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Physiological Complications (550-106) Final Exam/Project Matrix Directions: Complete the matrix on drug classifications. Consider drug classifications and drugs not addressed in the learning plans of the course this semester, but that are included in the chapters not covered in the textbook. Consider what sub-categories may exist within a drug classification, examples of drugs within the classification and/or sub-categories, the CNS and physiological effects of the drugs within the classification, withdrawal effects of drugs within the classification, treatment issues of significance, therapeutic uses for the drug, and whether the drugs cited are legal, illegal, prescription, or OTC. Accuracy in identifying sub-categories within the correct classification and identifying drugs that accurately reflect the sub-category and the correct classification is critical in this assessment activity. Drug Classifications SubCategories of Drugs within the Drug Classification Specific Drugs within the Drug Classification CNS and Physiologic al Effects Characteris tic of the Class of Drugs Withdrawa l Effects Characteris tic of the Class of Drugs Sedative/hypnotic s or CNS Depressants Benzodiazepines, Nonbenzodiazepines, Barbiturates Alprazolam (Xanax), Diazepam (Valium), Zolpidem (Ambien), Eszoplicone (Lunesta), Primidone (Mysoline), Mephobarbital (Mebaral ) Calming or drowsiness {sedation} The treatment from withdrawal involves withdrawing the agent slowly in order to avoid convulsions or other side effects. At times rehabilitation centers or hospitalizatio n may be necessary to aid in withdrawal. Sleep {pharma-cological hypnosis} Unconscious ness Coma Surgical anesthesia Fatal respiratory/c ardiovascular depression Narcotic Analgesics Endogenous opioid peptides, Opium endorphins, dynorphins, enkephalins, morphine, Analgesic Effect, Antitussive Effect, Mood Alteration Effect, Flu like symptoms such as diarrhea, nausea, vomiting, Treatme nt Issues Unique to the Class of Drugs The biggest risk during drug rehab is relapse Therapeu tic Uses Legal, Illegal, Prescription,OTC Anxiety, treatment of insomnia, pharmacological hypnosis Legal Prescription Analgesics are pain relievers. They are used to block mild Legal Prescription and Illegal CNS Stimulants alkaloids, Semisynthetic opioids, Fully synthetic opioids codeine, heroin, oxycodone, hydrocodone , or Demerol, methadone, fentanyl. Dysphoria, Euphoria, Gastrointesti nal Effect, Respiratory System Effect runny nose, abdominal pain, and goose bumps. Sweating, agitation, and dilated pupils may also be symptomatic during drug rehab. There may also be psychologica l symptoms such as depression and mental illness. Amphetamin es, Methylpheni date Biphetamine, Dexedrine, Adderall, Concerta, Ritalin diet aids and as vasoconst rictors The withdrawal effects of all stimulants are almost mirror opposites of the acute effects. Thus, someone who has been using stimulants and stops will experience irritability, weakness, marked reduction in energy, hypersomnia , depression, loss of concentratio n, and increased appetite. These that could lead to death. Once an addict has gone through rehab, their tolerance to the drug is greatly reduced. Death may follow a return to analgesic drug abuse since the body is no longer used to the drugs. It is important to get involved in support groups to keep from returning to abuse of prescriptio n or street drugs. to severe pain signals sent throughout the nervous system to the brain. Central nervous system (CNS) stimulants are medicines that speed up physical and mental processes. Central nervous system stimulants are used to treat conditions characteriz ed by lack of adrenergic stimulation, including n arcolepsy a Legal Prescription symptoms are more severe in those who have taken higher doses over longer periods. They usually disappear within 2 to 3 days, but sometimes last for a week or more. Hallucinogens Antidepressants Selective serotonin reuptake inhibitors, Norepinephrine reuptake inhibitors, Noradrenergic and specific serotonergic antidepressant s (NaSSA), Serotonin– norepinephrine reuptake LSD, Mushrooms Mescaline, Ketamine Psychosis, panic attacks and dangerous accidents Citalopram ( Celexa), Escitalopram (Lexapro, Cipralex), Paroxetine (P axil, Seroxat), Fluoxetine (P rozac), Fluvoxamine (Luvox), Sertraline (Zo loft, Lustral), Atomoxetine (Strattera), Many off- label drugs can produce an antidepre ssant effect, but their use is controversial. Opioids wer e used to treat major depression until the late 1950s.Amph etamines wer e used until the mid1960s.Scant research on the use of opioids limit their use for the treatment of nd neonatal ap nea. cravings for hallucinoge ns fatigue irritability reduced ability to experience pleasure People who are psycholog ically dependen t on hallucinog ens may find they feel an urge to use it when they are in specific surroundi ngs or socialising with friends. There is a small risk of physical dependen ce from hallucinog ens. Anesthet ics Illegal and prescription Irritability Wrong drug for the person prescrib ed treat other conditions, on- or offlabel, for conditions such as anxiety disorders, o bsessive compulsive disorder, e ating disorders, c hronic pain, and some hormonemediated disorders such