SlideShare a Scribd company logo
1 of 33
Little clinical use, except methylxanthines
 Can be classified in to:


› Respiratory stimulants ( Analeptics).

› Convulsants
› Psychomotor stimulants
› Psychomimetic drugs
Doxapram :
 MOA not clear, may excite central neurons
 Short acting, high margin of safety.
 Low doses selective for respiratory centre
 ↑ Tidal volume & rate of respiration
Uses :
 Post-anaesthetic resp. depression
 COPD i.e. hypoxemic,hypercapnic res.fail
 Apnoea in premature infants
Dose- 2-5mg/min(max 4mg/kg) slow i.v
infusion.
Contraindications:
 Hypoxaemic, normocapnic resp.failureasthma
 Resp.fail due to neurological & muscular
diseases.
 Epilepsy
Side effect:
 Restlessness
 Tachycardia
 High doses: convulsions & arrhythmias

No clinical use
 Used as research tools
Strychnine:
 Alkaloid, convulsant poison.
 Spinal cord stimulant
 MOA: Blocking the receptors for Glycine
 In poisoning convulsion treated withDiazepam or clonazepam slow i.v

Picrotoxin:
 Blocks the Cl- ion channel of GABAA.
Bicuculline:
 Plant alkaloid, GABAA antagonist.
Pentylenetetrazole (PTZ):
 Direct depolarization of central neurons
 Provides useful animal model for testing
anticonvulsant drugs.
Amphetamine group:
 Amphetamine
 Dexamphetamine
 Methamphetamine
 Methylenedioxy Methampheta(MDMA)
 Methylphenedate
 Fenfluramine
Non-Amphetamine group
 Modafinil
 Atomoxetine
 Sibutramine
 Pemoline
Cocaine
Methylxanthines:
 Caffeine
 Theophylline
 Theobromine
MOA: ↑DA conc. In synaptic cleft by
 Enter N endings by active transport
 Displace DA(also NE) from vesicles
 Also inhibits MOA-B, ↓DA metabolism.
Pharmacological effects: (central)
 ↑ motor activity
 Euphoria & excitement
 Anorexia
 Stereotyped & psychotic behaviour
↑ BP, inhibition of GI motility
 Fatigue both physical & mental reduced.
 Amphetamine psychosis on repeated
use- paranoid ideas, A & T hallucinations.
PK:
 Well absorbed orally
 Freely penetrates BBB
 Unmetabolised drug excreted in urine

ADHD with minimal brain dysfunction:
 Characterised by› Hyperactivity
› Inability to concentrate
› Impulsive behavior
 Dexamphetamine,
 Methylphenedate,
 Atomoxetine quite effective.
Narcolepsy: Characterised by Sleep attacks during day time
 Night mares in awakening state
 Cataplexy-reversible
 Methylphenedate is still used
 Modafinil- devoid of abuse liability
Fenfluramine, dexfenfluramine used
earlier to treat obesity
 Discouraged due to: Tolerance
 Insomnia, pul.htn, abuse potential.
Sibutramine new drug used now
 Blocks neuronal uptake of mainly NE &
5HT (also dopamine) at hypothalamic
site that regulates food intake.

Use:
 Severe obesity with risk factors like DM.
Adverse effects:
 Dry mouth
 Headache
 Insomnia
 Constipation
 ↑in HR & BP
 CI in CVS diseases, withdrawn from
market
Tolerance
 Psychic dependence, rarely physical.
Amphetamine overdose:
 Euphoria, dizziness, tremors, HTN
 Irritability, anorexia, insomnia
 Higher doses- convulsions, psychotic
manifestations, arrhythmias, coma
 Rx –diazepam(slow i.v), haloperidol
 Gastric lavage, acidification of urine
 HTN-nifedipine/labetolol, arry-esmolol

Sudden deaths occurred with MDMA.
 Induces heat stroke like conditionrhabdomyolysis & renal failure
 Inappropriate secretion of ADH
Methylenedioxy amphetamine (love drug)
 75mg- psychotomimetic effects
 150 mg-LSD like effects
 300mg- amphetamine like
 SE: tachycardia, HTN, arrhythmias

