CLINICAL CHEMISTRY 2 TOPIC

WEEK
STIMULANTS
LECTURER: SHIRLEY SOLITARIO
BACHELOR OF SCIENCE IN MEDICAL LABORATORY SCIENCE
LECTURE 1
TRANSCRIBED BY: BERNADETTE N. VALDEZ
THIRD YEAR-SECOND SEMESTER
9 06
HISTORY • Other adverse effects are insomnia, irritability, weakness,
dizziness, tremor, hyperactive reflex
• The first of the synthetic stimulants, amphetamine (isolated in
1887), was first popularized in the 1930’s with an OTC nasal • Other adverse effects of stimulants on the gastrointestinal tract
decongestant (Bezedrine inhaler) containing the amphetamine include anorexia, nausea, vomiting, abdominal cramps, and
phenylisopropylamine and the following the discoveries of clinical diarrhea
applications for fatigue, narcolepsy and depression
• Stimulants also increase sexual arousal
• Stimulants were one of the first classes of drugs to be used in the
treatment of depression, beginning after the introduction of the STIMULANTS
amphetamines in the 1930s. However, they were largely
abandoned for treatment of depression following the introduction Stimulants are drugs that:
of conventional antidepressants in the 1950s. Subsequent to this,
there has been a resurgence in interest in stimulants for depression • stimulate the brain and the central nervous system
in recent years.
• increase the state of mental alertness
DEFINITION
• decrease appetite
What are stimulants?
a) Amphetamines
• A stimulant is a drug that speeds up the central nervous system to
increase neural activity in the brain. Stimulants tend to make b) Cocaine
people feel more alert and awake and can produce feelings of
c) Nicotine
euphoria.

What are prescription stimulants? Effects of Stimulants

• Prescription stimulants are medicines generally used to treat - Wakefulness

attention-deficit hyperactivity disorder (ADHD) and narcolepsy— - Alertness
uncontrollable episodes of deep sleep. They increase alertness, - Increased energy
attention, and energy - Euphoria
- Confusion
• Stimulants come in both legal and illegal forms. Prescription - Reduced appetite, Increased talkativeness
stimulants include Adderall, Dexedrine, diet aids like Preludin, - Increased breathing and heart rate
Fastin, Meridia, and street drugs such as methamphetamine, - Elevated blood pressure
cocaine, methcathinone, and other synthetic cathinones known as
“bath salts.” SOURCES

• They are mostly obtained from plant sources:

• Amphetamines may also be used to treat ADHD or narcolepsy.
o Cocaine (Erythroxylum coca)
• Stimulants are widely used as prescription medicine as well as
without a prescription (illicitly) o Caffeine (Thea sinensis)

- Examples of prescribed stimulants; Amphetamines, o Ephedrine (Ephedra sinica)

Ephedrine, Caffeine, Nicotine, etc.
o Nicotine (Nicotiana tobbacum)
- Examples of illicit stimulants; Cocaine, Crack Cocaine,
Methamphetamine. o Strychnine (Strychnox nux-vomica)

o Tea (Thea sinensis)

o Theophylline / Theobromine (Theobroma cacao)

MECHANISM OF ACTION

1. Block Neurotransmitter reuptake (Most reuptake inhibitors affect

EFFECTS either NE or 5-Ht Serotonin) : Cocaine

• Prescription stimulants increase the activity of the brain chemicals 2. Promote Neurotransmitter release: Amphetamine
dopamine and norepinephrine. Dopamine is involved in the
3. Block Metabolism: MAO inhibitors (monoamine oxidase) ex.
reinforcement of rewarding behaviors. Norepinephrine affects
Phenelzine
blood vessels, blood pressure and heart rate, blood sugar, and
breathing. 4. Antagonize the effect of inhibitory neurotransmitters: Picrotoxin
and Strychnine
Short term effects include
• The general mechanism of stimulants revolves around
• increased blood pressure and heart rate increased catecholamine levels and increased agonistic
• increased breathing activity at adrenergic receptors.
• decreased blood flow
• increased blood sugar
• opened-up breathing passages

