* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download Drugs
Survey
Document related concepts
Orphan drug wikipedia , lookup
Drug design wikipedia , lookup
Pharmacokinetics wikipedia , lookup
Drug discovery wikipedia , lookup
Psychedelic therapy wikipedia , lookup
Neuropharmacology wikipedia , lookup
Neuropsychopharmacology wikipedia , lookup
Pharmaceutical industry wikipedia , lookup
Prescription costs wikipedia , lookup
Pharmacognosy wikipedia , lookup
Prescription drug prices in the United States wikipedia , lookup
Pharmacogenomics wikipedia , lookup
Drug interaction wikipedia , lookup
Urban legends about drugs wikipedia , lookup
Transcript
Chapter 9: Drugs • Narcotics, Depressants, Stimulants, Hallucinogens, oh my!!!! Vocabulary Anabolic steroids Analgesic Confirmation Depressant Drug Hallucinogen Microcrystalline test Narcotic Physical Dependence Psychological Dependence Screening tests Stimulant What is a DRUG ???? A drug can be defined as a natural or synthetic substance that is used to produce physiological or psychological effects in humans or other higher order animals. Why do people take drugs? Necessity for sustaining and prolonging life Provide an escape from the pressures of life A means of ending life Why study drugs in forensics? 90 million Americans drink alcohol regularly with 10 million hopelessly addicted Today, approximately 23 million people in the US are users of illicit drugs. ½ million heroin addicts and nearly 6 million users of cocaine 75% of evidence now being evaluated in crime labs is drug related. Drug Dependence Psychological vs. Physical Psychological dependence – the conditioned use of a drug caused by underlying emotional needs Drug Dependence Psychological vs. Physical Physical dependence – physiological need for a drug that has been brought about by regular use. Characterized by ‘withdrawal sickness’ Withdrawal sickness or abstinence syndrome Refer to page 235 in your text book Table 9-1 categorizes some of the more commonly abused drugs according to their effect on the body. See page 236 Society and the Law The first drugs to be regulated by the law in the early years of the 20th century were those deemed to have “habit-forming” properties. Aimed primary at opium and derivatives, cocaine, and later marijuana Society and the Law The question of how to define and measure a drug’s influence on the individual and the danger it poses for society is difficult to assess. 1. What is the interaction of the drug with the person? 2. What is the impact on society? The social impact of drug dependence is directly related to the extent to which the user has become preoccupied with the drug. To what extent has the drug use become interwoven in the fabric of the user’s life?? What about Tobacco and Caffeine?? Turn to page 261 in text book. Answer questions 1-6 Types of Drugs Narcotics Hallucinogens Depressants Stimulates Club Drugs Anabolic Steroids Narcotic Derived from the Greek word narkotikos, which implies a state of lethargy or sluggishness. Pharmacologists classify as substance that brings relief from pain and produces sleep. They are analgesics – relive pain by exerting a depressing action on the central nervous system (CNS) Narcotic Unfortunately, ‘narcotic’ has come to be popularly associated with any drug that is socially unacceptable. This confusion has produced legal definitions that are at variance with the pharmacological actions of many drugs. Examples: marijuana and cocaine Narcotic Source of most analgesic narcotics is opium. This is a gummy, milky juice exuded through a cut made in the unripe pod of the poppy. It is brownish in color and has a morphine content from 421% Papaver somniferium aka ‘The Poppy’ Kingdom: Plantae Division: Magnoliophyta Class: Magnoliopsida Order: Ranunculales Family: Papaveraceae Genus: Papaver Species: P. somniferum Morphine Morphine C17H18NO3 Morphine can be used as an analgesic to relieve: – pain in myocardial infarction – pain in sickle cell crisis – pain associated with surgical conditions, pre- and postoperatively – pain associated with trauma – severe chronic pain, e.g., cancer[14] – pain from kidney stones (renal colic, ureterolithiasis) – severe back pain Morphine can also be used: – as an adjunct to general anesthesia – in epidural anesthesia or intrathecal analgesia – for palliative care (i.e., to alleviate pain without curing the underlying reason for it, usually because the latter is found impossible) – as an antitussive for severe cough – in nebulized form, for treatment of dyspnea, although the evidence for efficacy is slim.