1 / 99

Understanding Sedatives and Hallucinogens in Drug Abuse

Explore the effects and dangers of sedatives/hypnotics like benzodiazepines and barbiturates, as well as hallucinogens such as LSD and psilocybin. Learn about the mechanisms of action, metabolism, complications, overdose signs, and detoxification methods. Discover the risks associated with date rape drugs like Rohypnol and GHB. Stay informed about these drugs of abuse to prevent misuse and addiction.

eduardol
Download Presentation

Understanding Sedatives and Hallucinogens in Drug Abuse

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. بنام خداوند بخشنده مهربان

  2. The Drugs of Abuse "Drug-Use Is Life Abuse"

  3. The Drugs of Abuse • 1. Sedatives / Hypnotics • 2. Hallucinogens • 3. PCP (Phencyclidine) • 4. Anabolic Steroids • 5. Inhalants • 6. Opioid • 7. Alcohols

  4. The Drugs of Abuse • 1. Sedatives / Hypnotics

  5. High Potency / Short Acting Most Addiction Sympt. / Severity -Alperazolam -Lorazepam -triazolm Low Potency / Short Acting Good Temporary Sleepers for Hosp. Patients. -Serax -Temazepam 1. Benzodiazepines

  6. High Potency / Long Acting Substitute for Short Acting in Withdrawal -Prosom -Klonepin Low Potency / Long Acting Addiction In High Doses -Valium -Librium -Tranxene Benzodiazepines

  7. 2. Barbiturates • Short Acting (Highly Lipid Sol.) -Pentobarbital (Yellows) -Secobarbital (Reds) -Amobarbital (Blues) • Long Acting -Phenobarbital -Substitute for Short In Tx.

  8. Benzodiazepines Equiv. Doses • Alprazolam (Xanax) 1mg • Triazolam (Halcion) 0.25mg • Temazepam (Restoril) 15mg • Lorazepam (Ativan) 2mg • Diazepam (Valium) 10mg • Phenobarbital 30mg

  9. MOA • GABA Receptor CNS Inhibition --Benzos Potentiate GABA --Barbs Potentiate + Agonists • Respiratory Depression --Benzos + Other CNS Depressants --Barbs Alone • Both With Anticonvulsant Activity

  10. CNS Inhibition • With Dose: 1. Decreased Anxiety 2. Sedation 3. Amnesia 4. Hypnosis 5. Anesthesia 6. Reduced Reflexes / Respiration 7. Death

  11. Metabolism • Benzodiazepines by Liver Microsomal Enzymes, Metabolites May Be Active Extending Half-life. • Barbiturates by Cytochrome P450 Enzymes, Commonly Induced With Resulting Breakdown of Alcohol , Steroids, Fat Soluble Vitamins, and Anticoagulants.

  12. Discontinuation. • Return: Of Original Symptoms • Rebound: Intense Orig. Symptoms • Withdrawal: (Long Use, High Dose) -Anxiety, Panic -Paranoia, Hallucinations -Tremor, Seizures, Delirium -Depression, Irritability, N&V

  13. Withdrawal Timing • Short Acting Barbs --Onset 1/2 Day --Peak 1-3 Days • Short Acting Benzos --Onset 1 Day --Peak 2-4 Days • Long Acting Barbs / Benzos --Onset 2 Days --Peak 5-8 Days

  14. Complications • Benzodiazepines -Memory Loss, Amnesia -Ataxia, Incoordination, Vertigo -Diplopia, Dizziness -Impairment in Driving -Depression, Suicidal Ideation • Relatively Contraindicated in Addiction

  15. Overdose • Signs & Symptoms: --Slurred Speech, Staggering --Nystagmus, Slow Reaction --Respiratory Depression • Barbiturates: 3-10 Mg / Dl • Benzodiazepines: 1-2 Gm or More --Less With Alcohol !!!

  16. Benzo OD Treatment • Flumazenil --Benzo Antagonist --0.2 Mg, Then 0.3 Mg, Then 0.5 Mg, IV, Max 3.0mg --May Precipitate Withdrawal • Supportive Measures --Airway Management, Etc.