BERNADETTE N. VALDEZ 1 A.Y. 2022-2023 | BSMLS 3 | CC2

 DIFFERENT TYPES OF DRUG STIMULANTS ADVERSE EFFECTS OF AMPHETAMINES

1. ANALEPTIC STIMULANTS • Cardiovascular: Hypertension (7% to 22%, pediatric)

2. PSYCHOMOTOR STIMULANTS • Endocrine metabolic: Weight loss (4% to 9%, pediatric; 11% adult)
3. METHYLXANTHINES
• Gastrointestinal: Abdominal pain (11% to 14%, pediatric), loss of
appetite (22% to 36%), Xerostomia (35%)

1. ANALEPTIC STIMULANTS • Neurological: Headache (26%), Insomnia (12% to 17% pediatric);

(27%, adult)
• The term "analeptic" typically refers to respiratory analeptics (for • Psychiatric: Feeling nervous (6%)
example, doxapram). Analeptics are central nervous system (CNS)
stimulants that include a wide variety of medications used to treat FORMS OF AMPHETAMINES
depression, attention deficit hyperactivity disorder (ADHD), and
respiratory depression. • POWDER - can vary in color, most common in white to brown
• Analeptics have been used throughout history for two main • TABLETS AND CAPSULES – vary in color
purposes: helping patients recover from anesthesia more
efficiently and the management of respiratory distress and apnea. • CRYSTAL – the most potent form of amphetamine.

o FORMS: They generally occur in tablet formation - large sheet-like crystals or crystalline powder

Analeptic stimulants side effects:

• Sweating 3. METHYLXANTHINES

• Nausea • The methylxanthines are even milder stimulants. Unlike the

amphetamines and methylphenidate, which are synthetically
• Vomiting manufactured, these compounds occur naturally in various plants
and have been used by humans for many centuries. The most
• Urinary retention and muscle spasticity
important of them are caffeine, theophylline, and theobromine.
• Diarrhea
ADVERSE EFFECT OF METHYLXANTHINES
2. PSYCHOMOTOR STIMULANTS
• If administered regularly – psychological addiction–theism, which
is accompanied by the development of abstinent syndrome
• Psychomotor stimulants are drugs that act on the central nervous
(headache, retardness, fatigue, somnolence, depression)
system (CNS) to increase alertness, elevate mood, and produce
a sense of well-being. These drugs also decrease appetite and
• Insomnia, anxiety, agitation
the need for sleep. Stimulants can enhance stamina and improve
performance in tasks that have been impaired by fatigue or • Acute poisoning in case of overdosing (lethal dose – 10g for
boredom. caffeine – about 100 cups)

Psychomotor stimulants (AMPHETAMINES) • Increased happiness and excitement

• Mechanism of action: • Talk move, and think quickly, alertness, wakefulness, restlessness,
heart beats faster, nervousness and anxiety.
o Block the reuptake of norepinephrine and dopamine into the
presynaptic neuron and increase the release of these • Mood swings
monoamines into the extraneuronal space.
• Aggressiveness
Clinical uses:
• Paranoia, Twitching, and shaking of the body
1. Narcolepsy
• Increased Blood pressure, could lead to heart attack or stroke
2. Attention-deficit hyperactivity disorder
• Suppressed appetite, possible weight loss
o AFTER ADMINISTRATION: Hair Erection, Licking, Sniffing
are major side effects. • Anxiety reaction that includes: hypertension, tachycardia,
sweating, and paranoia
TYPES OF AMPHETAMINES
Caffeine and caffeine-like products (XANTHINES)
• Designer drugs are products of amphetamine and
• CNS EFFECTS
methamphetamine that have prominent psychedelic effects in
addition to their CNS stimulatory action. o 100-200mg/day – Alertness, arousal, and reduces tiredness
Some designer drugs are: o 300+ mg/day – Insomnia, Increase tension, anxiety, and muscle
twitches
• Meth cathinone (A combination of methamphetamine and
cocaine) o 500+ mg/day – panic sensations, chills, nausea, and clumsiness
• Methylenedioxy-n-methylamphetamine (MDMA, Ecstacy) o Extreme doses/day – May result in seizures, respiratory failure,
(Stimulant and Hallucinogen) and even death

• Methylenedioxyamphetamine • CARDIOVASCULAR AND RESPIRATORY EFFECTS

• Detroamphetamine: Used for ADHD and narcolepsy o 500 + mg leads to increased heart activity

