Drugs Classification
Jan 01, 2016
Drugs Administration and Absorption Ingestion
Dissolve in the stomach & absorbed by intestine Absorbed thought stomach walls (e.g., alcohol) Absorption will depend on various factors:
amount and type of food Injection
Strong, fast, predictable Subcutaneous, intramuscular, intravenous
Inhalation Difficult to regulate doses
Insufflation (snore) Absorption through mucous membrane of:
nose, mouth, rectum, vagina
Psychoactive/Psychotropic DrugsAction on Central Nervous System (CNS)
Analgesics Anesthetics Anxiolytics (anti-anxiety agents) Antidepressants Antipsychotics Anticonvulsants Mood stabilizers Stimulants Depressants Hallucinogens
Psychoactive Substances Usage Analgesics (painkillers)
used to relive pain without producing anesthesia or loss of consciousness
Psychiatric medications use in the treatment of psychiatric conditions anxiolytics, antidepressants, antipsychotics, anticonvulsants,
and mood stabilizers Recreational drugs
used/abused for their mood and perception altering effects, including those with accepted uses in medicine and psychiatry
frequently used include narcotics, stimulants, depressants, hallucinogens
Entheogens used for ritual and spiritual practice, such as the mescaline-
containing peyote cactus or psilocybin-containing mushrooms
CNS Depressants Slows down the central nervous system
Provide feeling of relaxation Reduced inhibitions Impair reflexes Impair coordination Reduce reaction time Slurring speech, stumbling walk, and loss of balance Hand-eye coordination is reduced Thought and judgment impaired
CNS Depressants Sedative
Barbiturates Benzodiazepines Solvents-sedatives Herbal sedatives Nonbenzodiazepine Uncategorized sedative-hypnotics
Narcotics (opiate derivatives) Antihistamines (diphenhydramine)
CNS DepresantsSedatives Also known as sedative-hypnotic Produces feelings of calmness, relaxation, sleepiness,
slowed breathing, reduction of anxiety, and at higher doses slurred speech, staggering gait, poor judgment, and slowcertain reflexes.
Whenused to induce sleep tend to be higher doses than those used to relieve anxiety.
May be referred to as tranquilizers, depressants, anxiolytics, soporifics, and sleeping pills.
Can be abused to produce an overly-calming effect (alcohol being the most common sedating drug).
At high doses many of these drugs can cause unconsciousness and even death.
CNS DepressantsBarbiturates Effect range mild sedation to anesthesia. Effective as anxiolytics, hypnotics and as anticonvulsants. Widely used in surgical anesthesia. Have addiction potential, both physical and psychological. Dangerous in overdose. Used for physician-assisted suicide (PAS), and in
combination with a muscle relaxant for capital punishment by lethal injection.
Thiopental is an ultra-short acting barbiturate that is marketed under the name Sodium Pentothal is sometimes used as a "truth serum". When dissolved in water, it can be swallowed or administered by intravenous injection. The drug does not itself force people to tell the truth, but is thought to decrease inhibitions, making subjects more likely to be caught off guard when questioned.
CNS DepressantsBarbiturates
amobarbital (Amytal) pentobarbital (Nembutal) secobarbital (Seconal) Phenobarbitol (Luminal)
CNS Depressants Benzodiazepines Minor tranquilizers with varying properties. Slow down the CNS. Useful in treating anxiety, insomnia, agitation,
seizures, muscle spasms, and alcohol withdrawal. Also used before medical procedures such as
endoscopies and dental work. Recreational stimulant users often use
benzodiazepines as a means of "coming down" All have an addictive potential.
