STIMULANTS

ROLL
 Nicotine

 A active ingredient in tobacco.

 it is 2nd only to alcohol as most abused drug
 Most commonly used are cigarettes, chewing
tobacco, pipe tobacco, hookan etc
 Smoked or held b/n gums and absorbed
through mucus membrane.
 Nicotine dependence
• People site many reasons for tobacco use such as
pleasure, improved performance, relief of depression
etc.

• Tobacco is responsible for 30% of all cancer death in

developed country.
 Acute intoxication due to tobacco
1. Insomnia
2. Bizarre dreams
3. Lability of mood
4. Derealization
5. Interference with personal functioning
6. Nausea and vomiting
7. Sweating
8. Tachycardia
 Tobacco withdrawal state
1. Craving for tobacco
2. weakness
3. Anxiety
4. Irritability
5. Insomnia
6. Increased cough
7. Mouth ulceration
8. Difficulty in concentrating
 Management of nicotine dependence
• Nicotine chewing gum
• Available dose 2/4mg
• It is advised to chew it very slowly to facilitate
slow release of nicotine
• It can be used every 2 to 3 hrly
• Tapered off within few weeks
 Psychological treatment
• Reassurance
• Behavioural therapy
• Relaxation therapy
• Aversion
 4.COCAINE
 Stimulant extracted from leaves of coca plant
 Strong stimulant mostly used as recreational
drug.
 Commonly inhaled or injected into veins.
 It is addictive & after short period of use, there
is a high risk that dependence will occur.
Main effect include
• heightened effect of euphoria,
• well being,
• increased self confidence,
• an increased motor and speech activity ,
• suppression of appetite.
 INTOXICATIION SYMPTOMS
• Restlessness • Paranoid delusion
• Insomnia • Pupillary dilation
• Delirium • Hallucination
• Seizures
• Tachycardia
• Anxiety
• Aggressiveness
• Hyper reaction
• Hypertension
 Withdrawal SYMPTOMS
• Craving • Feeling of helplessness
• Lethargy • depression
• Anxiety
• Fatigue
• Guilt
• Hopelessness
 TREATMENT
 Supportive and symptomatic management.
 Restrain for agitation
 Benzodiazepines for anxiety symptoms
 Beta blocker for tachycardia and hypertension
 Antipsychotic for psychotic symptoms
 Psychotherapy
 Caffeine
• Commonly used worldwide
• Socially acceptable
• Main ingredient in coffee , coca and other
beverages.
• Stimulate nervous system , relieve fatigue and
increasing alertness .
• In large amt can cause tremors , nervousness
and insomnia.
 Symptoms of intoxication
• Can occour in ingestion of over 500 mg/day
• Restlessness
• Excitement
• Flushed face
• GI disturbance
• Agitation
• Nervousness
• Insomnia
• Diuresis
• Muscle twitching
• Cardiac arrhythmia
 Withdrawal Symptoms
• Generalized weakness
• Headache
• Rhinorrhoea
• Nervousness
• Nausea
• Lethargy
• Drowsiness
• Irritability
• Yawing
 TREATMENT
• Reassurance
• Family therapy
• Drug therapy
• Decaffeinated beverage

Psychotherapy
• Behavioural modification
 HALLUCINOGENS
• it is the stimulants that produce profound
changes in thought patterns & moods, with
effect on brain stem & spinal cord.

• Incapable of normal decision making because

drug interfere with rational thought

• Also affect perception and emotion

• E.g. Dhaturo
 A. Lysergic acid diethylamide
• It is a drug well known for its psychological
effects which can include altered thinking
processes, an altered sense of time & spiritual
experiences.
• Route: ingestion, smoking
 INTOXICATION SYMPTOMS
 Change in perception
 Paranoid delusion
 Anxiety
 Pupillary dilation
 Tachycardia/palpitation
 Sweating
 Blurring of vision
 Tremors
 Incoordination
 Impaired judgement
 WITHDRAWAL SYMPTOMS
 Flash back- for weeks to month

TREATMENT
• Supportive and symptomatic
• Antianxiety
• Antipsychotic
• Antidepressant
• Supportive psychotherapy