Pharmacology 2: Block 1 Drugs of Abuse

Ethanol

MOA: CNS depressant; potentiates actions of GABA; inhibits release of ADH

Sx of Intox: Euphoria, impaired attention

Intoxication tx: None

Withdrawal tx: Benzodiazepines

Amphetamine (drug of abuse)

MOA: Increases synaptic concentration of norepinephrine and dopamine

Sx of Intox: Euphoria, decreased fatigue, hypervigilance, paranoia

Intoxication tx: Lorazepam for agitation and Haldol for psychosis

Withdrawal tx: Supportive care

Methamphetamine

MOA: Increases synaptic concentration of norepinephrine and dopamine (causes less norepinephrine release)

Sx of Intox: Euphoria, decreased fatigue, hypervigilance, paranoia,

Intoxication tx: Lorazepam for agitation and Haldol for psychosis

Withdrawal tx: Supportive care

MDMA (Ecstasy)

MOA: Increases dopamine and serotonin in the brain

Sx of Intox: Depersonalization, derealization, hallucinations, illusions,

Treatment: Supportive care for each

Cocaine

MOA: Inhibition of neuronal reuptake of norepinephrine and dopamine

Sx of Intox: Euphoria, decreased fatigue, hypervigilance, paranoia,

Intoxication tx: Lorazepam for agitation or seizures

Withdrawal tx: Supportive care

Caffeine

MOA: Produces mild stimulation by blocking adenosine receptors in neurons throughout the CNS
Sx of Intox: Decreased fatigue, increased concentration
Treatment: Supportive care for each

Nicotine (drug of abuse)

MOA: Activates cholinergic nicotinic receptors; inhibits monoamine oxidase

Sx of Intox: Tachycardia, increased concentration

Treatment: Supportive care for each

Marijuana

MOA: Primary cannabinoid is THC; binds to cannabinoid receptors in neurons

Sx of Intox: Mild stimulation followed by depressive stage; impaired short-term memory

Treatment: Supportive care for each

Lysergic acid diethylamide (LSD)

MOA: Selectively activates subtypes of serotonin (5-HT) receptors in neocortex, limbic system and brainstem

Sx of Intox: Visual hallucinations, synesthesia, little effect on cognitive function or arousal,

Treatment: Supportive care for each

Phencyclidine (PCP)

MOA: Dissociative anesthetic; blocks NMDA receptors

Sx of Intox: Anxiety, delusions, emotional lability

Intoxication tx: Lorazepam for agitation and Haldol for psychosis

Withdrawal tx: Supportive care

Benzodiazepines

MOA: Facilitates activity of GABA

Sx of Intox: Euphoria, impaired attention,

Intoxication tx: Flumazenil for overdose

Withdrawal tx: Supportive care