• Levoamphetamine: A psychostimulant used to increase o Can help with asthma-related respiratory promblem
alertness Dextroamphetamine
BERNADETTE N. VALDEZ 2 A.Y. 2022-2023 | BSMLS 3 | CC2
 CASE STUDY IN YEAR 2020 NICOTINE

Nicotiana tabacum, most addictive drug, potent para symphathomimetic

stimulant

CASE STUDY IN PARTICULAR STIMULANTS

The National Surveys on Drug Use and Health (NSDUH) 2015-2016

make a study of how many people use a certain stimulants from different
age bracket and what particular stimulant they used, and if it is
prescribed by doctors or not. HOW IS NICOTINE ADDICTIVE :

Among U.S. adults, 6.6% (annual average) used prescription stimulants Over time, nicotine affects the neurotransmitter in the brain changing
overall; 4.5% used without misuse, 1.9% misused without use disorders, the way certain brain cells work.
and 0.2% had use disorders.
When one stops using nicotine the changes remains for a while until
Approximately 16.0 million U.S. adults used prescription stimulants in the brain can revert back to normal state.
the preceding year (annual average), 5.0 million misused prescription
stimulants, and 0.4 million had use disorders. These change are what cause the withdrawal symptoms characteristics
of addiction.
STIMULANTS
AMPHETAMINE
o Cocaine
o Nicotine (POTENT CNS STIMULANT , PHENYL AMINE DERIVATIVE , USED
o Amphetamine IN ATTENTION DEFICIT HYPERACTIVITY DISORDER , STREET
NAME : BLACK BEAUTIES , CO-PILOTS ,CRYSTAL METH ,
Cocaine HEART)

(ERYTHROXYLON COCA , LOCAL ANESTHETIC & CNS Sign & symptoms of amphetamine abuse :
STIMULANT) STREET NAME : CRACK, SNOW , STAR DUST,
CHARLIE, NOSE CANDY . • Increased body temperature
Sign & symptoms of cocaine abuse : • Dry mouth
• Increase agitation . • Increased blood pressure
• Disinhibition • Faster breathing

• Change in concentration & focus . • Decreased appetite

• Common cold like symptoms . • Euphoria

• Increase movement .

MEDICAL USES

• Stimulants are sometimes referred to as uppers and reverse the

effects of fatigue on both mental and physical tasks.

• Therapeutic levels of stimulants can produce exhilaration,

extended wakefulness, and loss of appetite.

• These effects are greatly intensified when large doses of

stimulants are taken.

• Stimulants relax bronchial the bronchial muscles almost all

asthma medications contain stimulants

• Stimulants are also effective in treating cognitive disturbances in

HEROINE
HIV patients and in cancer patients going through cranial
• Most infamous product of opium poppy irradiation

• Current resurgence in use: white powder & black tar heroin

• High purity and skyrocketing profits

• Cheaper than “Oxy” and other pain meds

BERNADETTE N. VALDEZ 3 A.Y. 2022-2023 | BSMLS 3 | CC2

 HEALTH RISKS

• Repeated misuse of prescription stimulants, even within a short

period, can cause psychosis, anger, or paranoia.

• If the drug is injected, it is important to note that sharing drug

injection equipment and having impaired judgment from drug
misuse can increase the risk of contracting infectious diseases
such as HIV and hepatitis.

• Stimulants produce an overabundance of dopamine, the pleasure-

inducing chemical in the brain.

• After continued abuse of Stimulants, the brain no longer produces

normal amounts of dopamine; it’s been conditioned to receive
dopamine from taking the drug.

• When the individual stops taking the medication, they experience

withdrawal symptoms.

• This creates physical dependency on the drug and requires the

individual to continue using the drug in order to feel normal. Over
time, this can develop into an addiction.

TREATMENT

• Behavioral therapies, including cognitive-behavioral therapy and

contingency management (motivational incentives), can be
effective in helping to treat people with prescription stimulant
addiction.

• Cognitive-behavioral therapy helps modify the patient’s drug-use

expectations and behaviors, and it can effectively manage triggers
and stress. Contingency management provides vouchers or small
cash rewards for positive behaviors such as staying drug-free.

BERNADETTE N. VALDEZ 4 A.Y. 2022-2023 | BSMLS 3 | CC2