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Questions and Answers
What effect does consuming large amounts of non-alcoholic drinks have when taking khat?
What effect does consuming large amounts of non-alcoholic drinks have when taking khat?
Which of the following is NOT an acute effect of khat consumption?
Which of the following is NOT an acute effect of khat consumption?
What is one of the CNS-related complications of long-term khat use?
What is one of the CNS-related complications of long-term khat use?
Which of the following gastrointestinal issues is associated with long-term khat use?
Which of the following gastrointestinal issues is associated with long-term khat use?
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Khat-induced psychosis can include which of the following symptoms?
Khat-induced psychosis can include which of the following symptoms?
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Which cardiovascular risk is NOT associated with long-term khat abuse?
Which cardiovascular risk is NOT associated with long-term khat abuse?
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Which of the following is considered a long-term effect of khat on mental health?
Which of the following is considered a long-term effect of khat on mental health?
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Which of the following is a possible effect of khat on the liver?
Which of the following is a possible effect of khat on the liver?
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What mechanism of action does khat share with amphetamines?
What mechanism of action does khat share with amphetamines?
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Which is NOT a consequence of long-term khat usage on oral health?
Which is NOT a consequence of long-term khat usage on oral health?
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What typically follows a 'rush' from amphetamine use?
What typically follows a 'rush' from amphetamine use?
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Which chronic effect is NOT associated with amphetamine abuse?
Which chronic effect is NOT associated with amphetamine abuse?
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What is one of the potential treatments for amphetamine dependence?
What is one of the potential treatments for amphetamine dependence?
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What should be monitored due to parenteral amphetamine use?
What should be monitored due to parenteral amphetamine use?
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MDMA (ecstasy) primarily affects which neurotransmitter system?
MDMA (ecstasy) primarily affects which neurotransmitter system?
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What is a common method of ingestion for khat?
What is a common method of ingestion for khat?
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Which symptom is a result of prolonged amphetamine use?
Which symptom is a result of prolonged amphetamine use?
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What byproduct results mostly from the metabolism of cathinone?
What byproduct results mostly from the metabolism of cathinone?
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What cardiovascular risk is associated with amphetamine use?
What cardiovascular risk is associated with amphetamine use?
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What unique characteristic is associated with inhaled amphetamine use?
What unique characteristic is associated with inhaled amphetamine use?
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What is the biological half-life of methamphetamine?
What is the biological half-life of methamphetamine?
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Which of the following is a mechanism of action for methylphenidate?
Which of the following is a mechanism of action for methylphenidate?
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What is a potential acute effect of oral dextroamphetamine?
What is a potential acute effect of oral dextroamphetamine?
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Which drug is considered a central stimulant and a peripheral sympathomimetic?
Which drug is considered a central stimulant and a peripheral sympathomimetic?
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What is the therapeutic use of amphetamines for children?
What is the therapeutic use of amphetamines for children?
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Which of the following types of amphetamines is NOT mentioned in the content?
Which of the following types of amphetamines is NOT mentioned in the content?
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Which effect of amphetamines is due to their action on norepinephrine and dopamine?
Which effect of amphetamines is due to their action on norepinephrine and dopamine?
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Which of the following statements about Khat is true?
Which of the following statements about Khat is true?
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What should be developed for the treatment of amphetamine abuse and related conditions?
What should be developed for the treatment of amphetamine abuse and related conditions?
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What is a common adverse effect experienced when using amphetamines?
What is a common adverse effect experienced when using amphetamines?
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What physiological responses are commonly observed in acute amphetamine overdose?
What physiological responses are commonly observed in acute amphetamine overdose?
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What is the recommended treatment for severe hypertension during an amphetamine overdose?
What is the recommended treatment for severe hypertension during an amphetamine overdose?
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What is a major side effect associated with the use of amphetamines?
What is a major side effect associated with the use of amphetamines?
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Which of the following symptoms is NOT typically associated with amphetamine withdrawal?
Which of the following symptoms is NOT typically associated with amphetamine withdrawal?
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What is the primary sedative of choice for managing acute amphetamine overdose?
What is the primary sedative of choice for managing acute amphetamine overdose?
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How does the method of drug administration affect the rush experienced with intravenous amphetamine?
How does the method of drug administration affect the rush experienced with intravenous amphetamine?
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In cases of severe amphetamine toxicity, which intervention is used to enhance drug excretion?
In cases of severe amphetamine toxicity, which intervention is used to enhance drug excretion?
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What potential consequence occurs from using beta-blockers in the context of severe hypertension during an amphetamine overdose?
What potential consequence occurs from using beta-blockers in the context of severe hypertension during an amphetamine overdose?
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What is a common progression of symptoms seen in severe amphetamine overdose?
What is a common progression of symptoms seen in severe amphetamine overdose?
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Which intravenous medication may be used alongside benzodiazepines to treat seizures in amphetamine overdose?
Which intravenous medication may be used alongside benzodiazepines to treat seizures in amphetamine overdose?
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Study Notes
Amphetamine: Types, Uses, and Effects
- Amphetamines are a class of psychostimulant drugs that include amphetamine, methamphetamine, methylphenidate, pemoline, ephedrine, pseudoephedrine, fenfluramine, phentermine, naphazoline, oxymetazoline, and xylometazoline.
- The active ingredient in Khat is cathinone.
- Amphetamine sulphate is the most commonly used form of amphetamine and is available in oral and injectable forms.
