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CNS DEPRESSANTS

CNS DEPRESSANTS. CLASSIFICATION . ETHYL ALCOHOL GENERAL ANAESTHETICS OPIOID ANALGESICS SEDATIVE HYPNOTICS. ALCOHOL . INEBRIANT POISONS PRODUCE INTOXICATION THAT IS Light headedness Confusion Disorientation Drowsiness.

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CNS DEPRESSANTS

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  1. CNS DEPRESSANTS

  2. CLASSIFICATION • ETHYL ALCOHOL • GENERAL ANAESTHETICS • OPIOID ANALGESICS • SEDATIVE HYPNOTICS

  3. ALCOHOL • INEBRIANT POISONS PRODUCE INTOXICATION • THAT IS • Light headedness • Confusion • Disorientation • Drowsiness

  4. In most case there is recovery after prolonged sleep, with some after-effects(hangover) • Consisting of • Headache • Irritability • Lethargy • Nausea • Abdominal discomfort

  5. Alcohol-Ethyl alcohol • Transparent • Colorless • Volatile liquid • Spirituous odor • Burning taste

  6. Absolute alcohol contains 99.95% • Rectified spirit -90% • Denatured alcohol • Alcohol95% • Wood naphtha 5%

  7. Ethanol • sugar +yeast=ethanol by fermentation process • Process stops when 15% alcohol is formed as yeast is destroyed

  8. Alcoholic beverages • Are mixture of alcohol+water+small amount of congeners which are produced in fermentation • Flavour is due to congeners • Propyl alcohol • Octyl alcohol • Glycerine • Aldehydes

  9. Dimethyl and diethyl esters • Acids from acetic to linoleic,ketones,trimethylamine,allylmercaptan etc. • Total content of congeners rarely exceeds half%

  10. Odour may persist in tissues for several hours after all alcohol is metabolised Proof spirit-is one which at 10.5 degree celisus weighs exactly 12/13 part of equal measure of distilled water Under proof –weaker spirits Over proof – stronger spirits

  11. Proof is defined as twice the % of alcohol content of the drink • Expressed in units • 1 unit=8g of alcohol

  12. Alcohol content in beverages • Vodka:60 to 65% • Rum,liquors:50 to 60% • Whisky.gin,brandy:40 to 45% • port,sherry:20% • Wine ,champagne:10 to 15% • Beers:4 to 8%

  13. Vodka:60 to 65%

  14. Rum,liquors:50 to 60%

  15. Brandy40 to 45% of alcohol

  16. Beers:4 to 8%

  17. Whisky.gin,brandy:40 to 45%

  18. Safe limit of drinking to avoid liver damage • Men=210g/per week • Women=140g/per week

  19. Arrack • It is a liquor distilled from palm,rice,sugaror jaggery,etc. • 40 to 50% of alcohol • For kick-is mixed with chloral hydrate and potassium bromide.

  20. Absorption • Requires no digestion prior to absorption • Mouth & oesophagus-small amount absorbed • Stomach & small intestine- immediately 20% 80%

  21. 10 to 20% is prevent absorption by consumption of food with alcohol. • Warm alcoholic drinks- absorbed fast as they dilated the gastric capillaries. • Achloryhydria or chronic gastritis have slower absorption rates. • 10 to 20% conc of alcohol absorbed rapid

  22. Dil.alcohol- empty stomach -30 to 60mins -60% • 90% in 60 to 90 mins • Whisky and beer – in blood in just 2 to 3 mins after few sips • Max.conc in blood reached within 45 to 90 mins • Majority in 1 hour

  23. Carbonated drinks hastens absorption as the bubbles greatly increases the surface area carrying alcohol. • Food delays its absorption • Fats and protein delay more nearly for hours • Mixed meal depress max.conc in blood alcohol by half hour

  24. Lower and higher concentration absorbed quickly • Beer takes longer absorption time than stronger drinks .

  25. Drinks containing more than 40% of alcohol care absorbed more slowly • Due to 1.Pyloric spasm 2.Irritation of gastric mucosa and secretion of mucosa 3.Reduced gastric motility.

  26. Habituated drinkers absorb alcohol more rapidly than abstainers,probably due to more rapid emptying time of the stomach and thus the rate of absorption . • Drugs like benzine and atropine may slow the rate of absorption of alcohol by retarding the emptying time of stomach.