[15] Evidence is better for other routes.[16] – as an antidiarrheal in chronic conditions (e.g., for diarrhea associated with AIDS, although loperamide (a non-absorbed opioid acting only on the gut) is the most commonly used opioid for diarrhea). Morphine side affects: Constipation Addiction Tolerance Withdrawal Heroin or diacetylmorphine C21H23NO5 Heroin The German drug company Bayer named its new over the counter drug "Heroin" in 1895. The name was derived from the German word "heroisch" (heroic), due to its perceived "heroic" effects upon a user. However, it was chiefly developed as a morphine substitute for the coughs that did not have its addictive side-effects. Morphine at the time was a popular, but addictive recreational drug, so Bayer wanted to find a similar, but non-addictive substitute to market. However, contrary to Bayer's advertising as a "non-addictive morphine substitute," heroin would soon have one of the highest rates of dependence amongst its users. Codeine or methylmorphine C18H21NO3 While codeine can be extracted from opium, most codeine is synthesized from morphine through the process of O-methylation. It was first isolated in 1832 in France by Jean-Pierre Robiquet. The conversion of codeine to morphine occurs in the liver and is catalysed by the cytochrome P450 enzyme CYP2D6 Approximately 6–10% of the Caucasian population, 2% of Asians, and 1% of Arabs are "poor metabolizers"; they have little CYP2D6, and codeine is less effective for analgesia in these patients. Opiates (pg. 239) Synthetic drugs (not naturally derived) which have similar physiological effects on the body as the opium narcotics. OxyContin Methadone OxyContin OxyContin is the brand name of a time-release formula of oxycodone produced by the pharmaceutical company Purdue Pharma. It was approved by the U.S. Food and Drug Administration in 1995 and first introduced to the U.S. market in 1996. By 2001, OxyContin was the best-selling non-generic narcotic pain reliever in the U.S.; 2008 sales in the U.S. totaled $2.5 billion. An analysis of data from the U.S. Drug Enforcement Administration found that retail sales of oxycodone "jumped nearly six-fold between 1997 and 2005.“ Critics have accused Purdue Pharma of putting profits ahead of public interest by applying "significant political pressure" to attempt to reverse South Carolina's requiring prior approval before a person with Medicaid can receive the drug; for "fail[ing] to adequately warn consumers of the risks" of OxyContin such as dependence; and for promoting the drug "aggressively" and by means such as "promotional beach hats, pedometers and swing-music CDs." In May 2007 Purdue Pharma "agreed to pay $19.5 million" in fines relating to aggressive off-label marketing practices of OxyContin in 26 states and the District of Columbia. In specific, the company encouraged dosing more frequent than the recommended interval of 12 hours, and did not fully disclose the risk of hazardous or harmful use. Later in May 2007 Purdue Pharma and three of its top executives pleaded guilty in a Virginia federal court to charges that they misbranded OxyContin by representing it to have "less euphoric effect and less abuse potential" than it actually has, and by claiming that people taking the drug at low doses could stop taking it suddenly without symptoms of withdrawal. The FDA had not approved these claims. The company and the executives were to pay $634 million in fines for felony and misdemeanor misbranding In October 2007, officials in Kentucky filed a lawsuit against Purdue Pharma for misleading health care providers and consumers "regarding the appropriate uses, risks and safety of OxyContin"; as of mid-2008, however, the case had been "consolidated with other lawsuits into a single multi-litigation suit" in a federal court in New York. Turn to page 261 Answer questions 7-12 Hallucinogens Drugs that can cause marked alterations in normal thought processes, perceptions, and moods. Examples: Marijuana, LSD, PCP, Ecstasy Marijuana: Perhaps the most popular and controversial member of the hallucinogens Qualifies as the most used illicit drug used in the US today More than 43 million Americans have tried it and half of that number may be regular users. (according to latest surveys) Marijuana Preparation derived from the plant Cannabis sativa L Marijuana Preparation normally involves crushed leaves with proportions of seed, stem and flower. Plant secretes sticky resin known has hashish Marijuana Potent form is known as