Another
The different types of drugs include:
Stimulants speed up the nervous system
Depressants slow down the nervous system.
Opioids create a sense of euphoria and are habit-forming.
Hallucinogens and dissociatives alter a person’s perception of reality.
Inhalants create a euphoric feeling, usually with household items ingested as
gases or fumes.
Cannabis has depressant-like effects and also acts as a hallucinogen.
Stimulants
Stimulants or “uppers” impact the body’s central nervous system (CNS), causing the user to
feel as if they are “speeding up.” These drugs increase the user’s level of alertness,
pumping up heart rate, blood pressure, breathing and blood glucose levels.
Stimulants often come in pill form but are also consumed via snorting or even as food and
drink. For example, caffeine is found in many beverages, and cocaine is a snorted powder.
Different types of stimulants include:
Adderall. Ritalin, Synthetic marijuana.Cocaine, Methamphetamine, Caffeine
Risks of Stimulant Abuse
When abused, stimulants can cause a variety of undesirable consequences. These effects
can include:
Anxiety
Paranoia
Psychosis
High body temperature
Depression
Heart failure
Stroke
Seizures
Opioids
Among the most addictive types of drugs, opioids are powerful painkillers that produce a
sense of euphoria. Derived from the poppy plant, opioids are often prescribed to patients who
are suffering from intense pain. They are extremely habit-forming, and it may only take a
couple of weeks to become physically addicted to these types of drugs. In some rare
instances, studies have demonstrated that it is possible to become addicted after just one
dose of an opioid.
Opioids can be smoked, eaten, drank, injected or taken as pills. Examples of opioids
include:
Heroin
Morphine
Hydrocodone
Opium
Vicodin
OxyContin
Percocet
Codeine
Risks of Opioid Abuse
Opioid abuse can devastate a person’s life. Unfortunately, when someone decides to stop
using opioids, they may suffer tremendously. For example, opioid withdrawal can be
especially difficult, riddling sufferers with flu-like symptoms. Other withdrawal effects
include:
Nausea and vomiting
Diarrhea
Anxiety
Inability to sleep
Hot and cold flashes
Excessive sweating
Muscle cramps
Runny nose
Watery eyes
Depressants
Like stimulants, depressants also impact the body’s CNS but with the opposite effect,
making users feel as if things are “slowing down.” Thus, they are often called “downers” on
the street.
Doctors prescribe some depressants for anxiety, insomnia, obsessive-compulsive disorder
and other medical issues that prevent the sufferer from fully relaxing. These drugs often
offer a sedative experience, making them a tempting choice for teens and adults who wish
to escape everyday stresses.
Examples of depressants include:
Barbiturates
o Phenobarbital
o Pentobarbital
Benzodiazepines
o Rohypnol
o Xanax
o Valium
Alcohol
Alcohol as a Depressant
Alcohol acts as a depressant, making it a popular choice for people who need or want to
relax. Although drinking is often associated with immediate bursts of energy, the person’s
vital functions inevitably slow down. This slowing down can lead to slurred speech, altered
judgment and unsteady movement. Overdosing on alcohol can cause severe toxicity and
even death.
Tobacco as a Depressant
The active ingredient in tobacco is nicotine, a chemical that acts as both a stimulant and a
depressant. Tobacco gives users a minor, immediate rush, followed by a feeling of
relaxation. Nicotine is one of the most addictive substances available on the market and is
dangerous to even try.
Risks of Depressant Abuse
Depressants can be 0useful when used properly, but depressant abuse can cause a host of
issues in both the long and short term, including:
Confusion
Dizziness
Extreme sleepiness
Slowed heart rate
Difficulty speaking
Inability to concentrate
Lack of coordination
Labored or shallow breathing
Death
Hallucinogens
Hallucinogens are a class of drugs that alter a person’s perception of reality. They work by
disrupting brain activity, affecting mood, sensory perception and muscle control. They can
be made synthetically or found naturally.
Although research is currently being conducted on medicinal uses for these drugs, most of
these drugs are not prescribed and are considered recreational. Examples of hallucinogens
include:
Psilocybin (mushrooms)
Peyote (mescaline)
LSD (acid)
Risks of Hallucinogen Abuse
Hallucinogen abuse can have devastating effects that can last a lifetime:
Hallucinogen Persisting Perception Disorder, also known as flashbacks
Fear
Distorted cognition
Paranoia
Psychosis
Anxiety
Increased blood pressure
Nausea
Dissociatives
Dissociatives distort the user’s perception of reality and cause people to “dissociate” or feel
as if they are watching themselves from outside their own bodies. They may gain a false
sense of invincibility then engage in risky behavior such as driving under the influence or
having unsafe sex.