Only caffeine if used as CNS stimulant
PK:
 Oral- rapid but irregular absorption
 PPB:<50%
 Distributed all over the body
 Met: in liver by demethylation & oxid.
 Metabolites excreted in urine
 T1/2: 3-6hrs

AE:
 Gastric irritation, N, V
 Nervousness, insomnia, agitation
 Muscule twitch, rigidity
 ↑body temp,delirium, convulsions
 Tachy, extra systoles at high doses
Uses:
 In Analgesic mixture for headache
 Migraine
 Apnoea in premature infants
Produce changes in sensory
perceptions, thoughts, behaviour &
mood.
 Actions mimic psychoses- psychedelics
 Lysergic acid diethylamide (LSD)
 Mescaline
 Phencyclidine
 Cannabinoids

Derived from cereal fungus ergot
 Hofmann synthesized & experimented on
himself.
 Act as agonist at 5HT2 receptors.
 Excitation threshold of retina ↓-visual
hallucinations
 Excitation threshold of RAS↓-hyper
arousal state
 Experiences may be bad or good trip.

Extract of hemp plant-C.sativa, C.indica
 Bhang- paste of powdered dried
leaves, used as drink
 Marijuana- dried leaves & flowering
tops, smoked in pipes or rolled as
cigarettes.
 Charas or hashish- resinous exudates
leaves & flowering tops, potent smoked
inpipe.
 THC content more in hashish

Initial CNS stimulation later sedation.
 Stimulatory phaseeuphoria, ↑talkativeness, ↑appetite
 Felling of confidence, relaxation & well
being
 Other- analgesia, antiemetic
 Peripheral effects- tachy, VD, reddening
of conjunctiva











Two types CB 1& 2 receptors
CB1 in brain CB2 in periphery
Anandamide-endogenous ligand CB1.
Dronabinol, Nabilone- synt.analogues of
THC
Use: CB1 Agonists- ↑appetite in AIDS pts.
Dronabinol-antiemetic in cancer chemo.
Rimonabant : CB1 antagonist, used for
obesity, dose-20mg OD before Breakfast
Smoking cessation
Indications:
 AD, multi infarct dementia
 Mild cognitive impairment
 MR, learning defects, ADHD in children
 TIA, CVA, Stroke
 Organic psychosyndromes
 Sequale of head injury
 ECT, brain surgery
↑ global/regional blood flow
 Direct support of neuronal metabolism
 Enhancement of neurotransmission
 Improvement of discrete cerebral
functions

Main pathological features:
 Amyloid plaque
 Neurofibrillary tangles
 Marked ↓ in choline acetyltransferase &
loss of cholinergic neurons in brain.

ACEs that cross BBB are preferred.
Tacrine:
 Longer acting, reversible ACE
 Palliative for mild to moderate AD
 Orally active
 Improves memory, cognition, well being
 Facilitates Ach release
 AE: hepatotoxicity

Newer reversible Anti cholinesterase
 Better penetration in to CNS
 Better tolerated & less toxic than tacrine
 Clinical results modest & temporary
 Donepezil: 5mg OD orally evening ↑ max
10mg after 4 wks
 Rivastigmine:1.5 mg orally BD ↑ to 3mg
BD after 2 wks
 Galantamine:4mg BD orally ↑to 8mg BD
after 2 wks

Transdermal Rivastigmine patch –
applied every 24hrs
 SE:diarrhoe, N, V, ↑urination
Acetyl-L-carnitine:
 Structural analogue of Ach
 ↓ signs & symptoms of dementia in AD
 ↑ cholinergic transmission
 Also have antioxidant properties, slows
progression of AD

Excitotoxicity due to enhanced
Glutamate transmission via NMDA recp.
 Dose:5mg OD slowly ↑ to 10-20mg/day
 Non-comp. antagonist of NMDA recp.
 Better tolerated, less toxic.
Miscellaneous :
 Nootropics-piracetam, aniracetam
 High doses of vit E(1000 IU B.D)
 Antioxidants-vit
C, A, Zn, Se, bioflavonoids or spirulina ↓
progression even in middle stage AD.

