Drugs of Abuse (Opioids & Sedative Hypnotics)

High potential for abuse, no known medical use and lacks accepted safety for use

Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule I

Potential for abuse with proven and accepted medical use but WITH SEVERE RESTRICTIONS, because abuse may cause severe pscyho/physio dependence

Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule II

Heroin, lysertgic acied diethylamide

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Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule I

morphine, cocaine, methadone, methampetamine, phencyclidine



Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule II

Less potential for abuse than schedule I or II; with accepted medical use

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Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule III

Abuse may cause moderate or low physical dependence or high psychological dependence

Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule III

Anabolic steroids, codeine and hydrocodone, with aspirin or Tylenol



Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule III

The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule III

Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule IV

Abuse of the drug or other substance may lead to limited physical dependence or psychological dependence relative to the drugs or other substances in Schedule III

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Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule Iv

Valium and Vanax

Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule IV

The drug or other substance has a low potential for abuse relative to the drugs or other substances in Schedule IV

Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

Schedule V

cough syrups and codeine

Schedule I

Schedule II

Schedule III

Schedule IV

Schedule V

schedule V

• Reduction of concentration • Shorter duration of action



Pharmocokinetic tolerance

Pharmacodynamic tolerance

Pharmocokinetic tolerance

• Recruitment of Adaptor protein (β-arrestin)

• Desensitization

• Receptor internalization

Pharmocokinetic tolerance

Pharmacodynamic tolerance

Pharmacodynamic tolerance

Symptoms of Post Acute Withdrawal Syndrome (PAWS)

• Irritability and emotional outburst

• anxiety

• low energy

• toruble sleeping

• memory problems

• dizziness

• increased accident proneness

• delayed reflexes

• High motivation to obtain and use

• Negative consequences

Addiction

• Re-exposure

• Stress \n • Context recall

Relapse

• Alter perception; no reward/euphoria

• targets cortical and thalamic system

Nonaddictive Drug of Abuse

• Hallucinogens \n • Dissociative anesthetics • LSD \n • PCP/Ketamine \n • Dextromethorphan

Nonaddictive Drug of Abuse

Drugs that activate g protein coupled receptors

• Opioids \n • Cannabinoids

• GHB

• LSD,

• Mescaline

• Psilocybin

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GLOC MP

Drugs that bind to ionotropic receptors

• Nicotine

• Benzodiazepines

• Alcohol

• Ketamine

•. PCP

• Inhalants

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KABINP

Drugs that Bind to Transporters of Biogenic Amines

• Coccaine

• Amphetamines

• Ecstasy(MDMA)

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ACE

• strong analgesic

• opiates - morphine, codeine, thebaine, papaverine

• narcotic - “sleep inducing”

opioids

Supraspinal and spinal analgesia; sedation; inhibition of respiration; slowed gastrointestinal transit; modulation of hormone and neurotransmitter release

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* Endorphins > enkephalins > dynorphins

μ (mu)

Supraspinal and spinal analgesia; modulation of hormone and neurotransmitter release

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* Enkephalins > endorphins and dynorphins

δ (delta)

Supraspinal and spinal analgesia; psychotomimetic effects; slowed gastrointestinal transit

* Dynorphins > > endorphins and enkephalins

κ (kappa)

strong agonist of opioids in mu subtype

• morphine

• hydromorphone

• oxymorphone

• methadone

• meperidine

• fentanyl

• sufentanil

• alfentanil

• remifentanil

• levorphanol

strong agonist of opiods in delta subtype

* sufentanil

strong agonist of opioid for kappa subtype

• morphine

• sufentanil

• pentazocine

• nalbuphine

• butorphanol

partial agonist of opiods in mu subtype

• codeine

• hydrocodone

• pentazocine

• buprenorphine

• butorphanol

antagonist of opioid in mu subtype

* nalbuphine

antagonist of opioid in delta and kappa subtypes

* buprenorphine

scientific term for opium which is derived from

Papaver somniferum - poppy plant

* powerful narcotic, painkiller

opium

what is principal active ingredient of opium

morphine

opium induces what

* insomnia, hallucinations, nightmares

what does opium release

histamine

opium is administered through what route

• subcutaneous

• intravenous

opium has more pronounced effects than heroine

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t or f

t

morphine has greater effect than heroine true or false

T

other names for heroine

smack

H

ska

junk

heroine is a

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morphine

antidepressant

diamorphone

cannabis

diamorphone

it is an addictive drug as a white or brown powder

heroine

heroin is slow acting t or f

f - fast acting

what is the half life of heroine

3-5 hours

how many hours after does withdrawal happen for the drug heroin

5-10 hours

Synthesized from thebaine

oxycodone

derived from codeine

oxycodone

oxycodone is available in what route of administration. Where can this be found

oral form or tablet, component of cough syrup

a strong analgesic that is used for anesthetic or pust-surgical pain killers

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opium

meperidine

heroin

meperidine (pethedine;demerol)

attemtps to illicitly produce meperidine has resulted in MPTP which can cause what disease

parkinsonism

adverse effects of opiod analgesics with acute drug use

respiratory depression

nausea

pruritus

urticaria

constipation

urinary retention

delirium

sedation

myoclonus

seizures

adverse effects of opioid analgesic with chronic use

hypogonadism

immunosuppression

increased feeding

increased growth hormone secretion

withdrawal effects

tolerance, dependence

abuse, addiction

hyperalgesia

impairment while driving

antidote for opioid overdose

naloxone

what drug group

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Increased **central nervous system depression**, particularly respiratory depression.

