CCJ4938 DRUGS FINAL EXAM BOOK NOTES Goode ch. 11, 13, 14, and 15Goode chapter 11- the pharmaceutical neuroleptics• The ostensible reason governments control drugs is to ensure that the smallest possible number of people is harmed by their unauthorized, illicit use• Recreational drug users take psychoactive substances so that they can reach a state of extasis or “extranormality” – achieving a high or an “out-of-everyday-mind” experience• Pharmaceuticals: medicinal drugs• Neuroleptics: substances that “seize hold” of the nerves • Sedatives and tranquilizers are calming agents• Hypnotics: sleep-inducing agents• Antipsychotics: drugs designed to alleviate a mentally disordered individual • Antidepressants: agents designed to reduce or alleviate feelings of dejection, sadness, and gloom, or dysphoria o Few of these drugs’ users (with exception of sedatives) take these substances for recreational purposes • Depression has 2 meanings:o A mood of gloominess and despairo A mechanism of reducing the body’s organic functioning• Most pharm drugs have no psychoactive effect whatsoever • The Most popular drug category among the pharmaceuticals was made up of the antipsychotics; used to combat schizophrenia • Even though there is no illicit antidepressant use, antidepressants stand in 5th place with respect to causing overdose deaths, according to DAWN; most of these overdoses are suicides • A substantial number of narcotics- a popular recreational drug- did rank among the top 200 prescription drugs in 2009 • According to DAWN, narcotics are the top drug type in causing overdose deaths• All brand name drugs decline in sales after their peak in popularity o After the pharm company patent expires, the drug falls into the public domain, which means another company can sell it under a generic name o Nearly all psychoactive prescription drugs decline in popularity over the long run because physicians become aware of some of their undesirable side effects and search for less toxic substances • The total volume of prescriptions that are written for a given drug category may remain stable or even rise, while the number of particular drug products will rise and fall precipitously • Sedative-hypnotics: downers or general depressants that obtund signals passing through the CNS o At higher doses, sedatives are hypnotics that induce sleep • Barbiturates: CNS depressants that are derived from barbituric acido Classified according to the speed of their action o Ultra-short acting barbiturates: administered IV and produce unconsciousness and anesthesia within a minute, and their effects last two or three hours (used as recreational drugs)o Short- and intermediate- acting barbiturates: used for sedation and sleep aids; introduce an intoxication or high if taken in sufficient doses and have been extensively used recreationally on the street o Long-acting barbiturates: used as anti-anxiety agents as well as anti-epileptic drugs, do not produce a high, and are rarely used recreationally o Except as sedatives, barbiturates have been replaces by the benzodiazpam drugs which physicians regard as much safer o Alcohol is sometimes referred to by pharmacologists as a “liquid barbiturate” o Barbiturates are in many ways even more dangerous than heroin o The classic withdrawal syndrome appears upon discontinuation of “chronic” use of barbiturates The heavier the dependence, the more extreme the reactions It is possible to die of barbiturate withdrawal Death is caused by respiratory failure o Barbiturates demonstrate a cross-tolerance with alcohol Effects of the two taken together are synergistic- more toxic than the sum of their separate effects• Methaqualone: another sedative with effects similar to the barbiturates; once commonly prescribed, it has been classified as a Schedule I drug and thus is no longer legally prescribed in the US • Valium was the first and most successful of the benzodiazepines o Between 1969-1982, valium was the nation’s best-selling prescription drug • Long-term use of benzodiazepines may cause psychological impairment and even brain damage • In large doses, the benzos act as sedative-hypnotics- they produce drowsiness; in small to moderate doses, they act as calming agents and are effective in combating anxiety and tension • With respect to the recreational use of tranquilizers, the trend line shows a decline, then an increase • Tranquilizers are sold on the street and are used for both recreational and quasi-therapeutic purposes; taken in large enough doses over a long enough period of time, all the minor tranquilizers can produce a physical addiction or dependency • Rohypnol is a tranquilizer and a benzo • The antipsychotics were once referred to as “major” tranquilizers to distinguish them from the “minor” tranquilizers- the sedativeso The reasoning was that major tranquilizers pacified mental patients, or psychotics, while minor tranquilizers pacified ordinary neurotics o Today, the antipsychotic drugs are in the treatment of psychosiso Instead, psychiatrists use the antipsychotics in the treatment of psychosis; these drugs do NOT produce a high or intoxication, are virtually never used recreationally and are not sold on the underground market • On any given day in 1955, almost 560,000 mental patients resided in nonfederal mental hospitals in the country. That year, Thorazine, an antipsychotic drug, was introduced to treat psychosis. The number of resident patients dropped every year since then; today, there are fewer than 50,000 resident patients in publicly funded mental hospitals on any given day. It is possible that this figure represents an “irreducible minimum”- the number of mentally ill patients who are unresponsive to current drug treatment modalities- and will remain more or less stable over time o The change was the result of the drastic decline in the average length of stay in mental hospitals; in 1955, the average period of hospitalization was 6 months; today, it is 2-3 weekso Reduction in stay is due almost entirely to the use of antipsychoticso About 85% of all patients in state, local, and federal mental hospitals receive some form of antipsychotic medication • Studies have shown that about ¾ of all acute schizophrenics demonstrate significant improvement following the administration of antipsychotics, and 75-95% of all patients relapse if their medication is
View Full Document
Unlocking...