sinsemilla. This is made from the unfertilized flowering tops of the female plant. Marijuana Grows 5-15 feet Characterized by an odd number of leaflets on each leaf. Each usually having 5-9 leaflets, all having serrated or saw-toothed edges. Potency (THC content) depends on its form: Loose vegetation 3-4.5 % Sinsemilla 6-12% Hashish 2-8% Liquid hashish 8-22% Marijuana Turn to page 240 for history Show “Hemp for Victory” Marijuana Was not until 1964 that THC (tetrahydrocannabinol) was isolated the chemical substance that was responsible for the hallucinogenic properties THC is mostly found in the resin, flowers, and leaves Beware! Potential Medical Use Two promising areas of research are marijuana’s reduction in eye pressure in glaucoma and lessening nausea caused by powerful anticancer drugs. Marijuana Timeline 1906 Pure Food and Drug Act Regulates labeling of products containing certain drugs including cocaine and heroin 1914 Harrison Narcotics Tax Act Regulates opiates and cocaine 1937 Marihuana Tax Act Criminalizes marijuana 1964 Convention on Narcotics Treaty to control marijuana 1970 Controlled Substance Act Scheduling list for drugs Other Hallucinogens Lyseric acid diethylamide (LSD) Synthesized from lyseric acid, a substance derived from ergot, which is a type of fungus that attacks certain grasses and grains (rye). (1938) 1st described by Swiss chemist Albert Hofman after he accidentally ingested, 1943. Very potent, 25 micrograms, enough to start vivid visual hallucinogens that can last 12 hours. Mood swings, anxiety, tension. Prone to flashbacks. LSD A single dose of LSD may be between 100 and 500 micrograms — an amount roughly equal to one-tenth the mass of a grain of sand. Threshold effects can be felt with as little as 25 micrograms of LSD. Dosages of LSD are measured in micrograms (µg), or millionths of a gram. By comparison, dosages of most drugs, both recreational and medicinal, are measured in milligrams (mg), or thousandths of a gram. For example, an active dose of mescaline, roughly 0.2 to 0.5g, has effects comparable to 100 µg or less of LSD. LSD LSD was first synthesized on November 16, 1938 by Swiss chemist Dr. Albert Hofmann at the Sandoz Laboratories in Basel, Switzerland as part of a large research program searching for medically useful ergot alkaloid derivatives. LSD's psychedelic properties were discovered 5 years later when Hofmann accidentally ingested an unknown quantity of the chemical. The first intentional ingestion of LSD occurred on April 19, 1943, when Dr. Hofmann ingested 250 µg of LSD. He hypothesized this would be a threshold dose based on the dosages of other ergot alkaloids. Hofmann found the effects to be much stronger than he anticipated. Sandoz Laboratories introduced LSD as a psychiatric drug in 1947 LSD Beginning in the 1950s the US Central Intelligence Agency began a research program code named Project MKULTRA. Experiments included administering LSD to CIA employees, military personnel, doctors, other government agents, prostitutes, mentally ill patients, and members of the general public in order to study their reactions, usually without the subject's knowledge. The project was revealed in the US congressional Rockefeller Commission report in 1975. In 1963 the Sandoz patents expired on LSD. Also in 1963, the US Food and Drug Administration classified LSD as an Investigational New Drug, which meant new restrictions on medical and scientific use. Several figures, including Aldous Huxley, Timothy Leary, and Al Hubbard, began to advocate the use of LSD. LSD became central to the counterculture of the 1960s. On October 24, 1968, possession of LSD was made illegal in the United States. The last FDA approved human study with LSD, for use in dying cancer patients, ended in 1980. Legally approved and regulated psychiatric use of LSD continued in Switzerland until 1993. Today, medical research is resuming around the world. Phencyclidine (PCP) Synthesized by rather simple chemical process which has led to the increase of abuse. Clandestine Laboratories (see Fig. 9-5) Mixed with other drugs such as LSD or amphetamines and sold as powder hence ‘Angel Dust’ PCP Following oral intake (1-6 milligrams) user feels strength and invulnerability, along with dreamy detachment. Follows with unresponsiveness, confusion, agitation, depression, feelings of isolation, audio/visual hallucinations and sometimes paranoia. Depressant A substance used to depress the functions of the central nervous system. Depressants calm irritability and anxiety and may induce sleep