- Amphetamines have a rapid onset of action when inhaled, followed by intravenous administration and oral administration.
- Amphetamines have a biological half-life of about 8 hours for amphetamine and 12 hours for methamphetamine, resulting in a powerful psychic effect that can last several hours.
- Amphetamine is a central stimulant and a peripheral sympathomimetic that enhances the synaptic activity of biogenic amines, specifically norepinephrine, dopamine, and serotonin.
- All amphetamines stimulate the release of dopamine and norepinephrine.
- Methylphenidate and pemoline inhibit the reuptake of catecholamines.
- Ephedrine and pseudoephedrine directly activate catecholamine receptors.
- Amphetamines are used therapeutically to treat narcolepsy and attention deficit hyperactivity disorder (ADHD) in children.
- Oral dextroamphetamine can cause alertness, euphoria, increased motor activity, improved coordination, and increased physical activity.
- Intravenous amphetamine produces a short-lasting “flash” or “rush”, similar to an electric shock.
- The "rush" is even more intense and rapid when crystal methamphetamine “ice” is inhaled.
- Amphetamine overdose can lead to excitement, confusion, headache, chest pain, hypertension, tachycardia, flushing, profuse sweating, mydriasis, delirium, hallucinations, hyperpnea, cardiac arrhythmia, hyperpyrexia, seizures, shock, coma, and death.
- The combination of hyperthermia and agitation can be rapidly fatal.
- Treatment for amphetamine overdose includes intravenous benzodiazepines to reduce excitement and protect against injury, cardiorespiratory support, phenytoin for seizures, and vasodilators like nitrates or alpha-blockers for severe hypertension.
- Avoid beta-blockers in cases of severe hypertension, as they can aggravate blood pressure.
- Forced diuresis and urine acidification can enhance drug excretion.
- Peritoneal dialysis or hemodialysis are used for severe refractory cases.
- Tolerance to amphetamine develops rapidly, leading to an increased dose required to achieve the desired effect.
- Amphetamine withdrawal symptoms include depression, fatigue, increased appetite, and sleepiness.
- Amphetamine dependence can lead to “crashing”, a period of deep sleep after the “rush” subsides, followed by hunger, lethargy, and depression upon waking.
Chronic Effects of Amphetamine Abuse
- Amphetamine abuse can cause sleep problems, anxiety, suppression of appetite, high blood pressure, neurotoxicity, psychosis, hepatocellular toxicity, myocardial infarction, cardiomyopathy, increased risk of coronary atherosclerosis, and stroke.
- Amphetamine abuse can lead to hallucinations and brain damage due to decreasing dopamine D2 receptor availability in the caudate and putamen, causing motor and cognitive impairment.
- Amphetamine psychosis is very similar to schizophrenia.
- Parenteral amphetamine use carries a high risk of infections, especially involving unusual organisms that affect the nervous system, and an increased risk for human immunodeficiency virus (HIV) infection.
- Inhaling amphetamine can cause pneumomediastinum.
Treatment of Amphetamine Abuse
- There is no proven effective treatment for amphetamine dependence and abuse.
- Fluoxetine may decrease craving.
- Imipramine may increase the duration of adherence to treatment.
MDMA (Ecstasy)
- MDMA is typically taken orally in tablets, capsules, or powder but can be smoked, snorted, or injected.
- MDMA causes euphoria, CNS stimulation, a mild hallucinogenic effect, increased heart rate, and blood pressure.
- It destroys serotonin-producing neurons.
Khat
- Khat contains cathinone and cathine, both amphetamine-like substances.
- It is commonly used in Somalia, Yemen, and Ethiopia.
- Khat leaves are typically chewed or brewed as a beverage, but can also be smoked, made into tea, or sprinkled on food.
- Excessive khat use can lead to dependence and physical and mental problems.
- The euphoric effect of khat appears shortly after chewing begins, suggesting absorption from the oral mucosa.
- Cathinone is rapidly metabolized mainly in the liver, and only a small amount (about 2%) is excreted unchanged in the urine.
- Most cathinone is metabolized to norephedrine and excreted in that form.
- Drinking large amounts of non-alcoholic beverages while taking khat enhances the effects of khat due to pharmacological synergism with methylxanthines found in tea and cola.
Khat: Mechanism of Action and CNS Effects
- Like amphetamine, khat releases catecholamines from presynaptic storage sites, inhibits their reuptake, and increases dopamine and serotonin release.
- The acute effects of khat include increased alertness, enhanced concentration, and a flow of ideas.
- Long-term khat abuse can lead to CNS complications, including insomnia, violence, impairment of mental health (learning and memory), and khat-induced psychosis.
- Khat-induced psychosis can cause depression, manic and delusional behavior, hallucinations, and paranoia.
Khat: Effects on the GIT and CVS
- Long-term khat abuse can lead to gastrointestinal complications, including anorexia, weight loss, dental problems, stomatitis, gastritis, constipation, hemorrhoids, liver damage, and an increased incidence of oral malignancies.
- Khat abuse can increase the risk of hypertension, acute heart attack, ischemic heart diseases, stroke, and death.
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Description
This quiz explores the various types of amphetamines, their uses, and the effects they have on the body. Understand the mechanisms of action for these psychostimulant drugs and their pharmacokinetic properties. Dive into the world of substances that influence mental states and neurotransmitter activity.