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sedative hypnotics

antipsychotic agents

monoamine oxidase inhibitors

sedative-hypnotics

what drug group

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increased sedation. variable effects on **respiratory depression.** Accentuation of cardiovascular effects (antimuscarinic and a-blocking actions)

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sedative hypnotics

antipsychotic agents

monoamine oxidase inhibitors

antipsychotic agents

what drug group matches the opioid drug interaction

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Relative contraindication to all opioid analgesics because of the high incidence of **hyperpyrexic coma; hypertension** has also been reported.

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sedative hypnotics

antipsychotic agents

monoamine oxidase inhibitors

monoamine oxidase inhibitors

these are anxiolytic agents which lessens anxiety;

sedatives

this type of drugs relaxes or causes hypnotism

hypnotics

examples of sedative hypnotics

alcohol

barbitruates

benzodiazepines

gamma-hydroxybutyric acid (GHB)

sedative hypnotics can be what

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short acting

long acting

short - long acting

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short to long acting

for sedative hypnotics the longer the duration, the more the withdrawal true or false

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\

false

\
the longer the duration, the lesser the withdrawal

short duration of action is used to treat addiction to sedative hypnotics true or false

false

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long duration of action

withdrawal effects of sedative hypnotics include

anxiety

tremors

twitches

vomiting

what are the clinical uses of sedative hypnotics

• anxiety

• insomnia

• sedation and amnesia before and during medical/surgical procedures

• epilepsy and seizure for children

• component of balanced anesthesia

• control of ethanol

• muscle relaxation in neuromuscular disorders

• panic attacks

range of effect of sedative hypnotics

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lower dose

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causes:

sedation

range of effect of sedative hypnotics

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hypnotic state makes the person ___

half asleep

range of effect of sedative hypnotics

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when the dose is increased, individual is at _____

anesthetic state

range of effect of sedative hypnotics

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when individual is overdosed, he or she is in ____

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coma state

Common Sedative-Hypnotic drugs such as diazepam, flurazepam and lorazepam are conjugated to become more water-soluble, allowing them to be secreted in the urine.

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T or F

T

What receptor is common for most sedative hypnotics

GABA Receptor

an antidote to benzodiazepine overdose

Flumazenil

Flumazenil is not used as antidote for barbiturate overdose

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t or f

t

flumazenil can reverse the hypnotic effects of zolpidem

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t or f

t

Rare occurence of physiologic dependence

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benzodiazepines

opium

cannabis

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benzodiazepines

“Therapeutic Dose Dependence”

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benzodiazepines

opium

cannabinoids

gamma hydroxybutyric acid

benzodiazepines

Weight loss, change in perception, paresthesia, headache

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benzodiazepines

opium

cannabinoids

gamma hydroxybutyric acid

benzodiazepines

used for date rape

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flunitrazepam

opium

cannabinoids

gamma hydroxybutyric acid

flunitrazepam

What is the trade name of flunitrazepam

Rohypnol: roofies (1mg tab)

What schedule regulation is flunitrazepam

Schedule IV

Flunitrazepam causes what

anterograde amnesia

Older sedative hypnotic

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flunitrazepam

opium

barbiturates

gamma hydroxybutyric acid

barbiturates

targets GABAa receptors

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flunitrazepam

opium

barbiturates

gamma hydroxybutyric acid

barbiturates

short acting drugs

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flunitrazepam

opium

barbiturates

gamma hydroxybutyric acid

barbiturates

Not used as much as other drugs because of their unpredictable effects

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flunitrazepam

opium

barbiturates

gamma hydroxybutyric acid

barbiturates

causes euphoria

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flunitrazepam

alcohol

barbiturates

gamma hydroxybutyric acid

alcohol

Targets and affects GABAa and NMDA

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flunitrazepam

alcohol

barbiturates

gamma hydroxybutyric acid

alcohol

withdrawal effects of alcohol

Motor agitation, anxiety, insomnia, hallucination, abnormal vital signs, seizures

Targets type b GABA receptors (GABAb)

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flunitrazepam

alcohol

barbiturates

gamma hydroxybutyric acid

Naturally found in body and can be found in fermented drinks like guava

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flunitrazepam

alcohol

barbiturates

gamma hydroxybutyric acid

Euphoric, sedative, anabolic

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flunitrazepam

alcohol

barbiturates

gamma hydroxybutyric acid

gamma hydroxybutyric acid

Popularly known as liquid ecstasy, soap, easy lay, vita-G

● Georgia homeboy

● Use with alcohol can produce breathing problems or respiratory depression

gamma hydroxybutyric acid

gamma hydroxybutyric acid withdrawal effects

Insomnia, anxiety, tremors, sweating

treatment for short and long acting drugs

• chlordiazepoxide

• phenobarbital

treatment for alcohol

• disulfiram

• naltrexone

• support groups that would prevent relapsing

scientific term for marijuana

Cannabis sativa

other term for marijuana

Mary Jane or Five Fingers because of its morphology

what is the addictive component of marijuana

tetrahydrocannabinol (THC),

what receptors does marijuana bind to

Cannabinoide receptors (CB1)

route of administration for marijuana

Smoked, mixed with food (happy brownies), or mixed in coffee

how many inhalations does marijuana take into effect

2-3 inhalations