Drugs - Use, Misuse and Abuse

1. DRUGS - Use, Misuse and Abuse
Presented by
Dr. N. Venkateswaramurthy
Professor & Head
Department of Pharmacy Practice
J.K.K.Nattraja College of Pharmacy

2. Drug - any substance that causes a change in
a person’s physical or psychological state.
Medicine- any drug used to cure, prevent, or
treat illness or discomfort.
UNDERSTANDING DRUGS & MEDICINES

4. TYPES OF MEDICINES
 Antibiotic- kills bacteria to help cure infections
 Stimulant- increases alertness; helps people with
attention deficit hyperactivity disorder (ADHD) to focus
their attention
 Anti-anxiety- helps people who are excessively nervous
or panicked to calm down
 Vaccine- Prevents infections in people exposed to the
infectious agent
 Sedative- causes sleepiness

5. DEVELOPMENT…….

7. 460000000 USD = 3135,93,49,968
INR

8. KEY TERMS
 Side effect- an effect that is caused by a drug &
that is different from the drug’s intended effect

10. Thalidomide –
phocomelia (the
"seal limb“)

11. Thalidomide –
phocomelia (the
"seal limb“)

12. Angioedema (swelling of the lips, tongue, and throat causing difficulty
breathing)- ACE inhibitors- Captopril-Enalapril-Lisinopril

13. AMLODIPINE
PEDAL EDEMA

14. ANTIHYPERTENSIVES(ACE INHIBITORS)-
ANGIOEDEMA

16. PHENYTOIN
GINGIVAL ENLARGEMENT

17. ANTIBIOTICS,SULFA DRUGS, NSAIDS-STEVEN JOHNSON SYNDROME(SJ

19. ANTIBIOTICS,SULFA DRUGS, NSAIDS-PHOTOSENSITIVITY

20. CHLORAMPHENICOL-GREY BABY SYNDROME

21. RIFAMPICIN
DARK URINE

22. METOPROLOL
PRURITUS

23. IMIPRAMINE
XEROSTOMIA

24. METHOTREXATE
ALOPECIA

25. PROMETHAZINE
UTICARIA

26. The most common cause is certain medications such as lamotrigine,
carbamazepine, allopurinol, sulfonamide antibiotics, and nevirapine

27. TYPES OF DRUGS
 Prescription
 A doctor’s prescription is
required to legally use/obtain
Over-the-counter (OTC)
 can be purchased at stores
 Recreational
 Drugs that contain chemicals used to help people relax or
socialize
 Alcohol, tobacco, coffee, tea, and chocolate

28. TYPES OF DRUGS
 Herbal Preparations
 Herbal teas and other products of plants that are believed to
have medicinal properties
 Illicit (illegal)
 Generally recognized as harmful
 All of them are psychoactive
 Commercial Preparations
 Commonly used chemical substances, including cosmetics,
household cleaning products and industrial by-products.

29. WHY PEOPLE ABUSE THE DRUGS…………..

30. HAPPY BRAIN CHEMICALS…………..

31. DRUGS HIJACK THE BRAIN’S
Dopamine produces a
feeling of pleasure
Serotonin produces a
feeling of well being
 Immediate effect of drug
use is an increase in
dopamine
reward

32. MISUSING AND ABUSING DRUGS
Drug Misuse
 The use of a drug for a
purpose for which it was not
intended.
Drug Abuse
 The excessive use of any
drug

33. TAKING DRUGS
 Ingestion
 most common but slowest route (eating)
 Produces effects within 20 minutes to 1 hour
 mucosal absorption (chewing tobacco, cocaine)
 Injection
 Intramuscular – into muscle tissue
 Subcutaneous – into fat directly beneath skin
 Intravenous - into vein
 Produces effects within 3 minutes

34. TAKING DRUGS
 Inhalation
 Through the nostrils
 Only small amounts can be
absorbed and metabolized in the lungs
 Effects are often frequent, but do not last long
 Mucosal absorption Absorbing the drug through the
mucous membrane (i.e. chewing tobacco or snorting
cocaine)
 Topical administration
 Through the skin (nicotine patch)

35. USE>ABUSE>ADDICTION
Why do people take drugs:
-to feel good
-to feel better
-to do better
-curiosity
-imitation
-love of risk
Why do people CONTINUE to take drugs:
-not to feel sick
-to feel ‘normal’
-loss of control
-habit
Why do people become ADDICTED:
-physical changes in the brain
-loss of judgment
-compulsive behavior

36. SIGNS OF TROUBLE
change in appetite or weight
unusual behaviour
sudden secretiveness
persistent lying
sudden violent temper
mood swings
relationship with family
and friends is bad
loss of interest in hobbies
lack of grooming
stealing.