  17. Detoxification • Gradual Dose Tapering Over Several Days to Weeks • Substitution of Long Acting Form: --Phenobarbital --Use Equivalent Dose and Taper by 30 Mg or 10% Per Day. (Max. 500mg / D)

  18. Detoxification-examples • Drug Daily dose PB dose Valium 40mg 30mg/10mg = 120mg Ativan 10mg 30mg/2mg = 150mg • PB is then tapered 10% / d X 10 d • Xanax requires slower tapering

  19. “Date Rape Drugs”Rohypnol & GHB Classified as depressants

  20. Rohypnol: Flunitrazepam • Benzodiazepine • Indirect GABA agonist • alcohol synergism • p.o. & intranasal administration • Dissolves easily in carbonated drinks • tasteless • odorless • Associated with sexual assaults

  21. Rohypnol: Flunitrazepam • Effects same as any benzodiazepine • feeling of well-being • lowered inhibitions • impaired judgment • Unique to Rohypnol • visual disturbances • no memory for period of intoxification(block any memory)

  22. GHB: Gamma-hydroxybutyrate • Homemade CNS depressant • “Grievous Bodily Harm” • GABA agonist • precursor • synergism with alcohol • Clear liquid, powder, tablet, capsule

  23. GHB: Gamma-hydroxybutyrate • Effects similar to benzodiazepines and barbiturates • Also • loss of consciousness • loss of reflexes • seizures, coma, death • Associated with sexual assault ~

  24. The Drugs of Abuse 2. Hallucinogens

  25. Hallucinogens • Alter Mood, Perception, Thinking. • Induce Delusions • Hallucinations Occur Infrequently 1. LSD 2. Psilocybin 3. Mescaline 4. MDMA 5.Marijuana

  26. MOA of Hallucinogens • LSD, Psilocybin, Mescaline: • Bind to Post-Synaptic Serotonin- 5-Hydroxy Tryptamine, (5-HT) Receptors • 5HT Agonists • Rapid Tolerance From Down Regulation of Receptors Occurs

  27. Lysergic Acid Diethylamide

  28. General specifications: • Very powerful hallocinogen • Alkaloied derivatives from (Psilocybe mexicana) • German word (Lyser Saure Diethylamide) • Ingestion( rote of misuse)

  29. At 10-30 Min. -Laugh / Cry -Euphoria -Paranoia -Impair Think. -Panic Attack -Tachycardia -Elev. BP -Tremors At 2-3 Hours -Hallucination -Synesthesia (Sounds Felt, Colors Heard) -Derealization -Distorted Time / Space -Blurring LSD Intoxication 8-12hr

  30. DDX of LSD Intoxication • Delirium, Dementia • Schizophrenia • Bipolar, Psychotic Disorders • Narcolepsy • Etoh, Marijuana, PCP Intoxication • Antiparkinsonian Drugs

  31. Lasting LSD Effects • Few Develop Florid Psychosis -A Pre-existing Disorder? • “Flashbacks” Occur in 16-57% -? CNS Pathology or Memory, Most Mild / Not Incapacitating • Physical Dependence and Withdrawal Do Not Occur

  32. Treatment LSD Overdose • “Bad Trip” --Quiet, Safe, Environment --Calm Supportive Friends --’Talk Down’ --Emphasize Effects Are From Drug and Temporary • Valium 10-20mg, Ativan 1-2mg

  33. MDMA (ecstasy)

  34. ECSTASY • MDMA(3,4 ETHYLENEDIOXYMETHAMPHETAMINE) • ADAM • X-TC • X- pill • SEX- PILL • CLARITY • ESSENCE • STACY • LOVER’S SPEED • EVE

  35. MDMA Effects • By 5HT Activity: --Minimal Hallucinations --Locomotor Hyperactivity --Hyperthermia

  36. MOA of MDMA • Increased Levels of 5HT, Dopamine and Norepinephrine by: --Increased Presynaptic Release --Inhibited Reuptake --Increased Dopamine Synthesis --Decreased Breakdown by Monoamine Oxidase Inhibition

  37. MDMA Intoxication • 5HT Activation: --Empathy & Insight --Sexsuality --Euphoria --Energy --Self Esteem

  38. MDMA Intoxication • Sympathetic Activation: --Diaphoresis --Mydriasis --Tachycardia --Hypertension --Increased Psychomotor Drive

  39. MDMA Neuro. Complications • Confusion, Paranoia, Panic • Psychosis, Acute and Chronic • Seizures, Status Epilepticus • Destruction of Serotonin Neurons With Long Term Use

  40. MDMA CV. Complications • Hypertension • Dysrhythmias • Pulmonary Edema • Cardiogenic Shock • Cerebral Hemorrhage • Mesenteric Ischemia

  41. MDMA Complications • Hyperthermia (>108 F) • Muscle Spasm • Rhabdomyolysis • Acute Hepatic or Renal Failure • DIC • Death

  42. MDMA Treatment • A, B, C’s • Alpha Blockers (Phentolamine) NOT Beta Blockers For Hypertension • Benzodiazepines (Agitation, Seizure) • Rapid Cooling to 39 C (Tepid H2O) • IV Fluids w Bicarb. To Alk. Urine

  43. "Shoot for the moon.  Even if you miss it, you will land among the stars."

More Related