Stimulants (Amphetamines ,Cocaine , Others )

Stimulants (Amphetamines ,Cocaine , Others )

-Are drugs that stimulate or excite the central nervous system.-Although the DSM-IV-TR categorizes amphetamines , cocaine , and central nervous system stimulants separately , the effects , intoxification , and withdrawal symptoms of these drugs are virtually identical

Stimulants have limited clinical use ( with the exception of stimulants used to treat attention deficit hyperactivity disorder ) and a high potential for abuse )-Amphetamines (uppers) were popular in the past ; they were used by people who wanted to lose weight or to stay awake .

- Cocaine an illegal drug with virtually no clinical use in medicine , is highly addictive and a popular recreational drug because of the intense and immediate feeling of euphoria it produces.- Methamphetamine is particularly dangerous .It is highly addictive and causes psychotic behaviour .Brain damage related to its use is frequent ,primarily as a result of the substances used to make it.

Intoxication ( intoxication of stimulants develops rapidly)

High or euphoric feelingHyperactivityHypervigilance Talkativeness Anxiety GrandiosityHallucinations Stereotypic (repetitive behaviour)Ager Fighting Impaired judgement

Physiologic effects

Tachycardia Elevated blood pressure Dilated pupils Perspiration (chills )NauseaChest pain Confusion Cardiac dysrhythmias.

Overdoses Seizures and coma ; deaths are rare .

Treatment Chlorpromazine (thorazine) , an antipsychotic , controls hallucinations , lowers blood pressure , and relives nausea ( Lehne,2001 ).Withdrawal and Detoxification Withdrawal from stimulants occurs within few hours to several days after cessation of the drug and is not LIFE THREATENINGDysphoria is the primary symptoms and is accompanied by fatigue ,vivid and unpleasant dreams, insomnia or hypersomnia , increased appetite , and psychomotor retardation or agitation.Withdrawal symptoms are referred to as crashing the person my experience depressive symptoms : Suicidal ideation for several days.Stimulant withdrawal is not treated pharmacologically.

Cannabis ( Marijuana )

Cannabis sativa is the hemp plant that is widely cultivate for its fiber used to make rope and cloth and for oil from its seeds.-This resin contains more than 60 substances called cannabinoids of which delta-9-tetrahydrocannabinol ( THC ) is thought to be responsible for most of the psychoactive effects.-It refers to the upper leaves , flowering tops , and stems of plant ; hashish is the dried resinous exudates from the leaves of the female plant.

It is most often smoke in cigarettes ( joints), but it can be eaten .It has a short term effects of lowering intra ocular pressure , but it is not approved for the treatment of GLAUCOMA.It has been studied for its effectiveness n relieving the nausea and vomiting associated with cancer chemotherapy and the anorexia and weight loss of AIDS.

2 cannabinoids - treating nausea and vomiting from cancer chemotherapy.dronabinol (Marinol)nabilone ( Cesamet )

Intoxication and Overdose

It begins to act less than 1 minute after inhalation. Peaks effects usually occur in 20 to 30 minutes and last at least 2 to 3 hours.Report high feeling ( similar with alcohol )Lower inhibitionsRelaxation EuphoriaIncreased appetite

Symptoms of intoxification

Impaired motor coordinationInappropriate laughterImpaired judgement and short term memory Distortions of time and perceptionAnxiety Dysphoria Social withdrawal

Physiologic effects

Increased appetiteInclude conjunctival injection ( bloodshot eyes )Dry mouth HypotensionTachycardia

Excessive use : delirium , cannabis-induced psychotic disorder ,both are treated symptomatically . Overdoses of cannabis do not occur ( Macfadden & Woody ,2000 )

Withdrawal and Detoxification

Although some people have reported withdrawal symptoms of muscle aches , sweating , anxiety , and tremors , no clinically significant withdrawal syndrome is identified ( Lehne , 2001 )

Hallucinogens

Are substance that distort the users perception of reality and produce symptoms similar to psychosis including hallucinations ( usually visual) and depersonalization .Cause increased pulse , blood pressure , temperature , dilated pupils , hyperreflexia.Examples of hallucinogens : mescaline , psilocybin , lysergic acid diethylamide (LSD),and designer drugssuch as Ecstacy .

Phencyclidine (PCP),developed as an anesthetic , is included in this section because it acts similarity to hallucinogens.

Intoxication and OverdoseMaladaptive behavioural or Psychological changes :

Anxiety Depression Paranoid ideation Ideas of referenceFear of losing ones mindPotentially dangerous behaviour ( jumping as out a window in the belief that one can fly ( Abraham,2000)

Physiologic symptoms

Sweating TachycardiaPalpitationsBlurred vision Tremors Lack of coordination

PCP intoxification

Belligerence AggressionImpulsivityUnpredictable behaviour

Toxic reaction to hallucinogens(except PCP) are primarily psychological ; overdoses as such do not occur.These drugs are not direct cause of death ,.although fatalities have occurred from related accidents ,aggression, and suicide.

Treatment of toxic reaction is supportive.Psychotic reactions are managed best by isolation from external stimuli; physical restraints may be necessary for the safety of the client and others. PCP toxicity can include seizures, hypertension, hyperthermia, and respiratory depression. Medications are use to control seizures and blood pressure. Cooling devices such as a hyperthermia blanket are used, and mechanical ventilation is used to support respiration

WITHDRAWAL AND DETOXIFICATION

No withdrawal syndrome has been identified for hallucinogens, although some people have reported a craving for the drug. Hallucinogens can produce flashbacks, which are transient recurrences of perceptual disturbances like those experienced with hallucinogen use. These episodes occur even after all traces of the hallucinogen are gone and may persist for a few months up to 5 years.