1
Q
Cocaine is a CNS ____
A
stimulant
2
Q
Where does cocaine come from?
A
- natural alkaloid from the leaves of Erythroxylon coca
- leaves are dried and converted to coca paste and used to produce cocaine HCl
- used by the Incas in religious ceremonies
3
Q
What was cocaine initially marketed as?
A
- marketed as a tonic and headache remedy in 1885 (coca cola)
- there was 0.25mg/mL cocaine in coca cola
- removed this in 1993
4
Q
What did Freud promote cocaine for the treatment of?
A
-asthma, wasting diseases, and syphilis
5
Q
What are some forms of cocaine?
A
- HCl salt
- crack (free base form) - gets it’s name from the sound made when it is smoked
- crack is only smoked (not snorted or injected)
- crack has a lower melting point than cocaine
6
Q
What are some street names for cocaine?
A
-coke
-crack
-blow
-flake
-dust
-snow
etc.
7
Q
What are methods of ingestion for cocaine?
A
- IV
- smoking
- snorting
- oral (rare due to 1st pass effect)
- topically
8
Q
Who is at the bottle of drug-user hierarchy?
A
needle users are at the bottom
9
Q
What is free-basing of cocaine?
A
- when you take cocaine Hal and add water and a base
- involves an extraction
- add ether
- shake it and mix in separators funnel
- cocaine goes into ether layer, pull that off and evaporate it
- then you have free cocaine base which you can smoke
- ether is flammable tho so there was lots of explosions, fires, and deaths from this
10
Q
What are the desired effects of cocaine?
A
- intense euphoria
- decreased anxiety
- decreased social inhibitions
- increased alertness and mental clarity
- increased performance in simple tasks
- increased self-confidence
11
Q
onset, peak and duration for cocaine that is smoked
A
onset: 7 seconds
peak: 1-5 min
duration: 20 min
12
Q
onset, peak and duration for cocaine that is oral
A
onset: 10 min
peak: 60 min
duration: 60 min
13
Q
duration of cocaine that is snorted
A
up to 90 min
14
Q
what are other side effects of cocaine
A
- increase BP and temperature
- dilated pupils (mydriasis) - “bunny eyes”
- sensitivity to light
- rapid speech
- nausea/vomiting
15
Q
What can happen with higher doses and chronic use of cocaine?
A
- dysphoria
- fatigue
- confusion
- disoriented behaviour
- delusions
- paranoia
- antisocial
- aggresive
16
Q
List the 3 phases of cocaine withdrawal
A
1) The Crash Phase
2) The Withdrawal phase
3) Extinction Phase
17
Q
Describe 1) The crash phase
A
- lasts up to 4 days
- agitation, depression, irritability
- intense cravings for cocaine!
- fatigue
18
Q
Describe 2) The withdrawal phase
A
- lasts up to 10 weeks
- increased anxiety
- lack of energy
- variable cravings
- angry outbursts
19
Q
Describe 3) The extinction phase
A
- can last for an indeterminable amount of time
- episodic cravings for the drug
20
Q
What is cocaine-induced excited delirium?
A
- associated with chronic high-dose use of cocaine
- dissociative state
- violence
- exaggerated strength
- increased body temp
- cardio-respiratory arrest
- rhabdomyolysis
- sudden death
21
Q
Cocaine:
does tolerance develop?
A
yes - you need more of the drug to get the same effect
22
Q
Cocaine:
what types of dependence develops?
A
- psychological dependence develops
- physiological (although not all agree)
23
Q
What is psychological dependence?
A
you have cravings
24
Q
What is physiological dependence?
A
can’t function without (i.e. withdrawal)
25
What are some interpretation challenges in analysis of cocaine?
- enzymes in blood breakdown cocaine
| - some people use cocaine + ethanol (stimulant + depressant) which makes cocaethylene
26
Why use a stimulant and a depressant together?
- get a better high
- depends on when they take it
- the depressant makes the crash not as severe
27
What is methamphetamine?
- a powerful and highly addictive CNS stimulant
| - amphetamine derivative
28
What has meth been used for in the past?
- tx of narcolepsy, depression
| - diet pill
29
What is a key precursor for meth?
-pseudoephedrine or ephedrine (OTC decongestant man)
30
How much pseudoephedrine to make 1 oz of meth?
30 grams
31
What are some other ingredients in meth production?