¡gracias
"thank you" in Spanish

More Related Content

What's hot

Antihistamine Drugs (Pharmacology)
Antihistamine Drugs  (Pharmacology)Antihistamine Drugs  (Pharmacology)
Antihistamine Drugs (Pharmacology)Rahul Ranjan
 
Antidepressants -pharmacology
Antidepressants -pharmacologyAntidepressants -pharmacology
Antidepressants -pharmacologypavithra vinayak
 
Antidepressants - Pharmacology
 Antidepressants - Pharmacology Antidepressants - Pharmacology
Antidepressants - PharmacologyAreej Abu Hanieh
 
CNS stimulants & cognitive enhancers
CNS stimulants & cognitive enhancersCNS stimulants & cognitive enhancers
CNS stimulants & cognitive enhancersDr.UMER SUFYAN M
 
Pharmacology of dopamine
Pharmacology of dopaminePharmacology of dopamine
Pharmacology of dopaminesumitwankh
 
Antipsychotic drug
Antipsychotic drug Antipsychotic drug
Antipsychotic drug Vibha Manu
 
(Autocoids) Histamine Pharmacology ppt
(Autocoids) Histamine Pharmacology ppt(Autocoids) Histamine Pharmacology ppt
(Autocoids) Histamine Pharmacology pptPranatiChavan
 
Androgens, anabolic steroids and antiandrogens
Androgens, anabolic steroids  and antiandrogensAndrogens, anabolic steroids  and antiandrogens
Androgens, anabolic steroids and antiandrogensAnkita Bist
 
Notes sedative & hypnotics
Notes sedative & hypnoticsNotes sedative & hypnotics
Notes sedative & hypnoticsBabitha Devu
 
Neurohumoral transmission in CNS
Neurohumoral transmission in CNSNeurohumoral transmission in CNS
Neurohumoral transmission in CNSSanchit Dhankhar
 

What's hot (20)

Antihistamine Drugs (Pharmacology)
Antihistamine Drugs  (Pharmacology)Antihistamine Drugs  (Pharmacology)
Antihistamine Drugs (Pharmacology)
 
Dopamine
DopamineDopamine
Dopamine
 
Antidepressants -pharmacology
Antidepressants -pharmacologyAntidepressants -pharmacology
Antidepressants -pharmacology
 
Antidepressants Pharmacology
Antidepressants  PharmacologyAntidepressants  Pharmacology
Antidepressants Pharmacology
 
Anti-epileptic drugs
Anti-epileptic drugsAnti-epileptic drugs
Anti-epileptic drugs
 
Antidepressants - Pharmacology
 Antidepressants - Pharmacology Antidepressants - Pharmacology
Antidepressants - Pharmacology
 
Antianxiety agents
Antianxiety agentsAntianxiety agents
Antianxiety agents
 
Antiparkinsonian drugs - drdhriti
Antiparkinsonian drugs - drdhritiAntiparkinsonian drugs - drdhriti
Antiparkinsonian drugs - drdhriti
 
CNS stimulants & cognitive enhancers
CNS stimulants & cognitive enhancersCNS stimulants & cognitive enhancers
CNS stimulants & cognitive enhancers
 
Pharmacology of dopamine
Pharmacology of dopaminePharmacology of dopamine
Pharmacology of dopamine
 
Serotonin & Their antagonists
Serotonin & Their antagonistsSerotonin & Their antagonists
Serotonin & Their antagonists
 
5-HT Pharmacology - drdhriti
5-HT Pharmacology - drdhriti5-HT Pharmacology - drdhriti
5-HT Pharmacology - drdhriti
 
Antipsychotic drugs
Antipsychotic drugsAntipsychotic drugs
Antipsychotic drugs
 
Antipsychotic drug
Antipsychotic drug Antipsychotic drug
Antipsychotic drug
 
Adrenergic Drugs - drdhriti
Adrenergic Drugs - drdhritiAdrenergic Drugs - drdhriti
Adrenergic Drugs - drdhriti
 
(Autocoids) Histamine Pharmacology ppt
(Autocoids) Histamine Pharmacology ppt(Autocoids) Histamine Pharmacology ppt
(Autocoids) Histamine Pharmacology ppt
 
Androgens, anabolic steroids and antiandrogens
Androgens, anabolic steroids  and antiandrogensAndrogens, anabolic steroids  and antiandrogens
Androgens, anabolic steroids and antiandrogens
 
Notes sedative & hypnotics
Notes sedative & hypnoticsNotes sedative & hypnotics
Notes sedative & hypnotics
 
