Psychoactive Drugs: pharmacology, intoxication, withdrawal, and treatment
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- Опубліковано 17 лип 2024
- This is a brief video on psychoactive drugs, including the pharmacology of these drugs, intoxication symptoms, withdrawal symptoms, and relevant treatments.
Errata: error at 3:27; misspoke, should have said "agonize" not "antagonize"; proper word listed on slide.
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ADDITIONAL TAGS:
Anti addiction medications
1. cocaine
2. crack cocaine
3. methylphenidate (Ritalin)
4. ephedrine
5. MDMA (Ecstasy)
6. mescaline (cactus)
7. LSD blotter
8. psilocybin mushroom (Psilocybe cubensis)
9. Salvia divinorum
10. diphenhydramine (Benadryl)
11. Amanita muscaria mushroom
12. Tylenol 3 (contains codeine)
13. codeine with muscle relaxant
14. pipe tobacco
15. bupropion (Zyban)
16. cannabis
17. hashish
Depressants / sedatives
Alcohol, barbiturates, benzodiazepines
MoA: enhancement of GABA receptor
Intoxication: incoordination, ataxia, slurred speech, euphoria, nystagmus, attention impairment, behavior inhibition, coma, blackouts, AST = 2*ALT
Hypotension, respiratory depression → benzos and barbs
Treatment: flumazenil for benzo OD, supportive for others
Withdrawal: hallucinations, seizures, hypertension, nausea, sweating, insomnia, anxiety, agitation, tremors
Muscle cramps, twitches, tachycardia → benzos and barbs
Delirium tremens (2-4 days after last drink)→ fluctuating consciousness, high HR, seizures, tremors, anxiety
Treatment: benzodiazepines
Can be fatal
Opioids
Heroin, prescription pain meds (oxycodone, hydrocodone, etc)
MoA: agonize opioid receptor, especially mu subtype
Intoxication: motor slowness, slurred speech, euphoria, impaired attention and sedation, miosis, respiratory depression
Treatment: naloxone, naltrexone (opioid antagonists)
Withdrawal: depression/anxiety, diarrhea, cramps, sweating, piloerection, pupillary dilation, yawning, muscle aches
Treatment: supportive for pain and GI distress; methadone and buprenorphine (weaker agonists) can help
Not fatal
Heroin and oxycodone are most widely abused opioids → responsible for many deaths
Depressants / sedatives
Opioids
Stimulants
Cannabinoids (marijuana)
Hallucinogens (LSD)
Dissociatives (PCP)
Anti addiction medications
Stimulants
Cocaine, amphetamines, methamphetamines, MDMA (ecstasy), cathinone (bath salts), caffeine, nicotine
MoA:
Cocaine → block norepi and DA reuptake
Amphetamine → increase synaptic [norepi] and [DA]
Nicotine → agonize PNS/CNS cholinergic receptors
Caffeine → enhance DA effect by blocking ADO receptors
Intoxication:
Amphetamines → behavioral (grandiose, euphoric, hypervigilant, paranoia, agitation); autonomic (inc BP/HR, chills, sweating, n/v)
Cocaine → add hallucinations of bugs on skin
Treatment: lorazepam (anxiety); haloperidol (psychosis); vitals
Withdrawal:
Amphetamines/cocaine → appetite, low HR, depression, fatigue
Nicotineappetite, low HR, dysphoria, anxiety, irritability
Caffeine mild dysphoria, headaches, anxiety
Treatment: supportive
Cannabinoids
Marijuana, hashish, synthetic blends (e.g., K2, spice)
MoA: delta-5-tetrahydrocannabinol (THC) binds to cannabinoid receptor, which inhibits adenylate cyclase and cAMP production
Intoxication: conjunctivitis, dry mouth, high BP/HR, appetite, euphoria, hallucinations at high doses, agitation
Treatment: lorazepam for agitation
Withdrawal: irritability, agitation, insomnia, nausea
Treatment: supportive
Unnecessary because not fatal
Social implications: maybe amotivational syndrome, gateway drug
Physiological changes: low testosterone in men, decreased ovulation in females, low birth weights in neonates, increased neonatal malformations
Medical form (dronabinol) used as supportive addition to with chemo (antiemetic) or AIDS treatment (stimulate appetite)
Hallucinogens
LSD (acid), psilocybin (shrooms), mescaline (peyote)
MoA: LSD activates serotonin receptors in the limbic system, neocortex, and brainstem
Intoxication: hallucinations, delusions, mydriasis, tachycardia, sweating, ataxia, tremor
Euphoria, paranoia → psilocybin
Psychosis, flashbacks → LSD
Treatment: lorazepam for agitation, haloperidol for psychosis
Withdrawal: none
Dissociatives
PCP, ketamine
MoA: both PCP and ketamine block glutamate NMDA receptors
Ketamine is used as an anesthetic (NMDA antagonist)
Intoxication: dissociation, hallucinations, impulsivity, analgesia, often violent behavior, high BP/HR, miosis, nystagmus, delusions, seizures
Benzodiazepines and antipsychotics → PCP
Monitor for serotonin syndrome and rhabdomyolysis
Alcohol addiction
Disulfiram (blocks aldehyde dehydrogenase)
Acamprosate (analog of GABA, NMDA receptor antagonist)
Naltrexone (opioid antagonist)
Endogenous opioid pathways play a key role in pathway that leads to reinforcement for alcohol addiction
Opioid addiction
Naltrexone (opioid antagonist)
Buprenorphine/naltrexone
I just want to thank you for posting your lectures, they are perfectly sensible, and informative. The breakdown is greatly appreciated. Thank you.