- starter fluid
- acetone
- drain cleaner
- lithium batteries
- paint thinner
32
For every 1 gram of meth produced, ____ waste is produced
5-6 grams
33
How much pseudoephedrine is allowed to be bought at one time?
3600mg (60 x 60mg tabs)
*effective Jan 2006
34
List and describe the 3 methods of meth production
1) P2P method (phenyl-2-propanone)
- takes a long time, not popular
2) Ephedrine or pseudoephedrine reduction
- more popular, easy to produce, gives a better yield
- contains red phosphorus (scrape match striker plates to get red phosphorus)
- need iodine
3) Nazi or Birch method
- lithium batteries, ether, anhydrous ammonia
- good yield, high quality
35
street names for meth?
- speed
- ice
- crank
- crystal
36
methods of ingestion for meth?
can be snorted, smoked, injected or swallowed
37
desired effects of meth
- euphoria
- increased alertness and mental clarity
- increased sense of well being
- increased energy and confidence
38
onset and duration of meth??
onset: within seconds if smoked or injected
duration: 4-12 hours
39
what are some side effects of meth
- tremors
- insomnia
- mental confusion
- irritable, confused
- hyperthermia
*picture someone who had lots of caffeine x 100
40
What happens once effects of meth subside?
user usually experiences extreme fatigue leading to prolonged and disturbed sleep - which can lead to depression
41
Meth:
| Tolerance?
yes - develops quickly
42
Meth:
| What types of dependence?
both psychological and physiological
43
What isomer of meth is more pharmacologically active, more addictive, and more toxic?
'd' isomer !!!!
```
D = dextro
L = levo
```
44
What contains the L form of methamphetamine?
Vix inhalers
45
When you identify the presence of meth in the lab, you don't know if it's D or L
!!!! okay so further testing is needed to determine that
46
What is MDMA also known as?
ecstasy
47
Describe what ecstasy or MDMA is
- classified as hallucinogenic amine
- "designer drug"
- first synthesized as appetite suppressant, adjunct to psychotherapy
- mainly used for recreational use now (ex. raves)
48
Street names for MDMA
- ecstasy
- Adam
- E
- love drug
- hug drug
- XTC
49
Methods of ingestion for MDMA
- oral - most common (tablets, capsules, mixed with liquid)
- snorted
- smoked
- injected (rare)
50
What is a 253 A charge?
impairment (with any level or no alcohol if drugs are involved)
51
What is a 253 B charge?
greater than or equal to 80mg% BAC
52
desired effects of MDMA
- euphoria
- increased sense of well being
- increased energy and self confidence
- instensification of feelings
- overwhelming desire to communicate
- profound empathy
53
onset and duration of MDMA
onset: 30-45 min if swallowed
duration: 4-6 hours
54
other side effects of MDMA
- feelings of panic
- depression
- mental confusion
- anxiety
55
Describe symptoms of toxicity of MDMA
- increased HR
- sweating
- muscle tension and cramping
- dry mouth
- teeth grinding (brusixm happens with stimulants) - people wear SOOTHERS
- blurred vision
- nausea/dizziness
56
symptoms of MDMA overdose
- convulsions
- hyperthermia
- behavioural changes
- rhabdomyolysis
- intravascular coagulation
- acute renal failure
57
MDMA:
| tolerance?
yes
58
MDMA:
| what types of dependence?
only psychological dependence devlops
Year 4 - Toxicology
flashcards
Decks in class (24)
# Cards
-
Lecture 1 - Toxicology & Biotransformation89
-
Lecture 2 - General Management Principles & Toxidromes29
-
Lecture 3 - General Methods for Treatment of ODs80
-
Lecture 4 - Acid/Base Abnormalities56
-
Lecture 5 - Acetaminophen38
-
Lecture 6 - Iron65
-
Lecture 7 - Salicylates40
-
Lecture 8 - Antivirals82
-
Lecture 9 - Antineoplastic Agents103
-
Lecture 10 - Antidepressants49
-
Lecture 10 - Benzos39
-
Lecture 11 - Cardiac Glycosides44
-
Lecture 12 - Alcohols82
-
Lecture 13 - Drug Abuse & Addiction62
-
Forensic Overview52
-
Forensic 158
-
Forensic 233
-
Forensic 364
-
Lecture 19 - Poisons42
-
Lecture 20 - DIHD61
-
Lecture 20 - Eye & Ear Toxicity59
-
Kidney55
-
Liver62
-
Skin41