Neurotransmitter - Dopamine
Neurotransmitter - DopamineNeurotransmitter - Dopamine
Neurotransmitter - Dopamine
 
Neurohumoral transmission in CNS
Neurohumoral transmission in CNSNeurohumoral transmission in CNS
Neurohumoral transmission in CNS
 

Viewers also liked

Viewers also liked (8)

Local anesthetics
Local anestheticsLocal anesthetics
Local anesthetics
 
Antimalarials
AntimalarialsAntimalarials
Antimalarials
 
corticosteroids
corticosteroidscorticosteroids
corticosteroids
 
Alpha adrenergic blockers
Alpha adrenergic blockersAlpha adrenergic blockers
Alpha adrenergic blockers
 
Treatment of other anemias
Treatment  of other anemiasTreatment  of other anemias
Treatment of other anemias
 
Hypolipidemic drugs
Hypolipidemic drugsHypolipidemic drugs
Hypolipidemic drugs
 
Principles of drug action
Principles of drug actionPrinciples of drug action
Principles of drug action
 
drugs for peptic ulcer
drugs for peptic ulcerdrugs for peptic ulcer
drugs for peptic ulcer
 

Similar to Stimulants and Psychoactive Drugs: Uses, Mechanisms, and Side Effects

CNS STIMULANTS & COGNITIVE ENHANCERS
CNS STIMULANTS&COGNITIVE ENHANCERSCNS STIMULANTS&COGNITIVE ENHANCERS
CNS STIMULANTS & COGNITIVE ENHANCERSGHSPL
 
cnsstimulants & cognitive enhancers.pptx
cnsstimulants & cognitive enhancers.pptxcnsstimulants & cognitive enhancers.pptx
cnsstimulants & cognitive enhancers.pptxKIRTI GUPTA
 
1633799628 235553d83656729aefdf4016d0fe5a28
1633799628 235553d83656729aefdf4016d0fe5a281633799628 235553d83656729aefdf4016d0fe5a28
1633799628 235553d83656729aefdf4016d0fe5a28muthulakshmi623285
 
CNS stimulants and cognitive enhancers
CNS stimulants and cognitive enhancersCNS stimulants and cognitive enhancers
CNS stimulants and cognitive enhancersMahi Yeruva
 
Cns stimulant final ppt july 2021
Cns stimulant final ppt  july 2021Cns stimulant final ppt  july 2021
Cns stimulant final ppt july 2021muthulakshmi623285
 
Central Nervous System Stimulants presentation
Central Nervous System Stimulants presentationCentral Nervous System Stimulants presentation
Central Nervous System Stimulants presentationDixitGoyal10
 
Cns stimulants
Cns stimulantsCns stimulants
Cns stimulantsraj kumar
 
Cns stimulants
Cns stimulantsCns stimulants
Cns stimulantsraj kumar
 
Cns stimulants
Cns stimulantsCns stimulants
Cns stimulantsraj kumar
 
Cns stimulants updated 2020
Cns stimulants updated 2020Cns stimulants updated 2020
Cns stimulants updated 2020lateef khan
 
Central Nervous System Agents
Central Nervous System AgentsCentral Nervous System Agents
Central Nervous System AgentsTosca Torres
 
Class anti depressants
Class anti depressantsClass anti depressants
Class anti depressantsRaghu Prasada
 
Class antidepressants, antimaniacs, cns stimulants
Class antidepressants, antimaniacs, cns stimulantsClass antidepressants, antimaniacs, cns stimulants
Class antidepressants, antimaniacs, cns stimulantsRaghu Prasada
 

Similar to Stimulants and Psychoactive Drugs: Uses, Mechanisms, and Side Effects (20)

CNS STIMULANTS & COGNITIVE ENHANCERS
CNS STIMULANTS&COGNITIVE ENHANCERSCNS STIMULANTS&COGNITIVE ENHANCERS
CNS STIMULANTS & COGNITIVE ENHANCERS
 
cnsstimulants & cognitive enhancers.pptx
cnsstimulants & cognitive enhancers.pptxcnsstimulants & cognitive enhancers.pptx
cnsstimulants & cognitive enhancers.pptx
 