  27. Alcohol is absorbed rapidly in gastrectomy. • Conc of alcohol in air is high irritation and breathing difficulty • 60% of alcohol inhaled can be absorbed into systemic circulation. • Skin poor absorbent of alcohol

  28. Distribution • Some lost by diffusion into alveolar air as arterial blood passes through the lungs. • In arterial blood the alcohol concentration is less due to passage through the capillary network

  29. Adipose tissue –ethanol is insoulble in fat. • Red cells contains less alcohol then plasma. • Plasma level of alcohol is high • Serum level of alcohol is high • A given intake of alcohol will prouce high level of alcohol in obese people then lean of same weight due to the aqueous compartment is smaller

  30. Ethanol passes through blood brain barrier and baths neuron via the cerebral extracelluar fluid. • In females the con is higher due to small aqueous compartment

  31. Excretion • 5% ingested alcohol excreted via breath • 5% in urine • Negligible amount are excreted in the sweat,saliva,milk ,tears and faeces. • Odour is due to excretion via skin glands.

  32. Metabolism 90% of alcohol absorbed in oxidised in liver 10% is excreted liver

  33. Acetate is oxidised into co2 and water in krebs cycle • Diabetic who is ketogenic will produce fat from alcohol , because he cannot use the sugar. • Enzymes can be increased by regulary use of alcoholic beverages and alcohol decrease may be doubled

  34. OXIDATION • Alcohol is not stored in tissues • Disappears from blood fairly uniform rate of about 10 to 15ml per hour • This is equivalent of about 15mg 100ml • Larger doses are lost faster. • Chronic alcoholics are able to metabolise alcohol faster -40 to 50 mg/100ml /hr

  35. BECAUSE DUE TO INCREASE IN LIVER ENZYME • THUS THEY DEVELOP LIVER DAMAGE. • Later due to liver damage alcohol metabolism is depressed. • Due to which the remain intoxicated for hours after a few drinks. • 10% of alcohol which is metabolised is deposited in tissues as lipids in form of neytral fat and cholesterol.

  36. ACTION • Traces of ethyl alcohol are found in all persons. • Endogenous alcohol • Normal metabolism • Bacterial activity in git

  37. Well –known stimulant • Selective depressantespecially of higher nervous centres which it inhibits. • Ethanol depress reticular activating system • Frontal lobes –sensitive to low concentration(mood changes) • Followed by occipital lobe (visual disturbances)

  38. Cerebellum – loss of coordination • Lower concentration-depression of more specialised and sensitive cells of cerebral cortex(centres regulating conduct,judgement,self criticism)

  39. Increasing concentration –depresses more brain function. • Finally vital centres in mid brain and medulla are depressed – death from cardio –respiratory failure.

  40. Causes generalisedvasodialation ,especially in skin. • Not true aphrodisiac • Hynotic and diaphorectic • Creates sensation of warmth ,but increases heat loss • Low concentration –heart rate increased • More than 300mg % -bradycardia

  41. Moderate –stimulates appetite as it promotes salivation and secretion of gastric juice • Stronger beverages the reverse action • Little brandy –carminative action • Diuresis occurs secondary to inhibition of ADH Release from posterior pituitary.

  42. Spiritous liquors on emptying the stomach can cause severe ,even haemorrhagic gastritis. • It has toxic effect on almost every organ system. • Due to effect of metabolite acetaldehyde or to redox potential of cells but the mechanism is not known clearly

  43. All the neuro transmitter system are affected ,no specific receptors

  44. It has synergistic effect with other sedative-hypnotic agents. • 15 to 30g /day consumption increases the concentration of hdl and decreases ldl. • It has favourable effects on haemostatic factors such plasma fibrinogen ,fibrinolytic activity and platelet adhesiveness.

  45. MIXING OF DRINKS-greater intoxication Than the amount consumed. Due to presence or formation of substances which affect the rate of emptying of stomach,with more rapid absorption of alcohol.

  46. Roman saying “IN VINO VERITAS” which means “IN WINE THERE IS TRUTH” • The real personality of individual often will be revealed when he is intoxicated.

  47. Cause of death • Direct depressive effects upon brain stem mediated via the respiratory centre • Aspiration of vomit • Death due to acute overdoses not common • Chronic effects of alcohol are common.

  48. 3 phases • There are three phases of intoxication • Stage of excitement • Stage of incoordination • Stage of coma

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