Cocaine amphetamines

Antipsychotic medications are indicated in the treatment of acute and chronic psychotic disorders. These include schizophrenia, schizoaffective disorder, and manic states occurring as part of a bipolar disorder or schizoaffective disorder. The co-adminstration of antipsychotic medication with antidepressants has also been shown to increase the remission rate of severe depressive episodes that are accompanied by psychotic symptoms. Antipsychotic medications are frequently used in the management of agitation associated with delirium, dementia, and toxic effects of both prescribed medications (e.g. L-dopa used in Parkinson s disease) and illicit dtugs (e.g. cocaine, amphetamines, andPCP). They are also indicated in the management of tics that result from Gilles de la Tourette s syndrome, and widely used to control the motor and behavioural manifestations of Huntington s disease. 

The nucleus accumbens is part of the limbic system. It receives dopaminergic input through the mesolimbic system that originates from cell bodies in the ventral segmental area (A 10 cell group). This mesolimbic dopaminergic pathway is part of the reward pathways. Drugs of abuse (cocaine, amphetamine, opiates or nicotine) have been shown to increase the level of dopamine release in these neurons. 

Identify the typical signs and symptoms of intoxication associated with the use of alcohol, opioids, cocaine/amphetamines, and cannabis, and determine the appropriate treatment measures to produce a desired outcome following episodes of intoxication. 

The treatment goals for acute intoxication of ethanol, cocaine/amphetamines, and opioids include (1) management of psychological manifestations of intoxication, such as aggression, hostility, or psychosis, and (2) management of medical manifestations of intoxication such as respiratory depression, hyperthermia, hypertension, cardiac arrhythmias, or stroke. 

The treatment goals for withdrawal from ethanol, cocaine/ amphetamines, and opioids include (1) a determination if pharmacologic treatment of withdrawal symptoms is necessary, (2) management of medical manifestations of withdrawal such as hypertension, seizures, arthralgias, and nausea, and (3) referral to the appropriate program for substance abuse treatment. 

The abused substances covered in this chapter include nicotine, alcohol, cocaine, amphetamines, cannabis, and opioids. While many more substances can be and have been abused, these drugs are among the most popular. 

The treatment goals for acute intoxication due to ethanol, cocaine/amphetamines, and opioids include (1) management of... 

Some CNS stimulants have an effect on the same systems that are involved in wakefulness, including glutamate-, NE-, DA-, 5-HT-, histamine-, hypocretin- and ACh-containing neurons. This group includes molecules such as cocaine, amphetamine, and nicotine. The sleep-promoting systems are concentrated in the medial part of the brainstem, dorsal reticular substance of the medulla, anterior hypothalamus, and basal forebrain (Jones 2005). Other stimulants, such as caffeine and theophylline, block some sleep-inducing mechanisms. Modafinil is also a CNS stimulant with an unknown mechanism of action. 

In rats, cocaine (6 mg/kg, i.p. or p.o.) has been shown to induce a significant increase in sleep latency and a reduction in total sleep time, including a decrease in both non-REM sleep and REM sleep (Schwartz 2004). In humans, cocaine, amphetamines, and methylphenidate also produce decreases in sleepiness, an increased latency to sleep, and a marked decrease in REM sleep associated with an increased latency to the onset of this state. Amphetamine, methylphenidate, and cocaine are known to act by enhancing the amount of the monoamines available within the synaptic cleft of synapses in the CNS. 

Cocainics Amphetamine-like compounds Opioids Cannabinoids... 

Eliminate alcohol, marijuana, cocaine, amphetamines, and hallucinogens... 

High abuse potential with possible medical value in U.S. Cocaine, amphetamines, strong opioid medications... 

The ion-trapping mechanism provides a method of some forensic value for detecting the presence of alkaloids (e.g., narcotics, cocaine, amphetamines) in cases of death suspected to be due to overdosage of self-administered drugs. Drug concentrations in gastric contents may be very high even after parenteral injection. 

Kronstrand et al. [48] developed an HPLC-MS-MS method able to screen simultaneously for opiates, cocaine, amphetamines, nicotine, and the metabolite cotinine, and selected benzodiazepines in hair. 