Depressants Alcohol Barbiturates Tranquilizers ‘Glue Sniffing’ Alcohol In the U.S. the alcohol industry annually produces over one billion gallons of spirits, wine, and beer for which 90 million consumers pay nearly $40 billion. Alcohol We forget sometimes that alcohol is a drug. Upon entering the blood stream it quickly travels to the brain, where it acts to suppress the brain’s control of thought processes and muscle coordination. Alcohol See page 245. How does alcohol fit into society, the laws and forensics?? Also a side note: Several of the benign bacteria in the intestine use fermentation as a form of anaerobic respiration. This metabolic reaction produces ethanol as a waste product, just like aerobic respiration produces carbon dioxide and water. Thus, human bodies inevitably contain some quantity of alcohol endogenously produced by these bacteria Barbituates (Downers) ‘Downers’ because they relax, create a feeling of well being, and produce sleep Act on the CNS to suppress function Derivatives of barbituric acid Barbituates (downers) Barbituric acid was first synthesized on December 6, 1864, by German researcher Adolf von Baeyer. This was done by condensing urea (an animal waste product) with diethyl malonate (an ester derived from the acid of apples). There are several stories about how the substance got its name. The most likely story is that Von Baeyer and his colleagues went to celebrate their discovery in a tavern where the town's artillery garrison were also celebrating the feast of Saint Barbara — the patron saint of artillerists. An artillery officer is said to have christened the new substance by amalgamating Barbara with urea. No substance of medical value was discovered, however, until 1903 when two German chemists working at Bayer, Emil Fischer and Joseph von Mering, discovered that barbital was very effective in putting dogs to sleep. Barbital was then marketed by Bayer under the trade name Veronal. It is said that Von Mering proposed this name because the most peaceful place he knew was the Italian city of Verona. It wasn't until the 1950s that the behavioural disturbances and physical dependence potential of barbiturates became recognised. Barbiturates 25 derivatives are currently used in medical practice in the U.S. Only 5 seem to have the most present-day applications: Amobarbital, Secobarbital, Phenobarbital, Pentobarbital, Butabarbital Like ethanol, barbiturates are intoxicating and produce similar effects during intoxication. The symptoms of barbiturate intoxication include respiratory depression, lowered blood pressure, fatigue, fever, unusual excitement, irritability, dizziness, poor concentration, sedation, confusion, impaired coordination, impaired judgment, addiction, and respiratory arrest which may lead to death Slang names: yellow jackets, blue devils, reds Tranquilizers Although these drugs are considered depressants, they do differ from ‘barbs’ in the extent of their actions on the CNS. Generally these drugs produce a relaxing tranquility without impairment of high-thinking faculties or inducement of sleep. Tranquilizers ‘Major’ tranquilizers: reserpine and chlorpromazine have been successfully used to reduce anxiety and tensions in mental patients. ‘Mild’ tranquilizers: meprobamate (Miltown), chlordiazepoxide (Librium) and diazepram (Valium) Tranquilizers Chlorpromazine (as chlorpromazine hydrochloride, abbreviated CPZ, marketed in the US as Thorazine, as Largactil in Europe) is the oldest typical antipsychotic. Chlorpromazine effectively treats schizophrenia, severe mania in people with bipolar disorder, and uncontrollable hiccups. Tranquilizers Reserpine was isolated in 1952 from the dried root of Rauwolfia serpentina (Indian snakeroot), (which had been known as Sarpaganda and had been used for centuries in India for the treatment of insanity, as well as fever and snakebites — even Mahatma Gandhi used it as a tranquilizer during his lifetime. Its molecular structure was elucidated in 1953 and natural configuration published in 1955. It was introduced in 1954, two years after chlorpromazine. The first total synthesis was accomplished by R. B. Woodward in 1958 Tranquilizers Reserpine is an indole alkaloid, antipsychotic and antihypertensive drug that has been used for the control of high blood pressure and for the relief of psychotic behaviors, although because of the development of better drugs for these purposes and because of its numerous sideeffects, it is rarely used today Tranquilizers Do you think we are creating a legalized drug