CNS Depressants Benzodiazepines (minor tranquilizers)
alprazolam (Xanax) bromazepam (Lexotan) clonazepam (Klonopin) diazepam (Valium) estazolam (Prosom) flunitrazepam (Rohypnol) lorazepam (Ativan) midazolam (Versed) nitrazepam (Mogadon) oxazepam (Serax) triazolam (Halcion) temazepam (Restoril, Normison, Planum, Tenox, and
Temaze) chlordiazepoxide (Librium)
CNS DepressantsSolvents-Sedatives
chloral hydrate (Noctec) diethyl ether (Ether) ethyl alcohol (alcoholic beverage) methyl trichloride (Chloroform)
CNS DepressantsAlcohol
Among the most abused drugs in our society. Can be as potent as many other illegal drugs. Can cause severe damage to a developing fetus. Reduces sensitivity to pain. Long-term effect can produce damage to liver, heart and
pancreas. Linked to gastro intestinal problems, malnutrition, high
blood pressure, and lower resistance to disease. Also linked to several types of cancer; including esophagus,
stomach, liver, pancreas and colon. People often do not realize that they are becoming
dependent on alcohol.
Other CNS Depressants Herbal sedatives
kava valerian
Nonbenzodiazepine sedatives eszopiclone (Lunesta) zaleplon (Sonata) zolpidem (Ambien) zopiclone (Imovane, Zimovane)
Uncategorized sedative-hypnotics ethchlorvynol (Placidyl) glutethimide (Doriden) ketamine (Ketalar, Ketaset) methaqualone (Sopor, Quaalude) methyprylon (Noludar) ramelteon (Rozerem)
Narcotics
Refers to opium, opium derivatives, and their
semi-synthetic or fully synthetic substitutes. Most medical professionals prefer the more
precise term “opioid”, which refers to natural, semi-synthetic and synthetic substances that behave pharmacologically like morphine, the primary active constituent of opium.
Main use: pain relief and cough suppressant.
Four broad classes of Narcotics(opioids)
Endogenous Opioids produced naturally in the body (endorphins)
Opium Alkaloids morphine (the first alkaloid isolated from opium) codeine
Semi-synthetic Opioids heroin and oxycodone
Fully Synthetic Opioids methadone and pethidine
Clinical use of Narcotics(opioids)
Opioids have been used to treat acute pain such as post-operative pain
Used in palliative care to alleviate severe, chronic, disabling pain of terminal
conditions such as cancer In recent years there has been an increased
use of opioids in management chronic pain (transdermal patches)
Clinical use of Narcotics(opioids)
Cough (codeine and hydrocodone)
Diarrhea (opium)
Anxiety due to shortness of breath (oxymorphone)
Detoxification (methadone and buprenorphine )
Narcotics Classification Opium alkaloids Phenanthrenes naturally occurring in opium:
Codeine Morphine Thebaine Oripavine Preparations of mixed opium alkaloids, including papaveretum,
are still occasionally used. Semisynthetic derivatives
Diacetylmorphine (heroin) Dihydrocodeine Hydrocodone Hydromorphone Nicomorphine Oxycodone Oxymorphone
CNS Stimulants
Stimulate central nervous system (CNS) Increase alertness and wakefulness Some produce a sense of euphoria Can be used therapeutically
Narcolepsy - to counteract abnormal states that diminish alertness or consciousness
Used to boost endurance and productivity as well as to suppress appetite
Significant mood-altering effects Controlled substances in many jurisdictions
StimulantsAmphetamine Also known as amfetamine, and benzedrine
brand name: Adderall Prescription (Rx) stimulant used to treat
ADHD Traumatic brain injury Narcolepsy Chronic fatigue syndrome Initially used to control appetite
Also used illegally as a recreational club drug as a performance enhancer
StimulantsMethylphenidate (MPH)
Amphetamine-like Rx stimulant Used to treat
ADHD Traumatic brain injury Narcolepsy Chronic fatigue syndrome
Brand names include Ritalin (Ritalina, Rilatine) Attenta, Concerta Metadate, Methylin, Rubifen Focalin (dextro-methylphenidate) Daytrana (transdermal patch)
