1. Lecture 2

2. Inhalants Breathable chemical vapors that produce mind altering effects. There are four types of inhalants Solvents Gases Nitrites Aerosols Street names include poppers, snappers, ozone.

3. Inhalants are ingested into the body by breathing in the vapors of the product. Several methods of inhalation can be used by abusers: Using a bag Using a rag Using pressurized containers ( Aerosols )

4.  Euphoria  Lightheadedness  Exhilaration  Vivid fantasies and sometimes recklessness  Feeling of invincibility  Depending on the type of inhalant and method of use, possibly irritation and watering of the eyes, sneezing, coughing and nasal inflammation may occur.  Inhalants enter the bloodstream from the lungs and then go to other organs, particularly the brain and liver. Breathing, heart beat and other body functions are slowed down. If the person passes out with a plastic bag over the nose and mouth, death from suffocation can occur. Death can also occur if the person is startled or engages in strenuous activity while intoxicated.

5.  Effects include pallor, fatigue, forgetfulness, inability to think clearly, tremors, poor coordination and difficulty walking, thirst, weight loss, depression, irritability, hostility, and paranoia.  Kidney, liver and brain damage may occur. It is not known to what extent the damage is reversible.

6.  Psychological and physical dependence can develop.  Withdrawal symptoms include anxiety, depression, irritability, dizziness, tremors, nausea, abdominal pains and headaches.

7. Supportive treatment of acute overdose (eg. airway, breathing, circulation) Beta-blockers may be used to protect against fatal arrhythmias No medication can reverse the effects of most inhalants Long-term treatment of inhalant abuse includes: counseling strict abstinence drug treatment protocols (eg. 12-Step programs) Need for more basic and clinical research on treatment and prevention

9.  All derivatives of Barbituric acid  Produce a wide spectrum of central nervous system depression, from mild sedation to coma.  Nonspecific depressant.  In moderate amounts, these drugs produce a state of intoxication that is remarkably similar to alcohol intoxication. Symptoms include: 1- Slurred speech 2- loss of motor coordination 3-Impaired judgment.  Barbiturates were widely diverted from medical use and used on the street in the 60s where they were called “downers” and sold under a variety of different names.

10. Barbituric acid is synthesized by a condensation reaction that results in the release of H2O (dehydration) and the heterocyclic pyrimidine Further substitution of side chains on the ring produce the pharmacologically active barbiturates Malonic Acid Urea Barbituric Acid

11.  Sedatives, hypnotics, anesthetics and anticonvulsants.  The primary differences among many of these products are how fast they produce an effect and how long those effects last. Barbiturates are classified as ultrashort, short, intermediate, and long-acting.  The ultrashort-acting barbiturates produce anesthesia within about one minute after intravenous administration.  Those in current medical methohexital (Brevital®), thiamyl (Surital®) and thiopental (Pentothal®).

12.  Barbiturate abusers prefer short-acting and intermediate-acting barbiturates that include  Amobarbital (Amytal®), pentobarbitalts (Nembutal®), secobarbital(Seconal®), and Tuinal (an amobarbital/secobarbital combination product).  After oral administration, the onset of action is from 15 to 40 minutes, and the effects last up to six hours. These drugs are primarily used for insomnia and preoperative sedation. Veterinarians use pentobarbital for anesthesia and euthanasia.  Long-acting barbiturates include phenobarbital (Luminal®) and mephobarbital (Mebaral®), Effects of these drugs are realized in about one hour and last for about 12 hours, and are used primarily for daytime sedation and the treatment of seizure disorders.

13. How are Barbiturates Consumed? Orally – In pill, tablet or liquid form Injection – Into the blood stream Into muscle tissue Directly under the skin Inserted into the body via suppository.

14. Generic Name Street Name AmobarbitalDowners, blue heavens, blue velvet, blue devils PentobarbitalNembies, yellow jackets, abbots, Mexican yellows PhenobarbitalPurple hearts, goof balls SecobarbitalReds, red birds, red devils, lilly, F-40s, pinks, pink ladies, seggy TuinalRainbows, reds and blues, tooies, double trouble, gorilla pills, F-66s

15.  Small doses relieve tension; large doses produce drowsiness, staggering, blurred vision, impaired thinking, slurred speech, impaired perception of time and space, slowed reflexes and breathing, and reduced sensitivity to pain.  Overdoses can cause unconsciousness, coma and death.

16.  Long-term, high-dose use may result in effects similar to chronic intoxication (impaired vision, memory and judgment, and slurred speech), as well as depression or mood swings. Changes in liver function may result in faster metabolism of other drugs. Babies of chronic users may have difficulty in breathing and feeding, disturbed sleep patterns, sweating, irritability and fever.

17.  Regular use induces tolerance, making increased doses necessary to produce the desired effect.  The margin between an effective dose and a lethal dose gradually narrows. Psychological dependence can occur with regular use, as can physical dependence. Withdrawal symptoms including restlessness, anxiety, insomnia, delirium, seizures and may result in death. Marilyn Monroe died of barbiturate overdose in 1962