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WSU PSYCH 265 - high efficacy
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PSYCH 265 1st Edition Lecture 13Outline of Last Lecture I. Normal distribution II. Pharmacogenomics & pharmacogenetics III. Pharmacokinetic exampleIV. Pharmacodynamics exampleV. Personalized medicine Outline of Current Lecture I. Stimulants II. Amphetamine action III. Amphetamine effectsIV. Cocaine action V. Cocaine effectsVI. Methamphetamine vs. cocaineVII. Cocaine vs. crackVIII. Cocaine and alcohol IX. Intoxication with stimulants X. Long term effects of stimulants XI. Long term effects of stimulants XII. Withdrawal from stimulants These notes represent a detailed interpretation of the professor’s lecture. GradeBuddy is best used as a supplement to your own notes, not as a substitute.XIII. Therapeutic use of stimulants XIV. Narcolepsy XV. ADHDCurrent Lecture-Stimulants oHigh efficacy stimulants -Amphetamines -Amphetamine -Methylated amphetamines -Cathinones -Cocaine oLow-efficacy stimulants -Nicotine -Caffeine -2010 greatest drug threats by region oMethamphetamine and cocaine are major drug threats, albeit in different parts of the country -Amphetamine action oAmphetamine acts at norepinephrine and dopamine neurons in the brain oAmphetamine enters the nerve terminal by using the reuptake mechanism oAmphetamine bears a structural resemblance to both NE and dopamine -Amphetamine effectsoAlpha-adrenergic receptors -Increased wakefulness -Increased respiration -Decreased appetite oDopaminergic receptors -Euphoria -Increased sense of energy -Increased sense of confidence -Psychotic behavior (high doses)-Cocaine action oBinds to the transporter and prevents neuronal reuptake of neurotransmitter oInhibits the transporters for NE and dopamine oEffects are similar to those of amphetamine -Cocaine effects oAlpha-adrenergic receptors -Increased wakefulness -Increased respiration -Decreased appetite oDopaminergic receptors -Euphoria -Increased sense of energy-Increased sense of confidence -Psychotic behavior (high doses)-Methamphetamine vs. cocaine oMethamphetamine -Man-made-Smoking produces high that lasts 8-24 hr -50% of drug eliminated in 12 hr -Increases neuronal release of dopamine and blocks neuronal reuptake of dopamine -Used in treatment of ADHD and narcolepsy (C-II)oCocaine -Isolated from erythoxylon coca-Smoking produces high that lasts 20-30 min -50% of drug eliminated in 1 hr -Blocks neuronal reuptake of dopamine -Used as local anesthetic in some surgical procedures (C-II)-Cocaine vs. crack oCocaine -Cocaine hydrochloride -Isolated from leaves of coca plant, erythoxylon coca-Topical, injectable, oral, insufflation (snorting)-Bioavailiability 70-75% (snorted)-Onset of action 10-30 sec (snorting)-Time to peak levels in brain: 10 min (snorting)-Duration of action 2 hours -Used as local anesthetic in some surgical procedures (C-II)oCrack -Cocaine freebase -Conversion from cocaine salt using NaHCO3 or NH3-Smokable form of cocaine -Bioavailability 90%-Onset of action 1-2 sec (smoking)-Time to peak levels in brain- 8 sec (smoking)-Duration of action 5-15 min -No accepted medical use (C-I)- cocaine and alcohol oConcurrent use of cocaine and alcohol results in formation of cocaethylene oInstead of being converted to inactive metabolites, cocaine is converted to an active metabolite with similar properties oCocaethylene inhibits reuptake of NE, dopamine and serotonin, producing stimulant, euphoric, anorectic, and sympathomimetic effects-Intoxication with stimulants oCocaine -Cardiopulmonary symptoms -Psychiatric complaints (altered mental state and suicidal ideation)-Neurological problems (seizures, delirium)oAmphetamine -Mainly altered mental status (confusion, delusions, paranoid reactions, hallucinations, suicidal ideation)-Long term effects of stimulants oPsychological and physiological dependence oTolerance development oMyocardial infarction, cardiac arrhythmias, stroke oToxicc psychosis (paranoia, hallucinations, stereotyped behavior) oAggressive of violent behavior, depression oWeight loss-Intoxication with stimulants oCocaine -Cardiopulmonary symptoms -Psychiatric complaints (altered mental state and suicidal ideation)-Neurological problems (seizures, delirium)oAmphetamine -Mainly altered mental status (confusion, delusions, paranoid reactions, hallucinations, suicidal ideation)-Long term effects of stimulants oPsycho and physio dependence oTolerance development oMyocardial infarction, cardiac arrhythmias, stroke oToxic pscyhosis (paranoia, hallucinations, stereotypes behavior) oAggressive or violent behavior, depression oWeight loss-Withdrawal from stimulants oDysphoria, depression oFatigue, loss of physical and mental energy, excessive sleepoDecreased interest in surroundings oIntense drug craving oIncreased appetite oVivid, unpleasant dreams -Thereapeutic use of stimulants oAmphetamines -Narcolepsy -ADHD oCocaine -Local anesthesia -Narcolepsy oChronic neurological disorder that characterized by impaired control of the sleep-wake-cycle oMajor signs of narcolepsy -Excessive sleepiness (EDS)-chronic pervasive sleep with sudden, brief and irresistible sleep attacks at any time -Cataplexy--sudden loss of postural muscle tone triggered by strong emotions particularly laughter -Sleep paralysis--inability to move at the onset or end of sleep-Hypnagogic/hypnopompic hallucinations--vivid dreams occuring at the onset or end of sleep-ADHDoOne of most common childhood disorders and can continue through adolescence and adulthood oType of ADHD -Attention deficit (difficulty staying focused and paying attention)-Hyperactivity and impulsivity (difficulty controlling behavior)oADHD affects 9% American children aged 13-19 boys are 4 times at risk than girls oADHD affects about 4.1 american adults aged 18 yo and older in a given


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