StimulantsMethamphetamine Also known as: Methyl amphetamine or desoxyephedrine Rx for ADHD or narcolepsy under the brand name Desoxyn Used illegally for recreational purposes
“crystal meth" refers to the crystalline (smokeable form)
It is prone to abuse and addiction Rapidly enters the brain and triggers a cascading release of
norepinephrine, dopamine and serotonin Users may become obsessed or perform repetitive tasks
such as cleaning, hand-washing, or assembling and disassembling objects
Withdrawal is characterized by excessive sleeping, eating and depression-like symptoms, often accompanied by anxiety
Users often take benzodiazepines as a means of "coming down"
StimulantsMethcathinone
Potent CNS stimulant Controlled substance No clinical use at present Used as antidepressant during 1930-40 Snorted, smoked, injected, or ingested Chronic abuse may result in acute mental
confusion ranging from mild paranoia to psychosis
StimulantsCocaine
Stimulant of CNS Appetite suppressant Produce euphoric feelings Increased energy Most often used recreationally Used in medicine as a topical
anesthetic: eye, nose and throat surgeries
History of Cocaine
In 1879 cocaine was used to treat morphine addiction In 1884 cocaine is introduced as a local anesthetic In 1885 Parke-Davis sold cocaine in various forms,
including cigarettes, powder, and as a mixture that could be injected
Park-Davis promised that cocaine products would: “supply the place of food, make the coward brave, the silent
eloquent and render the sufferer insensitive to pain” In 1886 Coca-Cola included cocaine in its formula In 1903 cocaine is eliminated from Coca-Cola In 1914 the Harrison Narcotics Tax Act outlawed use of
cocaine This law incorrectly referred to cocaine as a narcotic Cocaine is a stimulant, not a narcotic
Forms of cocaine Cocaine Sulfate
Produced by macerating coca leaves with water that has been acidulated with sulfuric acid, or a solvent, like kerosene or benzene.
Often accomplished by putting the ingredients into a vat and stamping on it, similar to the method for crushing grapes in wine production.
When water is evaporated will yield a pasty mass Cocaine Sulfate is intermediate step to producing
cocaine hydrochloride (salt form) It is commonly sold in South America as a pasty
mass Also known as pasta, basuco, basa, pitillo, paco Smoked along with tobacco
Freebase Cocaine
Base form of cocaine Cocaine base is insoluble in water and is therefore not
suitable for drinking, snorting or injecting Smoking freebase is preferred by many because
cocaine is absorbed immediately into blood via the lungs, reaching the brain in about five seconds
Rush is more intense than sniffing the same amount of cocaine nasally
Peak of rush is over almost as soon as the user exhales
High typically lasts 5–10 minutes afterward
Crack Cocaine Another form, of freebase Often called "crack" or "rocks“ Created during early 1980s Popular because it is cheap Sodium bicarbonate (baking soda) is
preferred in preparing the freebase Commonly "cooked" the ratio of 50/50 to
40/60 % cocaine/bicarbonate When the rock is heated, the water boils,
making a crackling sound
Chewed/eaten
Coca leaves typically are mixed with an alkaline substance (such as lime) and chewed in the same way as chewing tobacco
It is absorbed by the mucous membrane of the mouth and GI tract
Coca leaves can be infused in liquid and consumed like tea
Not readily absorbed when ingested alone Need to be mixed with a highly alkaline
substance (such as lime) to be absorbed through the stomach
Coca Leaf InfusionsCoca Tea Coca tea is used in coca-leaf producing countries
much as any herbal medicinal tea. The free and legal commercialization of dried coca
leaves to be used as "coca tea" has been actively promoted by the governments of Peru and Bolivia for many years as a drink having medicinal powers.
