a number of serious health problem:

Sniffing glue and paint thinner causes kidney abnormalities, while sniffing the solvents toluene and trichloroethylene cause liver damage.

Memory impairment, attention deficits, and diminished intelligence

Deaths resulting from heart failure, asphyxiation, or aspiration have occurred.Slide18
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7.Anabolic steroids

A type of

steroid that mimics the male sex hormone testosterone.

Medical uses of anabolic steroids include replacement of inadequate levels of testosterone resulting from a reduction or absence of functioning testes,& also for certain kinds of anemia and breast cancer.

Bodybuilders and athletes often use anabolic steroids to build muscles and improve athletic performance. But using them this way is not legal or safe.

Anabolic steroids have many psychological and physical side effects Including:

Liver

damage and cancer

Sterility, reduction of the size of the testes and breast enlargement in men.

Increased facial hair ,a deeper voice and decreased breast size in women.

Acne.

Permanently stunted growth in adolescents.

Aggressive behavior, mood swings, depression.

Hypertension.

High cholesterol.

Injuries to tendons and muscles.Slide20
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General Management of drug abuse:

Stopping the use of the substance.

2.Pharmacotherapy

: as use of antidotes

e.g

:

Naloxone

for

opioid

abuse.

or substituting agents

e.g:a

long acting

opioid

(

e.g:methadone

) for shorter acting one(

e.g:heroin

) &use of chewed or

transdermal

nicotine.

3.Long term support, rehabilitation & Psychosocial therapies.