culture??? Tranquilizers Glue Sniffing- contain volatile or gaseous substances that decrease the CNS function Toluene is the most common but other solvents are naphtha, methyl ethyl ketone, gasoline, and trichloroethylene. See page 246. Glue Sniffing Music and musical culture Inhalant use, especially glue sniffing, is widely associated with the late 1970s punk youth subculture in the UK and North America. Raymond Cochrane and Douglas Carroll claim that when glue sniffing became widespread in the late 1970s, it was "...adopted by punks because public [negative] perceptions of sniffing fitted in with their self-image" as rebels against societal values. While punks at first used inhalants "...experimentally and as a cheap high, adult disgust and hostility [to the practice] encouraged punks to use glue sniffing as a way of shocking society". Glue Sniffing Inhalants are also referred to by bands from other genres, including several grunge bands—an early 1990s genre that was influenced by punk rock. The 1990s grunge band Nirvana, which was influenced by punk music, penned a song "Dumb", in which Kurt Cobain sings "my heart is broke/But I have some glue/ help me inhale /And mend it with you". L7, an all-female grunge band, penned a song entitled "Scrap" about a skinhead who inhales spray paint fumes until his mind "starts to gel". Glue Sniffing The Beck song "Fume" from his "Fresh Meat and Old Slabs" release is about inhaling nitrous oxide. Another Beck song, "Cold Ass Fashion," contains the line, "O.G. - Original Gluesniffer!" The band Primus's 1998 song "Lacquer Head" is about adolescents who use inhalants to get high. Hip hop performer Eminem wrote a song, "Bad Meets Evil," which refers to breathing "...ether in three lethal amounts." "The Brian Jonestown Massacre" a retro-rock band from the 1990s has a song entitled "Hyperventilation," which is about sniffing model airplane cement. Turn to page 262 Complete questions 1325 Stimulants What is a stimulant??? A substance taken to increase alertness or activity Examples: Amphetamines and Cocaine Amphetamines A group of synthetic drugs that simulate the central nervous system The name amphetamine is derived from its chemical name: alphamethylphenethylamine. Referred to as ‘uppers or speed’ Therapeutic dose 5-20 milligrams per day. Amphetamine Amphetamine (amfetamine (INN)) is a psychostimulant drug that is known to produce increased wakefulness and focus in association with decreased fatigue and appetite. Amphetamine is related to drugs such as methamphetamine, dextroamphetamine, and levoamphetamine, which are a group of potent drugs that act by increasing levels of dopamine and norepinephrine in the brain, inducing euphoria. Amphetamines The group includes prescription CNS drugs commonly used to treat attention-deficit hyperactivity disorder (ADHD). It is also used to treat symptoms of traumatic brain injury and the daytime drowsiness symptoms of narcolepsy, Postural Orthostatic Tachycardia Syndrome and chronic fatigue syndrome. Initially, amphetamine was more popularly used to diminish the appetite and to control weight. Brand names of the drugs that contain, or metabolize into, amphetamine include Adderall, Vyvanse, and Dexedrine, as well as Benzedrine in the past Methamphetamine Chemical derivative Referred to as ICE or Meth Made by a slow evaporation of methamphetamine solution to produce crystal clear ‘rocks’ then smoked Methamphetamine Chronic users exhibit violent destructive behavior and acute psychosis similar to paranoid schizophrenia. Has a STRONG physical dependance Methamphetamine 1. 2. 3. Physical effects Physical effects of amphetamine can include reduced appetite, increased/distorted sensations, hyperactivity, dilated pupils, flushing, restlessness, dry mouth, erectile dysfunction, headache, tachycardia, increased breathing rate, increased blood pressure, fever, sweating, diarrhea, constipation, blurred vision, impaired speech, dizziness, uncontrollable movements or shaking, insomnia, numbness, palpitations, and arrhythmia. In high doses or chronic use convulsions, dry or itchy skin, acne, pallor can occur. Occasionally amphetamine use in males can cause an odd and sometimes startling effect in which the penis when flaccid appears to have shrunk due to vasoconstriction. Amphetamine use in adolescence may impair adult working memory Cocaine A stimulant that comes from the Erythroxylon coca leaves. This plant is easily grown in the Andes Mountains of South America and tropical Asia. At one time it was used as a local painkiller