Drugs used recreationally - LSD, MDMA, phencyclidine, ketamine, cannabis, volatile solvents, opioids, cocaine, amphetamines, benzodiazepines, anticholinergics. 

Auditory unformed tinnitns, whistles formed voices, often insulting or accusatory - benzodiazepine withdrawal - cocaine, amphetamine, alcoholic hallucinosis, drug induced deliria and psychotic states... 

Tactile formication, feeling of insects etc. - cocaine, amphetamines, alcohol and benzodiazepine withdrawal... 

The primary class of stimulants for which there is a tremendous addiction problem is the sympathomimetic stimulants, which include cocaine, amphetamine, metham-phetamine (Desoxyti), methylphenidate Ritalin), and phenmetrazine. 

Comorbid dysthymia and substance disorder. A total of 642 patients were assessed. Thirty-nine had substance-related disorder and dysthymia (SRD-dysthymia) and 308 had SRD only. Data on past use were collected by a research associate using a questionnaire. The patients with SRD-dysthymia and SRD did not differ with regard to use of alcohol, tobacco, and benzodiazepines. The patients with SRD-dysthymia started caffeine use at an earlier age, had shorter use careers of cocaine, amphetamines, and opiates, and had fewer days of cocaine and cannabis use in the last year. They also had a lower rate of cannabis... 

Dopamine is removed from the synapse via two mechanisms. First, COMT degrades intrasynaptic DA. Second, the dopamine transporter (DAT) [see (4) in Fig. 2.9], a Na /CD-dependent neurotransmitter transporter, transports DA in either direction, depending on the concentration gradient. The DAT is blocked selectively by drugs such as cocaine, amphetamine, bupropion, and nomifensine. 

Stimulant), act directly on dopamine transmission. Both cocaine and amphetamine block reuptake of dopamine, which means that more dopamine is available to activate postsynaptic receptors. Due to the links between excessive dopamine and schizophrenia, it comes as no surprise that the use of cocaine, amphetamine, and similar drugs such as crack (a form of cocaine) often lead to symptoms strongly resembling schizophrenia. 

This chapter will focus on cocaine, amphetamine, methamphet-... 

There are not currently any medications that have been approved for treatment of MDMA addiction. In actuality, very few drugs of abuse have possible medical (pharmaceutical) treatments. Heroin addiction is one disease that is treatable by pharmaceutical means. Heroin addiction is often treated with methadone or levo-alpha-acetyl methadol (LAAM) administration. Similarly, alcohol addiction may be treated with pharmacological tools. However, most stimulants, such as cocaine, amphetamine, and MDMA, do not have medications available for treatment of addiction. 

The antipsychotics do not produce a ciassic withdrawai syndrome of the type seen with barbiturates or opioids nor do they produce psychological dependency, as seen with psychostimuiants (e.g., cocaine, amphetamine). Addicts and patients both dislike these drugs and do not spontaneously increase their dose. Indeed, they are more likely to discontinue them without medical advice. 

Cocaine, amphetamine, dextroamphetamine, methylphenidate, and pemoline are classified as psychomotor stimulants, producing an acute euphoria in control subjects, as well as a wide variety of responses in psychiatric patients. These stimulants are also effective in postponing the deterioration in psychomotor performance that often accompanies extreme fatigue, a property that may be useful in some carefully selected cases. 

Because neuronal uptake is necessary for the hypotensive activity of guanethidine, drugs that block the catecholamine uptake process or displace amines from the nerve terminal (see Chapter 6) block its effects. These include cocaine, amphetamine, tricyclic antidepressants, phenothiazines, and phenoxybenzamine. 

Cannabis Opiates Cocaine Amphetamine -type stimulants Methaqualone Depressants Inhalants Khat ... 

Opiates Cocaine Amphetamine-tv pe stimulants Cannabis Inhalants Sedatives ... 

Opiates Cocaine Amphetamine-ty >e stimulants Hallucinogens Cannabis Hypnotics and Sedatives Inhalants/ solvents ... 

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