Psychoactive drugs

Recreational use

solely for enjoyment or effects

Therapeutic use

treat physical/ mental ailment

Psychoactive drug

A chemical substance that is natural or synthetic which alters brain and nervous system function, leading to changes in perception, affect/feelings, mood, consciousness, thoughts and behavior. Examples include caffeine, alcohol, marijuana, and cocaine.

What is a Chemical name?

A unique name given to a chemical substance for scientists based on its chemical composition and molecular structure. It is used to identify and differentiate between different chemical compounds.

What is a Generic name for a psychoactive drug?

A **generic name** is a name created by the drug developer and accepted by a scientific body that indicates the drug’s classification. 

What is a Brand/ proprietary name for a psychoactive drug?

a **proprietary** or **brand name** is registered/patented by the manufacturer/company as a trademark and refers specifically to their drug product. 

What is the chemical name for xanax?

8-Chloro-1-methyl-6-phenyl-4H-s-triazolo \[4,3-α\] \[1,4\] benzodiazepine.

What is the generic name for Xanax?

alprazolam

what is the brand name for alprazolam?

xanax

Therapeutic use

**Therapeutic use** is the administration of a medication to treat a physical or mental ailment.

Recreational use

**recreational use** is the taking of a drug solely to enjoy or experience its pharmacological effects

Drug use

**drug use** means taking a drug properly in its correct dosage.

Drug misuse

Improper or excessive usage of a drug is **drug misuse. Misuse can be intentional or accidental.**

Example of drug use

Most people have used drugs this way such as by taking an aspirin to relieve a headache or drinking a beer.

Examples of drug misuse

* Injecting heroin to get high.
* Taking prescription opioids to experience relaxation instead of to relieve pain.
* Prematurely stopping a prescribed antibiotic treatment.
* stopping meds that should be tapered
* Taking twice the recommended dose because the regular amount isn’t effective enough. (taking a higher dose)
* Using someone else’s prescription medicine.

drug abuse

using a substance in a manner, amount or situation that causes problems socially, physically, psychologically, occupationally (totality of circumstances : if its one time not considered abuse)

drug dependence

drug use is so frequent and consistent it is difficult for your body to function without substance body adapts to the presence of drug can be physical/ psychological (body changes → dependence)

drug addiction

Compulsive drug use that continues despite awareness of its harmful consequences

drug addiction does not equal drug use does not equal drug abuse does not equal drug misuse does not equal drug dependence

true

Drugs are not good or bad

true

drugs have multiple effects and you can't choose which you get

true

Why is it a problem to blame the drug?

* Ignore factors that lead to abuse and addiction
* attempt to eliminate the substance

What personality factors influence drug use?

Sensation seeking and impulsivity

Risk

Increased likelihood of drug use

Protective

Decreased the likelihood of drug use

Drug use has been around for thousands of years

true

What are the three main reasons for a drug use?

* Spiritual use
* Economic
* Treat illness

Why is understanding drug use difficult?

* Not having accurate & complete data ex: surveys in school miss a large population (those who do not attend school)
* Isolating root cause of drug use

Two categories of problems

1. Actual drug use consumption of drug (OD’s, dependence)
2. Social Problems- indirect problems (jail, work & relationships.)

History of drugs

* Almost no regulations in the 1800s in the US
* Early 1900s brought regulations because the government was “protecting us- drugs were too dangerous”

Three main concerns that lead to regulations of drugs

1. Toxicity- drug toxicity
2. Dependence and addiction
3. Crime

one main concern that led to regulations of drugs is crime what are some of the stats for crime?

* Criminal behavior precedes drug use
* Alcohol is linked to violent crime
* Over half of all homicides involve alcohol
* 1/3 of sexual assaults reported involves alcohol
* 2/3 of all domestic violence situation involves alcohol

illicit drugs

illegal to sell, use, or possess

### 3 thing that shows that gove isnt “protecting us”

* Current laws don't represent rationally devise plans aren't based on research
* policies are reactive versus proactive
* Ineffective at addressing major concerns

War of drugs in 2023 how much did the US spend on the War of drugs

42\.5$ billion

what percentage does the DEA intercept illicit drugs?

10%

Drug OD rarely happen with a single drug it is most often a combo of sedatives/depressants

true

Drug illegal Prohibition

Criminalized sale used possession manufacture

Drug decriminalization

* Use, possession (of specific amount) acquisition not criminal (no Jail) but punishable by fines and citations


* Manufacture and sale still criminal

\

What does drug decriminalization not address

Drug purity or violence from drug trafficking

(not regulated not safe drug)

Drug legalization

Nothing criminal; sale, use, possession, manufacture legal

Nervous system is made of?

Central nervous system & peripheral nervous system

What is the central nervous system?

Brain + spinal cord

What is the peripheral nervous system?

Everything else besides brain and spinal cord

What parts does the peripheral nervous system have?

Automatic and somatic

What is the automatic part of the peripheral nervous system?

It is the involuntary system and it is made up of sympathetic and parasympathetic

What is sympathetic part of the peripheral nervous system's automatic (involuntary) part?

Increased elevates fighter flight (any threat)

What is parasympathetic part of the peripheral nervous system's automatic (involuntary) part?

Decreases brings us down

What is the somatic part of the peripheral nervous system?

voluntary muscle movement

What role does a nucleus accumbens play?