THANK YOU IT WAS VERY WELL EXPLAINED
Very good video!
At around 3:30 when discussing opioids you said 'antagonize' instead of agonize, otherwise solid information.
either a drug is an agonist at the receptor or an antagonist at the receptor , those words are more precise
If you are looking for a discreet online dealer that you can be very comfortable with, check out @myconuel profile on Instagram this profile is a well organized group of mycologists and researchers how post updates on their psilocybin research and growth of different strains, they also move and sell other psychedelic products like, Dmt, lsd, mdma, etc... discreetly, unnoticed and safe with a well planned out logistics system very discreet and fast to any location. You can trust them they got every legal matters covered. Inbox the profile on Instagram @myconuel.
T YIA you just helped me pass my Pharm quiz
You failed to mention about Methadone in treating opioid addiction and also I only know naltrexone and naloxone as a treatment in opioid intoxication, not as a treatment for addiction. Sorry for my bad English.
Marijuana withdrawal also includes anxiety and loss of appetite. Most drugs will show the rebound effect in withdrawals. If it causes one set of symptoms while intoxicated the withdrawals will likely be the opposite. Also, I know this is focusing on the medical aspect, but shouldn't treatment for all of these include a substance abuse treatment referral? Or are we always going to use drugs to fix drug problems? Just a few thoughts...
I smoked cannabis all day long for over 17 years and quit cold Turkey. I switch over to CBD, which is still essentially cannabis but without thc, and had no withdrawal, slept fine and no mood swings. Then quit CBD and was fine.
Other times I tried to quit without CBD it was super hard and I couldn't sleep or eat for a while and I was a mental wreck.
So there is a easy way to quit Cannabis, you just need to be smart about it. I still smoke sometimes but I'm not crazy addicted like I was before and I can go days without thinking about it.
Cbd also takes away the anxiety and bad side effects from using strong Cannabis. The herb these days is really unbalanced with a thc to CBD ratio of like 30:0, which is a recipe for bad side effects. Using cannabis these days is a art form. Find your art.
It is not buprenorphine and naltrexone, it is naloxone with is suboxone (the sublingual you are speaking of)
Methadone actually has a stronger "efficiency" then morphine and maybe heroine (well not actually diamorphine itself because it's basicly inactive but it's main metabolite 6-mam potency wise is about 2.8 - 4 times that of morphine but that doesn't mean it has a higher efficiency over morph but it pobably does, dia also has a stronger dopamine release over morph, I'm wondering if it could actually have less physicals withdraws then morphine in equivalent analgesic dosages because it distributes mostly to the cns so there would be less opioids binding to receptors that probably would only create mor side effects
A pretty good video, although there are a few mistakes. For instance, buprenorphine/naltrexone is not the correct drug combination under anti-addiction medications- It's Buprenorphine/Naloxone, AKA Suboxone.
Its the same active principle, just different administration methods
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Marijuana intoxication doesn't cause conjunctivitis (inflammation), but rather conjunctival vessel injection (dilation).
katzung
Pcp and spice are exactly the same just spice way more intense and the effect is exactly the same only people how have been through the addictions are the only experts a lot of this info is incorrect
Interesting, I did not know this. After seeing your comment, I did some research. Although PCP and spice do have different chemical makeups it does not seem as though they are extremely different. I would imagine either one could be marketed as the other? They both act on the cannabinoid receptors in the brain. It is noted that if one uses marijuana and PCP (likely spice as well), they are more likely to experience a psychotic break. Thank you for your comment. I learned something new today.
P.S. I hope you have found healthy ways to cope with addiction. I too have been through addictions and am proud to be 14 yrs sober from hard drugs :). I still have an addictive personality, have accepted that part of me, and constantly work on improving myself.
@@kyleolin3566 good man stay clean iv been clean off spice for 7 years
Sab s sasta nasha = water
huh? nah jk good vid
Diareaaaahhh...
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