37. EFFECTS OF DRUG ABUSE

42. CATEGORIES OF DRUGS
OF ABUSE
Stimulants
Depressants
Hallucinogens
Narcotics

43. NARCOTICS
OPIUM
OPIATES OPIOIDS
MORPHINE
HEROIN
CODEINE
DILAUDID
VICODIN
METHADONE
OXYCODONE
(oxycontin)

44. NARCOTICS
Used “commonly” to control moderate-
severe acute pain.
Can cause physiological tolerance (more
to get same effect).
Can cause physical dependence
(discomfort if abruptly stopped)

45.  Hallucinogens, or psychedelic drugs, are
drugs that alter the way you see, hear, or
feel things. They can cause people to
hallucinate or see stuff that isn’t there.
 Under the influence of hallucinogens,
people see images, hear sounds, and feel
sensations that seem real but do not exist.


48. LSD- lysergic acid diethylamide
3,4 Methylenedioxymethamphetamine(MDMA)
 Phencyclidine (PCP)
PEYOTE
Primarily Psychologically Addicting

49. HARMFUL EFFECTS
 Physical: Increased energy and heart rate,
Nausea

Nervous system: impairs memory, difficulty in judgment

Cardiovascular system: Abnormal heart rate, heart attacks

Digestive system: Inflammation of pancreas

Respiratory system: slow breathing, bronchitis
 Emotional: mood swings, panic attacks, loss of senses,
depression

Social: Loss of family, friends, and loved ones

Legal Consequences: Jail time and large fines


50. CLUB DRUGS
 Ecstasy (Methylenedioxymethamphetamine)
 GHB (Gamma-hydroxybutyrate)
 Rohypnol (Flunitrazepam – related to Valium,
Xanax)
 Ketamine ( anesthetic for humans and animals,
injected, smoked)
 Methamphetamine
 LSD (Lysergic Acid Diethylamide 25)

51. CLUB DRUGS
Methylene dioxymethamphetamine- Deve. In 1900 as
appetite suppressant. Has effects of Stimulant and Hallucinogen,
effects last approx 3-6hrs. Usual side effects (confusion,
depression, sleep problems, anxiety, paranoia, dehydration,
hypertension and heart or kidney failure) can last up to 1 mo.
Significant increase in BP, heart rate, increased sense of
alertness and energy.
GHB-(Gamma-hydroxybutyrate)
Sometimes used as Muscle Builder, and to enhance sexual
performance. GHB is a central nervous system depressant that
can relax or sedate the body.
At higher doses it can slow breathing and heart rate to
dangerous levels. Its intoxicating effects begin 10 to 20 minutes
after the drug is taken. GHB is cleared from the body relatively
quickly, so it is sometimes difficult to detect in emergency rooms
and other tx. facilities.

52. CLUB DRUGS
Rohypnol -Rohypnol is commonly referred to as a "date
rape drug,“- In the benzodiazepine family (valium, xanax). Is
tasteless and odorless, dissolves easily in carbonated beverages.
Effects are aggravated by concurrent use of alcohol. “Even without
alcohol, a dose of Rohypnol can impair a victim for 8 to 12 hours.”.
The drug causes profound “anterograde amnesia”;, individuals may
not remember events experienced while under the influence. One of
the “street names” is the “forget-me-pill”, and has/is used in many
reported/unreported sexual assaults.
Ketamine Actually classified as an anesthetic (animal).
Popularized in the 1980’s. High doses produced effects similar to
PCP (dream-like states and hallucinations. (smoked-usually in
marijuana, snorted, injected)