as dysmen orrhea, and for snoring, migraines, attention- Legal Prescription Anxiety Insomnia Headaches Dizziness Fatigue Nausea Return of depression symptoms inhibitors, Serotonin antagonist and reuptake inhibitors, Norepinephrine -dopamine reuptake inhibitors, Selective serotonin reuptake enhancers, Norepinephrine -dopamine disinhibitors, Tricyclic antidepressant s, Tertiary amine tricyclic antidepressant s, Secondary amine tricyclic antidepressant s, Monoamine oxidase inhibitor Reboxetine ( Edronax), Viloxazine (Vi valan), Mianserin (To lvon), Mirtazapine ( Remeron, Avanza, Zispin), Desvenlafaxi ne (Pristiq), Duloxetine (C ymbalta), Milnacipran (I xel, Savella), Venlafaxine ( Effexor) depression, whereas amphetamin es have found a thriving market for conditions as widely arrayed as attention deficit disorder, nar colepsy, and obesity, and continue to be studied for myriad applications. Both opioids and amphetamin es induce a therapeutic response very quickly, showing results within twenty-four to forty-eight hours; the therapeut ic ratios for both opioids and amphetamin es are greater than those of the tricyclic antidepressants. In a small study published in 1995, the opioid bupre norphine was shown to have potential for treating severe, treatmentresistant depression. The nutritional supplement t ryptophan is also used in treating some forms of seasonal depression o r in combination with use of bright light exposure. deficit hyperactivit y disorder (A DHD) and substa nce abuse. Low dose antipsy chotics are also used, as are benzodia zepines, and St John's wort. The use of benzodiazepi nes can cause a physical dependence. Abrupt benzodiazepi ne discontinuati on can induce life threatening seizures, and intense withdrawal symptoms. Antipsychotic s can have severe long term negative effects, such as tardive dyskinesia, brain atrophy, and metaboli c syndrome In ert placebos can also have significant antidepressa nt effects. Inhalants Volatile solvents, Aerosols, Gases, Nitrites Industrial or household products, Art or office supply solvents, Household aerosol propellants, Household or commercial products, Medical anesthetics, Organic nitrites, Most abused inhalants other than nitrites depress the central nervous system in a manner not unlike alcohol. The effects are similar— including slurred speech, lack of coordinatio n, euphoria, Excessive sweating Hand tremors Insomnia Hallucinatio ns Feelings of aggression or nervousnes s Headaches and muscle pains Psychosis Over the Counter, legal, illegal, prescription and dizziness. Inhalant abusers may also experience lightheadednes s, hallucinatio ns, and delu-sions. With repeated inhalations, many users feel less inhibited and less in control. Some may feel drowsy for several hours and experience a lingering headache. Unlike other types of inhalants, nitrites enhance sexual pleasure by dilating and relaxing blood vessels. Drugs of Abuse not Easily Classified Anabolic steroids Anadrol, Oxandrin, Durabolin, DepoTestosterone,o Equipoise, o insulin o o In men, anabolic steroids can: Reduce sper m count. Shrink the testicles. Cause you not to be able to father children. Enlarge the breasts. In women, anabolic steroids can: Abnormal physical or psycholog ical features that follow the abrupt discontinu ation of a drug that has the capability of producing physical sometimes prescribed by doctors to treat conditions in which testosteron e levels are abnormally low, or in certain chronic conditions such as AIDS th at are associated with loss of muscle mass. Athletes, bodybuilder Legal, illegal, prescription, OTC (some insulins) o o o o o o o o o o o o Increase body hair. Make skin rough. Decrease breast size. Enlarge the clitoris. Deepen the voice. In both men and women, anabolic steroids can cause: Bone growth to stop before it is complete in a teen. The teen may not reach his or her full adult height. A heart attack or stro ke, even in a very young person. High blood pr essure. Higher levels of bad choleste rol (LDL) and lower levels of good cholesterol (HDL). Liver disease and possibly liver cancer. The chance of these problems is higher when steroids are taken as a pill. Oily skin and acne. Male-pattern hair loss. dependen ce. In example, common opiates withdrawa l symptoms include sweating, goosebu mps, vomiting, anxiety, in somnia, andmuscl e pain. s, and other people sometimes abuse anabolic steroids in order to improve performanc e and physical appearanc e. o o Skin infections that can become severe if the drug was tainted with bacteria. Irritability, rage, uncontrolled high energy (mania), or false beliefs (delusions). Criteria for completing the matrix: 1. 2. 3. 4. 5. 6. 7. Learner identifies correct sub-categories within a drug classification. Learner correctly identifies drugs of the sub-category and classification. Learner identifies the CNS effects and characteristics of the drug classification. Learner identifies the withdrawal effects of the drugs within the drug classification. Learner identifies treatment issues characteristics of the drug classification. Learner identifies therapeutic uses of the drugs within the classification. Learner identifies whether drugs are legal, illegal, prescription, OTC. Total: (15 points) (15 points) (15 points) (15 points) (15 points) (10 points) (10 points) 95 Points