1633799628 235553d83656729aefdf4016d0fe5a28
1633799628 235553d83656729aefdf4016d0fe5a281633799628 235553d83656729aefdf4016d0fe5a28
1633799628 235553d83656729aefdf4016d0fe5a28
 
CNS stimulants and cognitive enhancers
CNS stimulants and cognitive enhancersCNS stimulants and cognitive enhancers
CNS stimulants and cognitive enhancers
 
Cns stimulant final ppt july 2021
Cns stimulant final ppt  july 2021Cns stimulant final ppt  july 2021
Cns stimulant final ppt july 2021
 
Central Nervous System Stimulants presentation
Central Nervous System Stimulants presentationCentral Nervous System Stimulants presentation
Central Nervous System Stimulants presentation
 
Cns stimulants
Cns stimulantsCns stimulants
Cns stimulants
 
Cns stimulants
Cns stimulantsCns stimulants
Cns stimulants
 
Cns stimulants
Cns stimulantsCns stimulants
Cns stimulants
 
ANTI MANIC DUGS
ANTI MANIC DUGSANTI MANIC DUGS
ANTI MANIC DUGS
 
Cns stimulants updated 2020
Cns stimulants updated 2020Cns stimulants updated 2020
Cns stimulants updated 2020
 
Methylphenidates child psy drug
Methylphenidates child psy drugMethylphenidates child psy drug
Methylphenidates child psy drug
 
Anti-anxiety drugs.pptx
Anti-anxiety drugs.pptxAnti-anxiety drugs.pptx
Anti-anxiety drugs.pptx
 
Central Nervous System Agents
Central Nervous System AgentsCentral Nervous System Agents
Central Nervous System Agents
 
Sedatives & hypnotics
Sedatives & hypnoticsSedatives & hypnotics
Sedatives & hypnotics
 
Antidepressants Tca Ssri
Antidepressants   Tca SsriAntidepressants   Tca Ssri
Antidepressants Tca Ssri
 
Class anti depressants
Class anti depressantsClass anti depressants
Class anti depressants
 
Class antidepressants, antimaniacs, cns stimulants
Class antidepressants, antimaniacs, cns stimulantsClass antidepressants, antimaniacs, cns stimulants
Class antidepressants, antimaniacs, cns stimulants
 
Antimanic agents
Antimanic agentsAntimanic agents
Antimanic agents
 
Ati 2
Ati 2Ati 2
Ati 2
 

Recently uploaded

Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Badalona Serveis Assistencials
 
97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAAjennyeacort
 
systemic bacteriology (7)............pptx
systemic bacteriology (7)............pptxsystemic bacteriology (7)............pptx
systemic bacteriology (7)............pptxEyobAlemu11
 
Clinical Pharmacotherapy of Scabies Disease
Clinical Pharmacotherapy of Scabies DiseaseClinical Pharmacotherapy of Scabies Disease
Clinical Pharmacotherapy of Scabies DiseaseSreenivasa Reddy Thalla
 
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...MehranMouzam
 
History and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfHistory and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfSasikiranMarri
 
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxSYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxdrashraf369
 
Basic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfBasic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfDivya Kanojiya
 
Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!ibtesaam huma
 
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...
Big Data Analysis Suggests COVID  Vaccination Increases Excess Mortality Of  ...Big Data Analysis Suggests COVID  Vaccination Increases Excess Mortality Of  ...
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...sdateam0
 
Culture and Health Disorders Social change.pptx
Culture and Health Disorders Social change.pptxCulture and Health Disorders Social change.pptx
Culture and Health Disorders Social change.pptxDr. Dheeraj Kumar
 
MedDRA-A-Comprehensive-Guide-to-Standardized-Medical-Terminology.pdf
MedDRA-A-Comprehensive-Guide-to-Standardized-Medical-Terminology.pdfMedDRA-A-Comprehensive-Guide-to-Standardized-Medical-Terminology.pdf
MedDRA-A-Comprehensive-Guide-to-Standardized-Medical-Terminology.pdfSasikiranMarri
 
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic AnalysisVarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic AnalysisGolden Helix
 
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
PULMONARY EDEMA AND  ITS  MANAGEMENT.pdfPULMONARY EDEMA AND  ITS  MANAGEMENT.pdf
PULMONARY EDEMA AND ITS MANAGEMENT.pdfDolisha Warbi
 