Visitors to the city of Cuzco in Peru, and La Paz in Bolivia are greeted with the offering of coca leaf infusions (prepared in tea pots with whole coca leaves) purportedly to help the newly-arrived
The effects of drinking coca tea are a mild stimulation and mood lift
It does not produce any significant numbing of the mouth nor does it give a rush like snorting cocaine
Insufflation “snorting," “sniffing," or "blowing" Powder cocaine The most common method of ingestion Drug is absorbed through mucous membrane of
sinuses Absorption is approximately 30-60 % Chronic use results in rhinitis and necrosis of the nasal
membranes Damage the inside of the nose since cocaine
constricts blood vessel Users report a burning sensation in the nostrils after
cocaine's anesthetic effects wear off Rolled up banknotes, hollowed-out pens, cut straws,
and specialized spoons are often used to insufflate cocaine
Injected Cocaine The highest blood levels of drug in the shortest amount of time Upon injection, cocaine reaches the brain in a matter of
seconds rush can be so intense that can induces uncontrollable
vomit Euphoria passes quickly Aside from the toxic effects of cocaine, there is danger of
circulatory emboli from the substances used to cut the drug risk of infection associated with use of contaminated
needles Speedball
Injected mixture of cocaine and heroin Dangerous combination, as drugs complement each other
StimulantsEcstasy/MDMA Methylenedioxymethamphetamine
Often known as E, X, or XTC Primary effect is inducing a general sense of
openness, energy, euphoria, and well-being Tactile sensations are enhanced, making
physical contact with others more pleasurable May produce aphrodisiac effects A patent for MDMA was granted in 1914 to the
German pharmaceutical company Merck It was patented as an intermediate chemical
used in the synthesis of a hydrastinine (a drug intended to control bleeding from wounds)
Hallucinogens Can cause subjective changes in
perception, thought, emotion and consciousness
Induce experiences that are qualitatively different from those of ordinary consciousness
Three broad categories Psychedelics Dissociatives Deliriants
Hallucinogenous Cannabis sativa
Herbal form of the drug consists of dried mature leaves of pistillate ("female") plants
Hashish (resinous form) Carefully produced and screened
hashish is up to three times as potent as the highest quality herbal varieties
Active chemical compound in cannabis is: Δ9-tetrahydrocannabinol (THC)
PsychedelicAny drug with perception-altering effects such as
Lysergic acid diethylamide (LSD), semisynthetic drug synthesized from lysergic acid derived from
ergot, a grain fungus that grows on rye Psilocybin (psilocybine)
found in psilocybin mushroom Mescaline occurs naturally in the
Peyote cactus, San Pedro cactus, Peruvian Torch cactus
Ayahuasca preparations (use for religious purposes) Seeds of Morning Glory & Hawaiian Baby Woodrose
Dissociatives Drugs Reduce (or block) signals to the conscious mind from
other parts of the brain, typically the physical senses Such a state of sensory deprivation can produce
hallucinations, and dreamlike states of mind Some are
PCP (angel dust) Ketamine (an anaesthetic) DXM (dextromethorphan) active ingredient in many
cough syrups nitrous oxide (inhalant) salvia divinorum (plant)
Deliriants Deliriants - effects similar to experience of delirious fevers Considered to be true hallucinogens as users will
have conversations with people who aren't there become angry with a 'person' mimicking their actions, not
realizing it is their own reflection in a mirror Included in this group are:
Plants such a: deadly nightshade, mandrake, henbane and datura
Pharmaceutical drugs when taken in very high doses: antihistamine diphenhydramine (Benadryl) antiemetic dimenhydrinate (Dramamine or Gravol)
Native Americans can consumed large amounts of tobacco during religious ceremonies to experience deliriant effects.
Can be toxic, can cause death due to overdose.
Metabolisms and Elimination
Elimination of most drugs by enzymes synthesized by liver
Some are deactivates by being passed in: urine, sweat, feces, mother's milk
Drug Tolerance
Decreased sensitivity to a drug Same doses has less effect Need more drug to have same effect
Cross tolerance Tolerance to the effect of one drug that develops
as the result of exposure to another drug that act by same mechanism
Drug ToleranceTwo type of changes
Metabolic Tolerance results from a reduction in the amount of
a drug getting to its sites of action Functional Tolerance
results from a reduction in the reactivity of the nervous system (or other sites of action) to a drug
Tolerance to psychoactive drugs mainly fuctional