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Drugs of Abuse (CNS Depressant(Alcohol) (Treatment to aid abstinence…
Drugs of Abuse
CNS Depressant(Alcohol)
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Higher dose: Sedation, ataxia, amnesia
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Chronic Alcoholism causes chronic gastritis, irreversible neurological effects, peripheral neuropathy, impaired testicular steroid synthesis and fatty liver disease
Treatment for Acute Withdrawal: Long-acting benzodiazepines, Haloperidol, Parental thiamine
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Opiods
E.g- Heroin, Morphine, Codeine
Rush, brief, intense euphoria
Overdose leads to decreased consciousness, pinpoint pupils
Tolerance and dependence develops rapidly within 12-24 hours. Eventually the dose for intoxication approaches fatal dose
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Detoxification: Methadone is an opioid with a long half-life, Buprenorephine is a partial __ receptor agonist and Clonidine is an alpha 2 noradrenergic agonist
Nicotine
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The central nicotinic receptors are activated leading to increased arousal, appetite suppression and anxiolytic effects
The peripheral nicotinic receptors are also activated leading to increased blood pressure and smooth muscle contraction
Activation of the dopamine reward pathway is by cholinergic neurons which activate the nicotinic and muscarinic receptors on dopaminergic neurons in the VTA and by the activation of presynaptic nicotinic receptors on dopaminergic axon terminals
The nicotinic receptors undergo RECEPTOR DESENSITIZATION where they undergo rapid 'switch-off' after initial stimulation.
Treatment: Nicotine replacement therapy, Bupropion- Increases dopamine and noradrenaline pathways in CNS and Varenicline- Partial agonist at alpha-4-beta-2 subtype of acetylcholine receptors
Psychostimulants
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Withdrawal causes bradycardia, sleepiness, fatigue, dysphoria and anhedonia
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Methamphetamine is directly neurotoxic to dopamine neurones and causes high addiction and dependence. The treatment is cognitive-behavioural treatment
Benzodiazepines
Anxiolytic, hypontic, antiepilieptic
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Withdrawal causes rebound anxiety, insomnia and seizures
Cannabinoids
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Nabiximols is a mouth spray of cannabis extract licensed for neuropathic pain, spasticity, overactive bladder, multiple sclerosis
Hallucinogens
LSD(lysergic acid diethylamide) is an ergot alkaloid derivative with no toxic fatalities but fatal accidents and suicides
MDMA(ecstasy) is a stimulant and is hallucinogens causes increased sociability, sense of empathy and personal insight, confusion and visual hallucinations. Overdose causes hyperthermia, seizures, sub-arachnoid haemorrhages, liver and renal failure