SWD (Short wave diathermy)- Physiotherapy.ppt
SWD (Short wave diathermy)- Physiotherapy.pptSWD (Short wave diathermy)- Physiotherapy.ppt
SWD (Short wave diathermy)- Physiotherapy.pptMumux Mirani
 
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptxPresentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptxpdamico1
 
Giftedness: Understanding Everyday Neurobiology for Self-Knowledge
Giftedness: Understanding Everyday Neurobiology for Self-KnowledgeGiftedness: Understanding Everyday Neurobiology for Self-Knowledge
Giftedness: Understanding Everyday Neurobiology for Self-Knowledgeassessoriafabianodea
 
Presentation on General Anesthetics pdf.
Presentation on General Anesthetics pdf.Presentation on General Anesthetics pdf.
Presentation on General Anesthetics pdf.Prerana Jadhav
 
Apiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptApiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptkedirjemalharun
 
Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.ANJALI
 

Recently uploaded (20)

Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
Presentació "Real-Life VR Integration for Mild Cognitive Impairment Rehabilit...
 
97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA97111 47426 Call Girls In Delhi MUNIRKAA
97111 47426 Call Girls In Delhi MUNIRKAA
 
systemic bacteriology (7)............pptx
systemic bacteriology (7)............pptxsystemic bacteriology (7)............pptx
systemic bacteriology (7)............pptx
 
Clinical Pharmacotherapy of Scabies Disease
Clinical Pharmacotherapy of Scabies DiseaseClinical Pharmacotherapy of Scabies Disease
Clinical Pharmacotherapy of Scabies Disease
 
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
Study on the Impact of FOCUS-PDCA Management Model on the Disinfection Qualit...
 
History and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdfHistory and Development of Pharmacovigilence.pdf
History and Development of Pharmacovigilence.pdf
 
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptxSYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
SYNDESMOTIC INJURY- ANATOMICAL REPAIR.pptx
 
Basic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdfBasic principles involved in the traditional systems of medicine PDF.pdf
Basic principles involved in the traditional systems of medicine PDF.pdf
 
Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!Biomechanics- Shoulder Joint!!!!!!!!!!!!
Biomechanics- Shoulder Joint!!!!!!!!!!!!
 
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...
Big Data Analysis Suggests COVID  Vaccination Increases Excess Mortality Of  ...Big Data Analysis Suggests COVID  Vaccination Increases Excess Mortality Of  ...
Big Data Analysis Suggests COVID Vaccination Increases Excess Mortality Of ...
 
Culture and Health Disorders Social change.pptx
Culture and Health Disorders Social change.pptxCulture and Health Disorders Social change.pptx
Culture and Health Disorders Social change.pptx
 
MedDRA-A-Comprehensive-Guide-to-Standardized-Medical-Terminology.pdf
MedDRA-A-Comprehensive-Guide-to-Standardized-Medical-Terminology.pdfMedDRA-A-Comprehensive-Guide-to-Standardized-Medical-Terminology.pdf
MedDRA-A-Comprehensive-Guide-to-Standardized-Medical-Terminology.pdf
 
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic AnalysisVarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
VarSeq 2.6.0: Advancing Pharmacogenomics and Genomic Analysis
 
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
PULMONARY EDEMA AND  ITS  MANAGEMENT.pdfPULMONARY EDEMA AND  ITS  MANAGEMENT.pdf
PULMONARY EDEMA AND ITS MANAGEMENT.pdf
 
SWD (Short wave diathermy)- Physiotherapy.ppt
SWD (Short wave diathermy)- Physiotherapy.pptSWD (Short wave diathermy)- Physiotherapy.ppt
SWD (Short wave diathermy)- Physiotherapy.ppt
 
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptxPresentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
Presentation for Bella Mahl 2024-03-28-24-MW-Overview-Bella.pptx
 
Giftedness: Understanding Everyday Neurobiology for Self-Knowledge
Giftedness: Understanding Everyday Neurobiology for Self-KnowledgeGiftedness: Understanding Everyday Neurobiology for Self-Knowledge
Giftedness: Understanding Everyday Neurobiology for Self-Knowledge
 
Presentation on General Anesthetics pdf.
Presentation on General Anesthetics pdf.Presentation on General Anesthetics pdf.
Presentation on General Anesthetics pdf.
 
Apiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.pptApiculture Chapter 1. Introduction 2.ppt
Apiculture Chapter 1. Introduction 2.ppt
 
Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.Statistical modeling in pharmaceutical research and development.
Statistical modeling in pharmaceutical research and development.
 

Stimulants and Psychoactive Drugs: Uses, Mechanisms, and Side Effects

  • 1.
  • 2. Little clinical use, except methylxanthines  Can be classified in to:  › Respiratory stimulants ( Analeptics). › Convulsants › Psychomotor stimulants › Psychomimetic drugs
  • 3. Doxapram :  MOA not clear, may excite central neurons  Short acting, high margin of safety.  Low doses selective for respiratory centre  ↑ Tidal volume & rate of respiration Uses :  Post-anaesthetic resp. depression  COPD i.e. hypoxemic,hypercapnic res.fail  Apnoea in premature infants
  • 4. Dose- 2-5mg/min(max 4mg/kg) slow i.v infusion. Contraindications:  Hypoxaemic, normocapnic resp.failureasthma  Resp.fail due to neurological & muscular diseases.  Epilepsy Side effect:  Restlessness  Tachycardia  High doses: convulsions & arrhythmias 
  • 5. No clinical use  Used as research tools Strychnine:  Alkaloid, convulsant poison.  Spinal cord stimulant  MOA: Blocking the receptors for Glycine  In poisoning convulsion treated withDiazepam or clonazepam slow i.v 
  • 6.
  • 7.
  • 8. Picrotoxin:  Blocks the Cl- ion channel of GABAA. Bicuculline:  Plant alkaloid, GABAA antagonist. Pentylenetetrazole (PTZ):  Direct depolarization of central neurons  Provides useful animal model for testing anticonvulsant drugs.
  • 9. Amphetamine group:  Amphetamine  Dexamphetamine  Methamphetamine  Methylenedioxy Methampheta(MDMA)  Methylphenedate  Fenfluramine
  • 10. Non-Amphetamine group  Modafinil  Atomoxetine  Sibutramine  Pemoline Cocaine Methylxanthines:  Caffeine  Theophylline  Theobromine
  • 11. MOA: ↑DA conc. In synaptic cleft by  Enter N endings by active transport  Displace DA(also NE) from vesicles  Also inhibits MOA-B, ↓DA metabolism. Pharmacological effects: (central)  ↑ motor activity  Euphoria & excitement  Anorexia  Stereotyped & psychotic behaviour
  • 12. ↑ BP, inhibition of GI motility  Fatigue both physical & mental reduced.  Amphetamine psychosis on repeated use- paranoid ideas, A & T hallucinations. PK:  Well absorbed orally  Freely penetrates BBB  Unmetabolised drug excreted in urine 
  • 13. ADHD with minimal brain dysfunction:  Characterised by› Hyperactivity › Inability to concentrate › Impulsive behavior  Dexamphetamine,  Methylphenedate,  Atomoxetine quite effective.
  • 14. Narcolepsy: Characterised by Sleep attacks during day time  Night mares in awakening state  Cataplexy-reversible  Methylphenedate is still used  Modafinil- devoid of abuse liability
  • 15. Fenfluramine, dexfenfluramine used earlier to treat obesity  Discouraged due to: Tolerance  Insomnia, pul.htn, abuse potential. Sibutramine new drug used now  Blocks neuronal uptake of mainly NE & 5HT (also dopamine) at hypothalamic site that regulates food intake. 
  • 16. Use:  Severe obesity with risk factors like DM. Adverse effects:  Dry mouth  Headache  Insomnia  Constipation  ↑in HR & BP  CI in CVS diseases, withdrawn from market
  • 17. Tolerance  Psychic dependence, rarely physical. Amphetamine overdose:  Euphoria, dizziness, tremors, HTN  Irritability, anorexia, insomnia  Higher doses- convulsions, psychotic manifestations, arrhythmias, coma  Rx –diazepam(slow i.v), haloperidol  Gastric lavage, acidification of urine  HTN-nifedipine/labetolol, arry-esmolol 
