1. Drugs that bind on biogenic amine transporters
Domina Petric, MD

2. Cocain Inhaled crack cocain absorbs very fast
in the lungs and passes into the brain.
In the peripheral
nervous system
cocain inhibits
voltage gated
sodium channels
and blocks
action potential.
In the central nervous system
cocain blocks dopamine,
noradrenaline
and serotonine reuptake.
Blockage of dopamine
transporter (DTA)
increases the level of dopamine
in the nucleus accumbens.

3. Cocain
Activation of sympathetic nervous system is
caused by blockage of noradrenaline transporter
which causes acute increase of arterial blood pressure,
tachycardia and ventricular arrhythmias.
Cocain abusers do not have apetite, they are also
hyperactive and sleep less.

4. Cocain
Cocaine abuse increases risk for intracranial hemorrhage,
ischemic cerebral stroke, acute myocardial infarction
and convulsions. Overdose can cause hyperthermia,
coma and death.

5. Cocain Desire for cocain is very strong. Abstinence syndrome
Reverse tolerance: patients become sensitive on small cocain dose.
Behavioral approach
Cocain
Desire for cocain is very strong.
Supportive care

6. Amphetamine
Amphetamines are indirect sympatomimetics that cause release of endogenous biogenic amines like dopamine and noradrenaline. They decrease normal vesicular release of biogenic amines and increase non vesicular release. Intravenous application! Severe psychical addiction!

7. Amphetamine
Amphetamine and its derivates cause euphoria, psychotic episodes, hallucinations and hyperthermia. They are neurotoxic (probably affecting NMDA receptors). Amphetamine causes tachycardia, vasoconstriction and hypertensive crisis. Abstinence syndrome includes dysphoria and general irritability.

8. Ecstasy (MDMA)
Ecstasy increases intimacy and emphaty without interfering with intellectual capabilities. Ecstasy increases levels of biogenic amines, especially serotonine. Severe MDMA abusers develop severe cognitive disorders. Acute toxic effects include hyperthermia and dehydration.

9. Ecstasy (MDMA)
MDMA can cause serotoninergic syndrome: mental status alterations, autonomic hyperactivity, neuromuscular alterations and convulsions. Dehydration can lead to excessive water intake which causes hyponatremia and convulsions. Abstinence syndrome: depression, agression and bad mood.

10. Katzung, Masters, Trevor.
Clinical pharmacology.