Plays a critical role in the word and development of addiction

Neuron

Analyze + transmit information a.k.a. communication

glia

Neuron support

* Firmness/structure
* Greek word for glue
* Common knowledge myth is 10 glia : 1 neuron ratio but it is actually closer to 1 glia to 1 neuron ratio

nerve conduction

* Neuron are polarized (different charge inside of cell verses outside)
* Blocking the ion channels prevents action potential (neuron firing)

Action potential

Electrical signal that initiates the chain of events

Action potential

“All-or-firing” neuron fires then action potential neurotransmitters are released. Excitatory- makes it easier to fire inhibitory- makes it less likely to fire

Life of a neurotransmitter

1. Precursors in the blood
2. Uptake- select precursors taken from the bloodstream to cell
3. Synthesis- precursor synthesized (through enzyme action) into neurotransmitter
4. Storage- neurotransmitter stored in synaptic vesicle
5. Release- when action potential arrives at vesicle the neurotransmitter is released so the release happens from the presynaptic neuron
6. Binding neurotransmitter binds into receptor on postsynaptic cell
7. Metabolismo any of the the unbound neurotransmitters will either be


1. Reuptake- taking back into the presynaptic neuron
2. Cleared from synaptic gap (cleff)

what does a post synaptic (dendrite) and presynaptic neuron (axon terminal) look like interacting?

this there is also antagonist Agnes receptors synaptic vesicles that you see in there. It's like a lock and key there's also a master key & a key that works in some places

What does Agonist do

Holds the door open

What does an antagonist do

Hold the door closed

Pharmacokinetics

Absorption Distribution Metabolism Excretion

First step of pharmacokinetics: Absorption

* Bioavailability= amount of drug that gets into bloodstream
* absorption rate varies by drug
* Both are impacted by route of admin (how do you get drug into body)

Fastest routes

Fastest routes:


1. Smoking is the fastest method of administration (5-8 seconds)
2. Insufflation: 10-12 seconds
3. IV: around 15 seconds

Bioavailability

The amount that does get absorbed is termed **bioavailability**, expressed as a percentage of the amount administered that enters the circulation.

Distribution

Drug bind to blood plasma protein and albumin

Distribution: what does higher affinity and low affinity mean?

High affinity equals more likely to bind

Low affinity equals less likely to bind

Binding helps with storage and balance

true

Binding of drugs: Higher amount bound to protein albumin equals less free molecules

True

Distribution: Binding of drugs: only free molecules have therapeutic effect because bound can't believe bloodstream

true

Drugs with high affinity will displace (pushoff) drugs with low affinity from the albumin

true

Does alcohol have low affinity or high affinity?

Low affinity

Does THC have low affinity or high affinity?

High affinity

Hi affinity needs higher effective dose

true

Bound drug molecules can't cross blood brain barrier

true

What is the blood brain barrier?

Filter that protects the brain

Small lipophilic molecules pass easier through the blood brain barrier

true

Cerebral trauma disrupts blood brain barrier and makes the barrier less effective

true

Effective dose → ED50

Dose that produces a meaningful effect and 50% of the population

Lethal dose → LD50

Dose that is lethal in 50% of the population

Toxic dose → TD50

Dose that is toxic but not lethal in 50% of the population

What is the therapeutic window?

Between the effective dose and the toxic/lethal dose

Therapeutic index

TD50/ED50 or LD50/ED50 this is used traditionally to determine drug safety and should always be greater than 1

Certain safety index

TD1 or LD 1 ÷ ED99 (near guaranteed response) (the one means what is the toxic dose and 1% what is the lethal dose in 1% and that's divided by the nearest guaranteed response of effective dose)

Time dependent factors

Onset, duration and termination of drug affects

* Route of admin
* How rapidly is drug absorbed and distributed
* How is drug eliminated from body

Would taking additional doses before drug is fully out of system lead to compounding effects

yes

Metabolism (liver)

The drug form is changing in the liver,

* Enzyme breaks down drug molecules into metabolites (“mini-me”)
* metabolites are easier to remove from body through excretion
* active metabolites have physiological effects similar to parent drug.

Is it true that active metabolites have physiological effects similar to parent drug.

yes it is

is it true metabolites are easier to remove from body through excretion?

yes its “mini me” of drug molecules !!!

CYP50 enzyme are most important in?

drug metabolism (breaking things down)

Anytime foreign molecules (drug) are detected more CYP50 enzymes are produced to return to homeostasis

true

Excretion

drug molecules leaves body unchanged (most often kidneys) mostly through urine but can be through sweat feces tears breath bile saliva & mothers milk (semen)

MOA

Mechanism of action

Mechanism of action

Alters neurotransmission

Drug interactions

Additive effect and synergistic effect

Drug interaction additive effect

Drugs have similar effects to what you would expect DA1 plus DB1 equals D2

drug interactions synergistic effect

Drugs interact and multiply affects can't predict what you're gonna get DA1 + DB1 = D3

Specific effects

Only happen when chemical compound is present

Nonspecific effects

Placebo effects

Nonspecific (placebo) effects

Real effects but come from a unique combo of factors not the chemical compound (the drug itself) **Placebo effects**

What factors could affect your nonspecific placebo effects?

Perceptions/ expectations/ background are what affect your nonspecific placebo effects

Threshold

Lowest dose that produces a measurable response