Depressants and Inhalants

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Chapter 9

• Depressants and Inhalants

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History and Pharmacology

• Before barbituates (1800s)
• Chloral hydrate, a.k.a. Knockout Drops or
  Mickey Finn when mixed with alcohol
• Paraldehyde (known for use in mental hospitals in
  the 1950s) noxious taste and odor
• Bromides (- to treat IBS stomach cramps, can stay
  in the body and cause depression)

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Information about depressants

• Depressants are drugs that produce central
  nervous system depression, and have been used
  throughout history to induce sleep, relieve
  stress, and allay anxiety. These drugs have been
  referred to as "downers," sedatives, hypnotics,
  minor tranquilizers, anxiolytics, and antianxiety
  medications. Unlike most other classes of drugs
  of abuse, depressants, except for methaqualone,
  are rarely produced in clandestine laboratories.
  Generally, legitimate pharmaceutical products are
  diverted to the illicit market.

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Drug Effects

• Like alcohol, depressants can cause symptoms of
  intoxication. These symptoms can include slurred
  speech, problems with coordination or walking,
  inattention and memory difficulties. In extreme
  cases, stupor and coma may occur.

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Withdrawal Symptoms

• Including anxiety, tremors, nightmares, insomnia,
  poor appetite, rapid pulse, rapid breathing,
  blood pressure abnormalities, dangerously high
  fever and seizures.

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Barbiturates

• More than 2,500 have been produced
• To treat seizure disorders and anesthesia.
• Three groupings short, intermediate, and
  long-acting (see Table 9-1)
• Decreases respiratory rate
• New agents developed due to liability of
  addiction and overdose

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Modern Agents

• Meprobamate (1950s)and Methaqualone (1970s
  qualudes)
• Benzodiazepines are popular today
• (Librium, Valium, Xanan, Ativan, Halcion,
  Rohypnol)to treat anxiety and sleep disorders
• - can cause over-sedation, memory impairment,
  poor motor coordination and confusion.
• significantly less respiratory depression than
  barbiturates

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Mechanism of Action

• Radioactive diazepam molecules had high affinity
  for receptor sites in brain
• These receptors did not bind with other known
  neurotransmitters or barbiturates

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Mechanism of Action, contd

• Receptors were near GABA neurotransmitter
• Appears they enhance the normal inhibitory
  effects of GABA
• Separation of anti-anxiety effect from hypnotic
  effect could lead to better drug selection

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Beneficial Uses

• Sedatives for anxiety
• Sleeping pills
• Anti-convulsants for epilepsy

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Causes for Concern

• Psychological dependence
• Physical dependence
• Withdrawal similar to alcohol
• Toxicity increases with combination
• Patterns of abuse examples
• Older adult that increases dose and tolerance
• Younger person getting high

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GHB Gamma Hydroxybutyrate

• GHB, GHB kits, and recipes for making GHB can be
  found on the Internet
• In recent years, GHB has emerged as a significant
  drug of abuse throughout the United States.
  Abusers of this drug fall into three major
  groups (1) users who take GHB for its MDMA-like
  hallucinogenic effects or as an intoxicant or
  euphoriant (2) bodybuilders who abuse GHB for
  its alleged utility as an anabolic agent or as a
  sleep aid and (3) individuals who use GHB as a
  weapon for sexual assault. GHB is frequently
  taken with alcohol or other drugs that heightens
  its effects and is often found at bars,
  nightclubs, rave parties, and gyms. Teenagers and
  young adults who frequent these establishments
  are the primary users.

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GHB involvement in rape cases is likely to be
unreported or unsubstantiated. GHB is quickly
eliminated from the body making detection in body
fluids unlikely and its fast onset of depressant
effects may render the victim with little memory
of the details of the attack. GHB has been shown
to produce drowsiness, nausea, unconsciousness,
seizures, severe respiratory depression, and
coma.
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Rohypnol

• Targeting Prevention Box The Drug-Induced Rape
  Prevention and Punishment Act (p. 206).
• Rohypnol, legally produced and sold in Latin
  America and Europe, is typically smuggled into
  the U.S. using mail. Lower doses of Rohypnol can
  cause muscle relaxation and can produce general
  sedative and hypnotic effects. In higher doses,
  Rohypnol causes a loss of muscle control, loss of
  consciousness, and partial amnesia. When combined
  with alcohol, the toxic effects of Rohypnol can
  be aggravated.16 The sedative effects of Rohypnol
  begin to appear approximately 1520 minutes after
  the drug is ingested. The effects typically last
  from 46 hours after administration of the drug.

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Street Terms - more info GHB Ketamine
Rohypnol Goop Cat valium Forget me
drug Grievous bodily harm K Mexican valium Max
Jet Roaches Soap Super acid Roofies
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Inhalants

• Gaseous anesthesia - nitrous oxide
• Nitrites - dilate the arteries
• Volatile solvents - sniffing glue, paint, etc.
  leads to brain damage, kidney failure and
  peripheral nerve damage

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Common Inhalants Protect your Children!!!

• www.medem.com/MedLB/article_detaillb.cfm?article_I
  DZZZDARS2B7Csub_cat23.
• The American Academy of Pediatric

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Chapter 9

• Depressants and Inhalants