CCJ4938 DRUGS FINAL EXAM BOOK NOTES Goode ch 11 13 14 and 15 Goode 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 Sedatives and tranquilizers are calming agents Pharmaceuticals medicinal drugs Neuroleptics substances that seize hold of the nerves 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 despair o 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 acid o 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 Death is caused by respiratory failure It is possible to die of barbiturate withdrawal 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 sedatives o 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 psychosis o 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 weeks o Reduction in stay is due almost entirely to the use of antipsychotics o About 85 of all patients in state local and federal mental hospitals receive some form of antipsychotic medication Studies have shown that about of all acute schizophrenics demonstrate significant improvement following the administration of antipsychotics and 75 95 of all patients relapse if their medication is discontinued The antipsychotic drugs not only are regarded as effective for most mental patients but are also the least expensive of all treatment modalities Antipsychotics are NOT addictive o Phenothiazines are in this category though and they do have side
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