reet
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wht differntiating features of these drugs EEFECTS and withdrawl symptoms??
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| DrVirgo
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Good Question.
They have similar intoxication and withdrawl efx.
Amphetamines cause the release of Dopamine, and
Cocaine prevents the re-uptake of Dopamine.
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| reet
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amphetamines also released NE ( centrally)
USES--IN NARCOLEPSY,, OCD,...........
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| Geroo
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do we use amphetamine for OCD?
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| DrVirgo
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amphetamines used in treatment of ADHD.
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| reet
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ADHD yes......... sorry about OCD
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| DrVirgo
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Cocaine:
Pharmacology - absorbed from all musocal surfaces
- most commonly taken IV, by nasal insufflation and by smoking "crack" is poorly water-soluble alkaloid form of cocaine. Smoked. Onset of action within minutes. Dissipated within 29 mins if ingested with alcohol may be metabolized in liver to a longer lasting more lethal metabolite local anaesthetic action on peripheral nerves blocks noradrenaline uptake a peripheral sympathetic nerve endings and blocks noradrenaline and dopamine re-uptake at central presynaptic sites. Result is increased sympathetic activity.
Poisoning Presentation - clinical effects due to nervous system stimulation CNS effects: euphoria, agitation, confusion, seizures, hyperthermia peripheral vasomotor stimulation by norepinephrine results in tachycardia and hypertension
Complications - TIA, cerebral haemorrhage, cerebral oedema, cerebral vasculitis and ischaemia arrhythmias, myocardial ischaemia and infarction, myocarditis hyperthermia leading to DIC rhabdomyolysis with acute renal failure acute psychosis aortic rupture secondary to severe hypertension sudden death. Due to combination of coronary vasoconstriction causing myocardial ischaemia, VT and increased BP. Can occur irrespective of amount ingested, prior use or route of administration and without underlying heart disease barotrauma
due to forceful Valsalva manoeuvres that are performed during smoking - pulmonary oedema
cardiogenic negative pressure (during smoking) capillary leak due to cocaine induced microangiopathy Differential diagnosis - other conditions causing hypoxia, fits or both may mimic neuroleptic malignant syndrome or acute withdrawal from sedatives or ethanol in pregnant patients: pre-eclampsia/eclampsia
General management - exclude medical causes for agitation most important aspect of care is to control psychomotor agitation and hence prevent complications nurse in single room with close monitoring but minimal intrusions check SpO2, ECG, core temperature, glucose IV thiamine cool by surface cooling if core temperature > 40oC indications for intubation and ventilation:
uncontrollable hyperthermia extreme agitation with danger of aspiration uncontrollable convulsions deep coma with danger of aspiration - sedate with diazepam IV until agitation and seizures stop do not use neuroleptics SVTs are common and are often caused by hyperthermia and agitation and require no specific antiarrhythmic therapy VT should be treated with lignocaine (although the similarity in pharmacological effects of lignocaine and cocaine is a theoretical disadvantage), sedation and ventilation severe hypertension not responding to sedation and artificial ventilation should be treated with labetalol or nitroprusside
avoid beta blockers unless patient heavily sedated as this may lead to increased alpha activity and increasing hypertension - treat rhabdomyolysis
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| DrVirgo
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Methamphetamine vs. Cocaine
Methamphetamine is classified as a psychostimulant, as are cocaine and amphetamine. Although methamphetamine is structurally similar to amphetamine, it differs significantly from cocaine. Even though these stimulants have similar behavioral and physiological effects, major differences exist in the basic mechanisms of how they work in nerve cells. Methamphetamine and cocaine both result in an accumulation of dopamine in the brain, which seems to produce the user's stimulation of feelings of euphoria. Although cocaine is quickly removed and almost completely metabolized in the body, methamphetamine has a longer duration of action and a larger percentage of the drug remains unchanged in the body. Therefore, methamphetamine is present in the brain longer, which ultimately leads to prolonged stimulant effects
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| Natasa
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What is the correct treatment for adult ADHD?
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| mjl1717
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ritalin(methylphenidae) although a stimulant paradoxically treats this.
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| Natasa
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I have found that the preferable TH for adult forms of ADHD is Bupropion????(vs.amphetamines that are used in children).
Anybody has an idea wether that is correct?
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| mitty
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reet
If the patient present with arrythmia,think of cocaine toxicity than amphetamine.
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