Term
| What is cocaine used for medically? |
|
Definition
anesthetic and vasoconstrictive for nosebleeds
(no longer for facial and scalp lacerations because too well absorbed) |
|
|
Term
| What is the primary and secondary effects of cocaine? |
|
Definition
Primary: block NE reuptake
Secondary: marked release of NE |
|
|
Term
| Which class of drugs should be avoided while treating toxic effects of Cocaine? Why? |
|
Definition
Beta blockers
creates unopposed alpha stimulation which leads to greater ischemia
should also avoid HALOPERIDOL because lowers threshhold for seizures |
|
|
Term
| How is cocaine a psycho stimulant? |
|
Definition
| stimulates limbic system and produces pleasurable effects by blocking DA reuptake in the nucleu accumbens |
|
|
Term
| How do you get crack and free-base? |
|
Definition
Cocaine doesn't light so a proton is removed so it can be smoked
(ammonia and diethy ether are used for free-base and baking soda for crack) |
|
|
Term
| What are the metabolites for cocaine and how are they broken down? |
|
Definition
Ecgonine methyl ester (EME)-esterases
Bensoylecgonine (BE)-nonenzymatic |
|
|
Term
| A drug screen for cocaine detects what? for how long? |
|
Definition
| Benzoylecgonine (BE) in the urine for 48-72 hrs |
|
|
Term
| What prolongs the metabolism of cocaine and why? |
|
Definition
Pancuronium
neuromuscular blockers (and ester anesthetics) compete for plasma cholinesterase which decreases EME and decrease cocaine metabolism |
|
|
Term
| What is a potent precipitant of convulsions because of its longer half life that cocaine? |
|
Definition
|
|
Term
| What are 3 cardiac effects from myocardial ischemia? |
|
Definition
increased myocardial oxygen demand from hypertension and tachycardia
coronary artery spasms from adrenergic effects
dilated cardiomyopathy with chronic use |
|
|
Term
| What are some other clinical manifestations of cocaine? (3) |
|
Definition
Crack lung:pulmonary effects from deep valsalva maneuver
Rhabdomyolysis:breakdown of skeletal muscle releasing myoglobin leading to renal failure
ichemic bowel |
|
|
Term
| What should be used for the treatment of cocaine? |
|
Definition
Benzodiazepines
Oxygen
Nitroglycerin |
|
|
Term
|
Definition
Ecstasy
an amphetamine analog
stimulant and hallucinogenic properties
causes serotonin release |
|
|
Term
|
Definition
| sedative hypnotic made of chloral hydrate |
|
|
Term
| What are some effects of opioids? |
|
Definition
miosis
bradycardia
hypothermia
decreased bowel signes
altered mental status
unresponsiveness |
|
|
Term
| What has potency 80 times that of morphine and causes less hypotension and less histamine release with chest wall rigidity? |
|
Definition
|
|
Term
| What is the opiod antidote? |
|
Definition
|
|
Term
| Who are at risk for delayed and prolonged toxicity from packet leak or rupture? |
|
Definition
|
|
Term
|
Definition
Whole Bowel Irrigation
mechanical flushing of the GI with polyethylene glycol |
|
|
Term
| Combinations of what case serotonin syndrome? |
|
Definition
| meperidine(demorol) or dextromethorophan with MAOIs may prodeuce serotonin syndrome because they exert effects on serotonin receptors |
|
|
Term
| What are symptoms of serotonin syndrome? |
|
Definition
| muscle rigidity, hyperthermia, and AMS |
|
|
Term
| What are the active metabolites of caffeine? |
|
Definition
| theophylline and theobromine |
|
|
Term
| Why does the heart pound after a significant dose of caffeine? |
|
Definition
| caffeine's blockade of A1 adenosine receptors in the heart |
|
|
Term
| What is the molecular mechanism of caffeine? |
|
Definition
| increase in the extracellular concentration of dopamine in the nucleus accumbens |
|
|
Term
| What is the pathway for caffeine? |
|
Definition
| antagonist of adenosine (A2A) > decreases adenylyl cyclase activity > decreases cyclic AMP > decreases protein kinase A > positive feedback causes increase in DARPP > increase in DA levels |
|
|
Term
| What increases theophylline metabolism? |
|
Definition
| smokers, phenytoin, pheobarbital, rifampin, atkins diet |
|
|
Term
| What are some effects of Methylxanthine toxicity? |
|
Definition
| N/V, gastritis, increasing pepsin and gastric acid, rhabdomyolysis, tremor myoclonis, hypokalemia, hyperglycemia |
|
|
Term
| What is an important methylxanthine toxicity point? |
|
Definition
| caffeine penetrates CNS better than Theophylline and theobromine so it promotes seizures |
|
|
Term
What is absinthe derived from?
What is the toxic component that the FDA measures levels of? |
|
Definition
Artemisia absinthium
wormwood
Thujone |
|
|
Term
| What are the effects of Peyote Lophophora Cactaceae? |
|
Definition
contains mescaline
psychedlic, kaleidoscopic colors, hallucinations, distorted perception of time |
|
|
Term
| What is a brand of neutral grain spirit that is available in concentrations of 75% and 95% alcohol? |
|
Definition
|
|
Term
| What is the leading cause of morbidity and mortalitiy in the US? |
|
Definition
|
|
Term
| What is Ginseng Abuse Syndrome? |
|
Definition
| long term use of ginseng causes hypertension, insomnia, anxiety, and morning diarrhea |
|
|
Term
| where do you find mepherdrone and methylenedioxypryrovalerone (MDPV)? |
|
Definition
bath salts
they inhibit DA and NE reuptake and have cocaine-typ and amphetamine-like effects |
|
|
Term
| Which drug has atropine and alkaloid as active ingrediants, hallucinogenic, and gives feeling of flying? |
|
Definition
|
|
Term
| Which flower has similar effects to LSD when taken in the hundreds? |
|
Definition
|
|
Term
| What is a potent k-opiod receptor agonist and may have potential as an analgesic or therapeutic tool for drug addictions? |
|
Definition
|
|
Term
What has a stregnth between caffeine and amphetamine?
What is the most potent compound? |
|
Definition
|
|
Term
| What is a legal stimulant that is structurally and pharmacologically similar to amphetamine? |
|
Definition
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