53. STIMULANTS
DEXEDRINE
CAFFEINE
METHEDRINE
AMPHETAMINE
COCAINE (CRACK)
BothPhysically& PsychologicallyAddicting

54. DEPRESSANTS
BARBITURATES
 SECONAL
 TUNIAL
 PHENOBARBITUAL
TRANQUILIZERS
 Valium
 Librium
 Xanax
 Ativan
Primarily Physically Addicting

55. ALCOHOL
55

56. ALCOHOL: BASIC FACTS (1)
Description: Alcohol or ethylalcohol (ethanol) is
present in varying amounts in beer, wine, and
liquors
Route of administration: Oral
Acute Effects: Sedation, euphoria, lower heart
rate and respiration, slowed reaction time,
impaired coordination, coma, death
56

57. ALCOHOL: BASIC FACTS (2)
Withdrawal Symptoms:
 Tremors, chills
 Cramps
 Hallucinations
 Convulsions
 Delirium tremens
 Death
57

58. LONG-TERM EFFECTS OF ALCOHOL
USE
 Decrease in blood cells leading to anemia,
slow-healing wounds and other diseases
 Brain damage, loss of memory, blackouts,
poor vision, slurred speech, and decreased
motor control
 Increased risk of high blood pressure,
hardening of arteries, and heart disease
 Liver cirrhosis, jaundice, and diabetes
 Immune system dysfunction
 Stomach ulcers, hemorrhaging, and gastritis
 Thiamine (and other) deficiencies
 Testicular and ovarian atrophy
 Harm to a fetus during pregnancy
58

59. TOBACCO
59

60. TOBACCO: BASIC FACTS (1)
Description: Tobacco products contain nicotine
plus more than 4,000 chemicals and a dozen
gases (mainly carbon monoxide)
Route of administration: Smoking, chewing
Acute Effects: Pleasure; relaxation; increased
concentration; release of glucose; increased
blood pressure, respiration, and heart rate
60

61. TOBACCO: BASIC FACTS (2)
Withdrawal Symptoms:
 Cognitive / attention deficits
 Sleep disturbance
 Increased appetite
 Hostility
 Irritability
 Low energy
 Headaches
61

62. LONG-TERM EFFECTS OF TOBACCO
USE
 Aneurysm
 Cataracts
 Cancer (lung and other types)
 Chronic bronchitis
 Emphysema
 Asthma symptoms
 Obstructive pulmonary diseases
 Heart disease (stroke, heart attack)
 Vascular disease
 Harm to a fetus during pregnancy,
low weight at birth
 Death
62

63. CANNABINOIDS
63HashishMarijuana

64. CANNABIS: BASIC FACTS (1)
Description: The active ingredient in cannabis is
delta-9-tetrahydrocannabinol (THC)
 Marijuana: tops and leaves of the plant Cannabis
sativa
 Hashish: more concentrated resinous form of the
plant
Route of administration:
 Smoked as a cigarette or in a pipe
 Oral, brewed as a tea or mixed with food
64

65. INHALANTS
 SOLVENTS (polish & paint removers, lighter fluid, gas)
 AEROSOLS (paint sprays, hair sprays)
 ADHESIVES (airplane glue, rubber cement)
 CLEANING AGENTS (spot removers, dry cleaning fluid)
 ROOM DEODORIZERS (glade, etc)
 NITROUS OXIDE (whipped cream, laughing gas)
Primarily Psychologically addicting “One of the most
dangerous”

66. DETECTION OF DRUGS IN URINE SAMPLES
 Amphet/Meth 2 days (1 use)
 Barbiturates 2 Days
 Benzodiazepines 2 Days (1 use)
 Marijuana 2 Days (1use)
7-28 Days (prolonged)
 Cocaine/Metabolite 2 Days (1 use)
4 Days (daily)
 Methadone 2-3 Days
 Narcotics 2 Days
 PCP 7 days (1 use)
“Hair Test can detect presence for up to 90 Days “

67. MEDICATIONS ARE AN IMPORTANT
ELEMENT OF TREATMENT.
Methadone
Naltrexone
Buprenorphine