and anesthetic Cocaine For over a thousand years South American indigenous peoples have chewed the coca leaf (Erythroxylon coca), a plant that contains vital nutrients as well as numerous alkaloids, including cocaine. The leaf was, and is, chewed almost universally by some indigenous communities— ancient Peruvian mummies have been found with the remains of coca leaves and pottery from the time period depicts humans, cheeks bulged with the presence of something on which they are chewing. There is also evidence that these cultures used a mixture of coca leaves and saliva as an anesthetic for the performance of trepanation. Cocaine When the Spanish arrived in South America, most at first ignored aboriginal claims that the leaf gave them strength and energy, and declared the practice of chewing it the work of the Devil. But after discovering that these claims were true, they legalized and taxed the leaf, taking 10% off the value of each crop.[9] In 1569, Nicolás Monardes described the practice of the natives of chewing a mixture of tobacco and coca leaves to induce "great contentment": Cocaine Medicalization With the discovery of this new alkaloid, Western medicine was quick to exploit the possible uses of this plant. In 1879, Vassili von Anrep, of the University of Würzburg, devised an experiment to demonstrate the analgesic properties of the newly-discovered alkaloid. He prepared two separate jars, one containing a cocaine-salt solution, with the other containing merely salt water. He then submerged a frog's legs into the two jars, one leg in the treatment and one in the control solution, and proceeded to stimulate the legs in several different ways. The leg that had been immersed in the cocaine solution reacted very differently than the leg that had been immersed in salt water. Cocaine Carl Koller (a close associate of Sigmund Freud, who would write about cocaine later) experimented with cocaine for ophthalmic usage. In an infamous experiment in 1884, he experimented upon himself by applying a cocaine solution to his own eye and then pricking it with pins. His findings were presented to the Heidelberg Ophthalmological Society. Also in 1884, Jellinek demonstrated the effects of cocaine as a respiratory system anesthetic. In 1885, William Halsted demonstrated nerve-block anesthesia, and James Corning demonstrated peridural anesthesia. 1898 saw Heinrich Quincke use cocaine for spinal anesthesia. Cocaine A chemist named Angelo Mariani who read Mantegazza’s paper became immediately intrigued with coca and its economic potential. In 1863, Mariani started marketing a wine called Vin Mariani, which had been treated with coca leaves, to become cocawine. The ethanol in wine acted as a solvent and extracted the cocaine from the coca leaves, altering the drink’s effect. It contained 6 mg cocaine per ounce of wine, but Vin Mariani which was to be exported contained 7.2 mg per ounce, to compete with the higher cocaine content of similar drinks in the United States. A “pinch of coca leaves” was included in John Styth Pemberton's original 1886 recipe for Coca-Cola, though the company began using decocainized leaves in 1906 when the Pure Food and Drug Act was passed. The actual amount of cocaine that Coca-Cola contained during the first twenty years of its production is practically impossible to determine. Pope Leo XIII purportedly carried a hipflask of the cocatreated Vin Mariani with him, and awarded a Vatican gold medal to Angelo Mariani. Crack Cocaine Crack is a lower purity form of free-base cocaine and contains sodium bicarbonate as impurity. Freebase and crack are often administered by smoking. The origin of the name is from the crackling sound (hence the onomatopoeic “crack”) produced when cocaine containing impurities are heated. Page 248 Has toxic effects, has one of the strongest psychological compulsions for continued use. Club Drugs Refers to synthetic drugs that are used at nightclubs, bars, and raves. Substances that are often used: 1. MDMA (Ecstasy) 2. GHB (gamma hydroxybutyrate) 3. Rohypnol (‘Roofies’) 4. Ketamine 5. Methamphetamine GHB and Roofies GHB and Rohypnol are CNS depressants. They are colorless, odorless, tasteless. They are usually connected with drugfacilitated sexual assault, rape, and robbery. GHB- dizziness, sedation, headache, and nausea. Rohypnol- muscle relaxation, loss of consciousness, and inability to remember what happened. MDMA aka Ecstasy Methylenedioxymethamphetamine Is a synthetic, mind-altering drug that exhibits hallucinogenic and amphetamine-like effects