Central nervous system abuse potential

Compounds available in the United States are Hsted in Table 1. Whereas they vary in degree, all of them share similar HabiUties of cardiovascular side effects, the potential for central nervous system (CNS) stimulation, the development of tolerance, and abuse potential. AH, with the exception of ma2indol, are derivatives of phenethylamine. The introduction of an oxygen atom on the -carbon of the side chain tends to reduce CNS stimulant properties without decreasing the anorectic activity. Following the Federal Controlled Dmg Act of 1970, dmgs were classified into one of five schedules according to medical utiUty and abuse potential. 

There are several approaches to help patients stop smoking. One approach is replacement therapy with nicotine in the form of gum, transdermal patch, nasal spray, or inhaler. All these forms have low abuse potential and are effective in patients motivated to stop smoking. Their action derives from slow absorption of nicotine that occupies 4 2 receptors in the central nervous system and reduces the desire to smoke and the pleasurable feelings of smoking. 

If, at the time a new-drug application is submitted to the Secretary for any drug having a stimulant, depressant, or hallucinogenic effect on the central nervous system, it appears that such drug has an abuse potential, such information shall be forwarded by the Secretary to the Attorney General. 

Amphetamines and similar central nervous system stimulants have been available for many years, but the substantial abuse liability and potential cardiovascular adverse effects have largely limited their use to the treatment of narcolepsy and attention-deficit-hyperactivity disorder. There has also been some utilization of amphetamines to combat sleepiness during military operations. 

Direct central nervous system effects of volatile nitrites have not yet been determined. In the body, nitrites are rapidly broken down into alcohol and nitrite ions, so the parent nitrite drugs may not reach the brain in concentrations comparable to those found in the blood. In one study, isoamyl nitrite concentrations were measured in the brains of rats exposed to the compound by inhalation. The drug was found to inhibit the synthesis or release of some adrenal steroids in the hypothalamus that are involved with stress. To understand the abuse potential of volatile nitrites, many more studies are needed to establish direct effects of the drugs on the brain. 

The mechanism of loperamide toxicity is related to opioid-like activity that causes depression of the central nervous system (CNS). The abuse potential for loperamide is low. 

Special warnings, precautions or use limitations cited in the product monograph should be included in the body copy. Examples include abuse potential for narcotics or central nervous system agents, or specific directions for use in special patient groups such as elderly people, children, pregnant women, nursing mothers, women of childbearing age. 

A second major consideration for social workers when a client is taking benzodiazepines is the potential for addiction and abuse. In addition to the potential abuse, the benzodiazepines are central nervous system depressants that when combined with another depressant such as alcohol can result in significant depression or have a lethal effect (Dulcan, 1999 ... 

Many sympathomimetics have strong excitatory effects on the central nervous system. These are mostly synthetic compounds and include amphetamines. The chemical structures and abusive potential of amphetamines are discussed separately in the following section. 

Other constraints are important for more complex products, for which mass is not central, but value. For example, central nervous system stimulants are a new class of substances addressed by production with engineered baker s yeast. Expressing the biosynthetic pathways for the opioids thebaine and hydrocodone, and parts of the morphine pathway in yeast, a first step is taken for easy production of opiates [21, 22]. This opens the possibility for the development of new painldllers with less addictive potential. However, it clearly is a new technology that could be abused with many negative consequences - so some contemplation about how to control these developments seems advisable [23]. Not only are narcotics in the center of interest but stimulants such as caffeine and theobromine have also recently been produced with genetically engineered 5. cerevisiae strains [24]. 

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