Partial agonist of nicotinic acetylcholine receptor of the α4β2-type • Cytisine: Natural analog (extracted from laburnum flowers) of varenicline •Oxazepam,others Positive modulators of the GABAA receptors, increase frequency of channel opening Enhances GABAergic synaptic transmission; attenuates withdrawal symptoms (tremor, hallucinations, anxiety) in alcoholics•preventswithdrawal seizures Delirium tremens Half-life4–15h•pharmacokineticsnotaffected by decreased liver function • Lorazepam:Alternatetooxazepamwithsimilarproperties
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Pharmacology of Drugs of Abuse
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When found by his parents, the patient was having visual hallucinations of colorful insects. Hallucinations are often caused by a cannabis overdose, especially when hashish is ingested. The slower kinetics of oral cannabis are more dif-ficult to control compared to smoking marijuana. The poor learning performance may be due to the interference of exogenous cannabis with endocannabinoids that fine-tune synaptic transmission and plasticity. While probably not fulfilling the criteria for addiction at present, the patient is at risk as epidemiologic studies show that drug abuse typically begins in late adolescence. The fact that he is not yet using other drugs is a positive sign.
SECTION VI DRUGS USED TO TREAT DISEASES OF THE BLOOD, INFLAMMATION, & GOUT
James L. Zehnder, MD*