Abuse (penyalahgunaan)

Tolerance
Dependence
Psychological dependence
Physiological dependence
Withdrawal/ Abstinence syndrome
Designer drug

Alasan Abuse
Euphoria
Halusinasi
Libido
Perasaan bebas dari ikatan (disinhibisi)
Self confidence

Drugs of abuse
Sedative hypnotics
Opioid Analgesics
Stimulants
Hallucinogens
Marijuana (Marihuana)
Inhalant
Steroid

Sedative hypnotics
Ethanol, Barbiturate, Benzodiazepine (BZ)
Secobarbital potensi adiksi yang tinggi
Efek : menurunkan anxiety
menimbulkan perasaan relax
Overdose:
Depresi pusat nafas dan Sirkulasi
Kematian

 Management:
*Jaga jalan nafas
*Ventilator
*Flumazenil

Withdrawal sedative
Excessive

CNS stimulation
anxiety, tremor, nausea vomiting
delirium, hallucination
Kejang
Sympathetic overactivity

Treatment withdrawal
Chordiazepoxide/ diazepam
Clonidine, propranolol

Opioid Analgesics

Efek opioid
i.v. heroin: orgasmic feeling, euphoria,
sedation
i.v.opioid: cepat terjadi Tolerance, Psych.
dan Physiological dependence

Overdosis: pin point pupil, respiratory

depression, Coma

Treatment overdose
Pasien dengan physiological dependence:

Nalorphine, jaga jalan nafas

Pasien tanpa physiological dependence:
Naloxon, jaga jalan nafas

Withdrawal opioid

Lacrimation, rhinorrhea, menguap,

berkeringat, lemah, kulit spt kulit
angsa,
nausea, vomiting, tremor, hyperpnea

Treatment:
Methadone
Buprenorphine (long acting opioid)

Stimulants
Caffeine and Nicotine
Amphetamine
Cocaine

Caffeine and Nicotine

Toxicity
CNS stimulation
Cardiac stimulation
Respiratory paralysis
Withdrawal
Lethargy
Irritability
Headache

Amphetamine

Effects
Euphoria, self confidence
Chronic high dose abuse (psychotic state)
Overdose:agitation,tachycardia,hyperreflexia
Chronic abuse:necrotizing arteritis (cerebral
hemorrhage, renal failure
Tolerance and withdrawal:
Appetite increased,sleepiness,exhaustion,
mental depression

 Congeners of Amphetamine that have

hallucinogenic:
DOM (Dimethoxy Methylamphetamine)
MDA (Methylene Dioxyamphetamine)
MDMA (ecstasy) (Methylene Dioxy
Methamphetamine

Cocaine
Effect:
Euphoria, Self Confidence,
Mental alertness
Overdose:
Arrhythmia
Seizure
Respiratory distress

Chronic abuse:
Vasoconstrictive, Hypertensive
Stroke, Myocard infarct
Withdrawal:
Severe depression

Hallucinogens

Phencyclidine (PCP)

Most dangerous
Overdose: nystagmus, hypertension
seizure

Other Hallucinogens:

LSD, Mescaline, psilocybin

Scopolamine, Other antimuscarinic

Marijuana/marihuana
Active compound:
THC (Tetrahydrocannabinol)
CBD (Cannabidiol)
CBN (Cannabinol)
Effects:
Euphoria, perasaan lepas, tertawa, spt
di alam mimpi
Vasodilatation, pulse rate increased

Habitual user: reddened conyunctiva

Withdrawal: A mild withdrawal
Impairment of judgement and
reflexes
Therapeutic effect:
Menurunkan tekanan intra Ocular
Antiemetic (Dronabinol)

Steroid

Effect: Increase in muscle mass & strength

Euphoria
Excessive use:
Behavioral effect, increases in libido
Cardiovascular, risk of myocard infarct
Acne
Masculinization
Withdrawal:
Fatigue and depression of mood

DRUG MISUSE

Salah diagnosis
Salah memilih obat
Dosis yang tidak tepat
Cara pemberian tidak tepat
Terlalu banyak jenis (polifarmasi)

Codein
10 mg
Doveri
100 mg
Ephedrine
15 mg
Aminophylin
160 mg
CTM
3 mg
Phenobarbital
15 mg