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  1. 1. DRUGSSide Effects and ConsequencesSara Dobbs MD
  2. 2. Ethanol• Beer 3-8% alcohol, Wine 10-15%, “hard alcohol” 40-50%. Also cold remedies, paint removers, perfumes.• Central Nervous System Depressant and GastricIrritant.• Initial exhilaration/disinhibition• Poor judgment, high risk situations• Slurred speech, incoordination, vomiting• Coma, shock, seizures,• Lethal dose 3g/kg
  3. 3. Ethanol• Long term use – addiction• Liver damage, gastric ulcers, pancreatitis,impairment of brain function• Withdrawal symptoms – hallucinations,tremors, seizures
  4. 4. Ethanol
  5. 5. Marijuana• Smoking can produce state of relaxation oreuphoria.• Can compromise ability to perform complextasks (driving, work). Concern re short termmemory• High doses can cause paranoia/psychosis• Concern about tainted products (e.g.PCP).• Can be addicting, can lower sperm counts,Carcinogens
  6. 6. MarijuanaLung Cancer
  7. 7. Marijuana
  8. 8. Amphetamines• Stimulate release of norepinephrine to directlystimulate central and respiratory systems andenhances dopamine.• Used by prescription for ADHD• Used to elevate mood, stay awake, decrease appetite• Recreational use much higher dose than prescribeduse – much more serious side effects - addiction• Can lead to agitation, confusion, seizures,hallucinations, cerebral hemorrhage, MI
  9. 9. Amphetamines
  10. 10. Amphetamines
  11. 11. Methamphetamine• In the amphetamine class• Highly addictive drug of abuse• Used to elevate mood, increase energy• Causes anorexia, meth mouth, skin picking, strokes,seizures, hallucinations, paranoia• Long term constant dopamine release causesneurologic damage – memory loss, Parkinson’sdisease.
  12. 12. Methamphetamine
  13. 13. Meth Mouth
  14. 14. Cocaine• Used as a topical local anesthetic during surgery• HIGHLY addictive – causes dopamine to accumulatein synaptic cleft – eventually causes down regulationof dopamine receptors resulting in tolerance andaddiction• Used for feelings of euphoria, increased energy• Side effects seizures, strokes, heart attacks,perforated nasal septum (vessel constriction)• Depression, body aches, lethargy, suicidal thoughtswhen not on cocaine
  15. 15. Cocaineperforated nasal septum
  16. 16. Cocaineblood vessel infarction
  17. 17. Opioids• Extracted from the poppy plant• Targets specific receptors in brain and body to control painand enhance pleasure, enhance dopamine release• Morphine and Codeine and others often used for pain control• Heroin – more addictive because of rapid brain penetration• Cause decrease respiration, constipation, pinpoint pupils,coma, itching• Develop tolerance, physical addiction – withdrawal see fevers,diarrhea, nausea, insomnia, muscle cramps (kicking the habit)and hairs standing on end (cold turkey)• Associated with blood infections from needles (HIV, hepatitis,bacteria)
  18. 18. Opioidspoppers and track marks
  19. 19. PCP“angel dust, rocket fuel”• Dissociative anesthetic; effects the levels of severalneurotransmitters• Can be used to taint marijuana• Distorted, bizarre, violent behavior and thoughtpatterns, “out of body” feeling• High doses can cause seizures, coma, muscle rigidity,rhabdomyolysis, death• Death usually caused by physical harm while on thedrug
  20. 20. PCP
  21. 21. PCP
  22. 22. Ecstasy• MDMA – synthetic amphetamine analogue• Can induce euphoria, increase intimacy, decreaseanxiety, increase self confidence, manic state• Aftereffects – anxiety, irritability, fatigue, depression,insomnia, impaired concentration, aches and pains• Overdose can cause hallucinations, hypertension,stroke, MI, kidney failure, hyperthermia, seizures,coma, death
  23. 23. SMOKING• Tobacco use causes almost 1 in 5 deaths in USA• 18% high school students smoking in 2011• Smoking causes 30% of all cancers – some examplesare lung (87% caused by smoking), oral cavity,esophageal, stomach, kidney, AML, pancreas,bladder, larynx, pharynx• Heart disease, bronchitis, emphysema, stroke• Increase risk of birth defects, SIDS• Shorten women’s life by 14.5 years and men’s by13.2 years (CDC study)
  24. 24. SMOKING
  25. 25. SMOKING
  26. 26. LSD• Hallucinogenic – alters serotonin anddopamine activity in the brain• Can appear anxious, fearful and exhibit bizarrebehavior, combative and self destructive• Can have flashbacks months or years later
  27. 27. LSD
  28. 28. Benzodiazepams• GABA enhancer, sedative hypnotic, anxiolytic,relaxant, anticonvulsant• Short, intermediate or long acting• Develop tolerance and dependence• Can see respiratory depression, coma, rarely death• Withdrawal can include tremors, insomnia, agitation,muscle spasm, depression, suicidal activities,psychosis, seizures
  29. 29. Inhalants• A variety of substances including glues, paints, gas• Can inhale through a bag our soaked towel• Transient feeling of euphoria, light-headedness• Can cause heart arrhythmias, respiratory distress,• Chronic use can lead to muscle wasting, ataxia,tremors, rashes near the mouth and nose and kidneydamage
  30. 30. What Else?• Acetaminophen (tylenol) - too much cancause severe liver damage• Drugs slipped into your drinks –benzodiazepams or sedatives• Pill parties
  31. 31. Alcohol and Substance AbuseAmy Winehouse