Abuse potential: 

Tx for withdrawal and abstinence: 

Methamphetamine - Increases release of DA and NE in basal ganglia; may cause amphetamine, psychosis; Rapid physical and psychological dependence; meth mouth, formication (crawling bugs feelin); Cardiotoxic/neurotoxic

Tx for Amphetamine and Methamphetamine = abstinence (withdrawal+crash), inpatient outpatient and supprt services; NA/Cocain Anonymouse

Basic Mechanism: Bind 5HT receptors in brainActs onf 5-HT receptors in the brain; synesthesia; doesn't cause dependence, doesn't effect DA receptors; causes euphoria and visual hallucinations (synesthesia)

LSD-  Lysergic acid diethylamide (LSD)

Psilocybin- magic mushrooms

Mescaline- from peyote

PCP, Ketamine- both NMDA antagonist; dissociative anesthetics, stimulant, depressant, hallucinogenic and analgesic; causes psychosis (aggressive behavior), Tx with haloperidol (PCP)

GHB- GABA weak agonist; dissociative anesthetics; date rape drug (GHB and ketamine)

Methadone

Naltrexone (ReVia) - blocks "high" from EtOH and benzos

Disufram (Antabuse)

Acamprosate (Campral)

Buproprion (Wellbutrin) - reduce cravings and depression in EtOH

Bromocriptine (Parlodel)- Decreases craving for Cocaine

Bath Salts - synthetic "cannabinoid" agonist; psychoactive effects = paranoia, hallucinations, mood swings

Inhaled Drugs- Unknown mechanism; Produces sense of euphoria

Can incluse NO (dentists) -> peripheral neuropathy; 

Cocaine- Mechanism:  Inhibits DA reuptake;

Pharm actions: Euphoria and reinforcement due to increased DA in nucleus accumbens and cortex; burs of energy and euphoria

Used for LA and vasoconstriction

Adverse consequences: Cerebral hemorrhage; temp may increase to 108-110; seizures; Physical and psychological dependence: Cardiac effects; "cocaine bugs"

Tx: Detox; inpatient tx; avoid environmental cues; NA/Cocain anonymous

Amphetamine- Mechanism: Increases release of DA, reverses DA transport through the DAT; also inhibits VMAT; usually for Narcolepsy, ADHD (Ritalin, Adderall): also fo obesity 

Effects: Stimulation, allertness, reduced fatigue, increased energy, decreased appetite

Adverse consequences: anxiety, insomnia, irritability; high doses/long term = psychosis, stereotypic behavior (constant repetition of meaningless activity)

Tx for Amphetamine and Methamphetamine = abstinence (withdrawal+crash), inpatient outpatient and supprt services; NA/Cocain Anonymouse

Marijuana- delta-9-tetrahydrocannabinol (THC); Targets presynaptic cannabinoid (CB1) receptors, Inhibits NT release (Glutamate and ACh); endogenous ligand = anandamide; No physical dependence; psychological dependence possible; 

Effects: Increased appetite and antiemetic (CA tx!) Pleasant feeling of well being, introspection, tranquility, rapid mood changes, altered perception of space and time; increased intesity of sensory perceptions

Drawbacks to chronic use: acute depression, acute panic reactions and mild paranoia may occur; amotivational syndrom, reversible reduction in testosterone levels/sperm production and motility; bronchial irritation and inflammation (CA risk of smoking)

Medical effects: anti-emetic (Chemo CA), analgesia (MS), appetite enhancement in AIDS pts

MDMA (Ecstasy)- Mechanism: Increases 5-HT activity by blocking reuptake and stimulating 5-HT receptors (NO DA INVOLVEMENT!);

 Effects: Feelings of peacefulness, acceptance, empathy, feelings of close and trust.

Toxicities: Hyperthermia, dehydration, kidney failures can lead to fatalities; long term serotonin neuron death results; may increase HR and BP; adverse effects = confusion, depression, sleep problems, anxiety, paranoia, muscle tension, teeth clenching, nausea, blurred vision, faintness, chills or sweating