  • 18. Sudden deaths occurred with MDMA.  Induces heat stroke like conditionrhabdomyolysis & renal failure  Inappropriate secretion of ADH Methylenedioxy amphetamine (love drug)  75mg- psychotomimetic effects  150 mg-LSD like effects  300mg- amphetamine like  SE: tachycardia, HTN, arrhythmias 
  • 19. Only caffeine if used as CNS stimulant PK:  Oral- rapid but irregular absorption  PPB:<50%  Distributed all over the body  Met: in liver by demethylation & oxid.  Metabolites excreted in urine  T1/2: 3-6hrs 
  • 20. AE:  Gastric irritation, N, V  Nervousness, insomnia, agitation  Muscule twitch, rigidity  ↑body temp,delirium, convulsions  Tachy, extra systoles at high doses Uses:  In Analgesic mixture for headache  Migraine  Apnoea in premature infants
  • 21. Produce changes in sensory perceptions, thoughts, behaviour & mood.  Actions mimic psychoses- psychedelics  Lysergic acid diethylamide (LSD)  Mescaline  Phencyclidine  Cannabinoids 
  • 22. Derived from cereal fungus ergot  Hofmann synthesized & experimented on himself.  Act as agonist at 5HT2 receptors.  Excitation threshold of retina ↓-visual hallucinations  Excitation threshold of RAS↓-hyper arousal state  Experiences may be bad or good trip. 
  • 23. Extract of hemp plant-C.sativa, C.indica  Bhang- paste of powdered dried leaves, used as drink  Marijuana- dried leaves & flowering tops, smoked in pipes or rolled as cigarettes.  Charas or hashish- resinous exudates leaves & flowering tops, potent smoked inpipe.  THC content more in hashish 
  • 24. Initial CNS stimulation later sedation.  Stimulatory phaseeuphoria, ↑talkativeness, ↑appetite  Felling of confidence, relaxation & well being  Other- analgesia, antiemetic  Peripheral effects- tachy, VD, reddening of conjunctiva 
  • 25.         Two types CB 1& 2 receptors CB1 in brain CB2 in periphery Anandamide-endogenous ligand CB1. Dronabinol, Nabilone- synt.analogues of THC Use: CB1 Agonists- ↑appetite in AIDS pts. Dronabinol-antiemetic in cancer chemo. Rimonabant : CB1 antagonist, used for obesity, dose-20mg OD before Breakfast Smoking cessation
  • 26. Indications:  AD, multi infarct dementia  Mild cognitive impairment  MR, learning defects, ADHD in children  TIA, CVA, Stroke  Organic psychosyndromes  Sequale of head injury  ECT, brain surgery
  • 27. ↑ global/regional blood flow  Direct support of neuronal metabolism  Enhancement of neurotransmission  Improvement of discrete cerebral functions 
  • 28. Main pathological features:  Amyloid plaque  Neurofibrillary tangles  Marked ↓ in choline acetyltransferase & loss of cholinergic neurons in brain. 
  • 29. ACEs that cross BBB are preferred. Tacrine:  Longer acting, reversible ACE  Palliative for mild to moderate AD  Orally active  Improves memory, cognition, well being  Facilitates Ach release  AE: hepatotoxicity 
  • 30. Newer reversible Anti cholinesterase  Better penetration in to CNS  Better tolerated & less toxic than tacrine  Clinical results modest & temporary  Donepezil: 5mg OD orally evening ↑ max 10mg after 4 wks  Rivastigmine:1.5 mg orally BD ↑ to 3mg BD after 2 wks  Galantamine:4mg BD orally ↑to 8mg BD after 2 wks 
  • 31. Transdermal Rivastigmine patch – applied every 24hrs  SE:diarrhoe, N, V, ↑urination Acetyl-L-carnitine:  Structural analogue of Ach  ↓ signs & symptoms of dementia in AD  ↑ cholinergic transmission  Also have antioxidant properties, slows progression of AD 
  • 32. Excitotoxicity due to enhanced Glutamate transmission via NMDA recp.  Dose:5mg OD slowly ↑ to 10-20mg/day  Non-comp. antagonist of NMDA recp.  Better tolerated, less toxic. Miscellaneous :  Nootropics-piracetam, aniracetam  High doses of vit E(1000 IU B.D)  Antioxidants-vit C, A, Zn, Se, bioflavonoids or spirulina ↓ progression even in middle stage AD. 