Amphetamines

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 * Ice, Krystal, Speed
 * Methamphetamine, meth. methamfetamin.jpg
 * Amphetamine (illegal in Poland, Germany)
 * drugs: Ephedrine, pseudoephedrine, phentermine, phenmetrazine, methylphenidate

Pharmacology

 * Mechanism of action – structural similarity to dopamine – phenylalkylamines
 * Indirect sympathomimetics - noradrenaline- like effects
 * Amphetamines release or replace neurotransmitters on the nerve endings
 * Amphetamines - agonists of dopamine, noradrenaline, serotonin

Abuse

 * Salts (HCl) – p.o., sniffing, i.v.
 * Base – inhalation, smoking
 * Usual daily doses 2–100 mg
 * Repeated doses in chronic conditions, whiplash, up to 5 g/day
 * Symptoms
 * euphoria, increased performance (doping)
 * risky behavior, spurts of thought at the expense of accuracy, impaired judgement
 * aggressiveness, irritability, psychological lability, anxiety
 * hypertension, anorexia nervosa – suppression of the feeling of hunger
 * Duration of stimulation: 2–4 hours
 * Overdose: restlessness, inability to concentrate, hallucinations, convulsions

Chronic abuse

 * weight loss
 * damage to the cardiovascular system, development of hypertension, cerebral hemorrhage
 * psychoses, punishments, depression , suicidal tendencies
 * the development of psychological dependence
 * development of tolerance

Enantiomer selectivity

 * Catecholamines ( dopamine, ...) and amphetamines - asymmetric atom C*
 * Number of asymmetries – number of enantiomers
 * Endogenous adrenaline and noradrenaline are levorotatory and have higher affinity for receptors and transport proteins than dextrorotatory enantiomers
 * Amphetamine acts as an indirect sympathomimetic. It has one asymmetric carbon. The dextrorotatory enantiomer (dextroamphetamine) has about 4 times stronger CNS stimulatory effects than the levorotatory isomer
 * Ephedrine contains contains 2 centers of asymmetry and therefore has 4 possible optical isomers:
 * (+) a (–) ephedrine
 * (+) a (–) pseudoephedrine
 * The most biologically effective is (–) ephedrine

=== Ephedrine, Pseudoephedrine === ''
 * The plant Ephedra vulgaris – a thousand-year tradition of use in China
 * Ephedrine is found in a number of plants
 * Synthetic ephedrine, pseudoephedrine
 * Ephedrine, pseudoephedrine components of composite medicinal products:
 * broncholytics
 * antitussive
 * antipyretics
 * analgesics (NUROFEN)
 * venopharmaceuticals
 * anorexic (norpseudoephedrine)
 * Ephedrine – direct and indirect sympathomimetic
 * Psychostimulant chronic effect - addiction
 * Ephedrine, pseudoephedrine – precursors of the illegal synthesis of methamphetamine

KHAT
''
 * The leaves of the Catha edulis plant are chewed - Arabia
 * They contain cathinone and nor-pseudoephedrine
 * Cathinone is metabolized to norephedrine

MDMA, XTC, ECTASY



 * 3,4-methylendioxymethamfetamin
 * MDMA and similar derivatives – entactogens, stimulants
 * en (Greek) – inside
 * tactus (Latin) – touch
 * gen (Greek) – to produce
 * MDMA – pleasant empathetic feelings, penicillin of the soul

Pharmacology

 * MDMA – a serotonin agonist
 * Sympathomimetic reaction ( hyperthermia, hyperactivity, salivation, mydriasis ))
 * Massive release of serotonin from nerve endings into the synapse - decrease in nerve endings - increase in extracellular serotonergic activity, non-specific stimulation of receptors in the CNS - serotonin syndrome
 * MDMA also releases dopamine (cytotoxic) which replaces serotonin in nerve endings – cell damage triggers unwanted biochemical reactions – neurotoxicity of MDMA
 * Repeated use – sensitization, allergy
 * prolongation and intensification of serotonergic syndrome
 * increasing the toxicity of further doses

Abusus

 * Tablets po – different logos, shapes, sizes, colors, unknown content
 * Effective single doses of 50-200 mg
 * Pleasant desirable symptoms: empathy, stimulation (dance drug)
 * Side unpleasant symptoms:
 * dry mouth
 * trismus (difficulty opening the mouth)
 * perspiration
 * fainting

Chronic abuse
* development of sensitization ( allergy )
 * depression
 * insomnia
 * psychosis
 * psychological dependence
 * tolerance

Health complications

 * tachycardia, arrhythmia , cardiac collapse
 * serotonin syndrome – sweating, tremors, hyperthermia, rhabdomyolysis, disseminated intravascular coagulation ( DIC ) – death
 * dehydration, hyponatremia, circulatory failure
 * liver failure (rare)
 * in chronic patients – cognitive disorders, psychoses, hypertension, vascular events

Risk factors

 * unknown contents of illegal tablets, drug cocktails, ethanol
 * individual state of health, receptivity

Ecstasy tablets
NSD - small change in structure - other pharmacological action - dangerous !!!
 * Tablets po – different logos, shapes, sizes, colors, unknown content
 * Dance drugs, New Synthetic Drugs (NSDs), "Designer drugs"
 * Expected Effect – Stimulant and Psychedelic (Empathy)
 * Psychedelics – natural hallucinogens (mescaline, DMT, etc.)
 * MDMA, a controlled psychotropic substance

Related articles

 * Substance Abuse • Drug Addiction and Illicit Production and Possession of Narcotic Substances • Opioid Abuse
 * Amphetamines • Cocaine • Cannabinoids • Hallucinogens • LSD • Psychotropic drugs • Barbiturates • Benzodiazepines • Ethanol
 * Cannabinoid use disorders • Opioid use disorders