These drugs work by interfering with the brain’s receptors for the chemical glutamate, which
plays a significant role in cognition, emotionality and pain perception. Dissociatives can be
taken as liquids, powders, solids or gases. The drugs include:
Ketamine
DXM (Dextromethorphan)
PCP (phencyclidine)
Risks of Dissociative Abuse
Dissociatives are very dangerous, especially when used over extended periods of time.
However, their immediate impact can be quite distressing as well:
Depression
Anxiety
Suicidal thoughts
Speech difficulties
Social withdrawal
Hallucinations
Detachment from reality
Numbness
Memory loss
Inhalants
Mostly made up of everyday household items, these drugs cause brief feelings of euphoria.
As the name suggests, inhalants are always inhaled as gases or fumes. The “highs” slightly
differ between inhalants, but most people who abuse inhalants are willing to huff whatever
substance they can get.
Examples of inhalants include:
Fumes of markers, paint, paint thinner, gasoline and glue
Nitrous oxide
Aerosol sprays
Room deodorizers
Risks of Inhalant Abuse
Inhalant abuse can have devastating effects, both immediate and in the long run:
Loss of smell
Brain damage
Nosebleeds
Weakness
Euphoria
Increased heart rate
Loss of consciousness
Hallucinations
Slurred speech
Cannabis
Most commonly recognized as marijuana, cannabis acts like a hallucinogen but also
produces depressant-like effects. It is a Schedule I drug (i.e., it has a high potential for
addiction) but has increasing medicinal uses in the United States. Still, marijuana is often
abused by those who do not medically require it.
Cannabis can be smoked, vaporized and even eaten if the THC is first rendered from the
plant matter. Examples of cannabis include:
Marijuana leaves
Hashish
Hash oil
Cannabis-based medicines, such as Sativex
Risks of Cannabis Abuse
Despite being one of the most widely used types of drugs, cannabis abuse can destroy lives
and have both short- and long-term impacts, including:
Lowered immunity to illness
Depression
Chronic anxiety
Reduced sperm count in men
Sedation
Slowed reaction times
Enhanced senses, such as seeing brighter colors
Impaired sense of time
DRUG ADMINISTRATION
A medication administration route is often classified by the location at which the drug is
administered, such as oral or intravenous. The choice of routes in which the medication is given
depends not only on convenience and compliance but also on the drug’s pharmacokinetics and
pharmacodynamic profile. Therefore it is crucial to understand the characteristics of the various
routes and techniques associated with them. Many interprofessional healthcare team members
are involved in the administration of medications to patients.
Enteral Route of Medication
Oral administration of medication is a convenient, cost-effective, and most commonly used
medication administration route. The primary site of drug absorption is usually the small
intestine, and the bioavailability of the medication is influenced by the amount of drug absorbed
across the intestinal epithelium. The first-pass effect is an important consideration for orally
administered medications. It refers to the drug metabolism whereby the drug concentration is
significantly diminished before it reaches the systemic circulation, often due to the metabolism in
the liver.
A sublingual or buccal route is another form of the enteral route of medication administration
that offers the benefit of bypassing the first-pass effect. By applying the drug directly under the
tongue (sublingual) or on the cheek (buccal), the medication undergoes a passive diffusion
through the venous blood in the oral cavity, which bypasses the hepatic portal vein and flows
into the superior vena cava. Compared to sublingual tissue, which has highly permeable mucosa
with rapid access to the underlying capillaries, buccal tissue is less permeable and has slower
drug absorption.
A rectal route is another enteral route of medication administration, and it allows for rapid and
effective absorption of medications via the highly vascularized rectal mucosa. Similar to
sublingual and buccal routes, rectally administered medications undergo passive diffusion and
partially bypass the first-pass metabolism. Only about half of the drug absorbed in the rectum
directly goes to the liver.
Parenteral Route of Medication
Intravenous injection is the most common parental route of medication administration and has
the benefit of bypassing the first-pass metabolism by the liver. Given their superficial location on
the skin, peripheral veins provide easy access to the circulatory system and are often utilized in
the parenteral administration of medications. The upper extremity is usually the preferred site for
intravenous medication as it has a lower incidence of thrombophlebitis and thrombosis than the
lower limbs. The median basilic or cephalic veins of the arm or the metacarpal veins on the
hand's dorsum are commonly used. In the lower extremity, the dorsal venous plexus of the foot
can be used.
An intramuscular medication route can be administered in different body muscles, including
deltoid, dorsogluteal, ventrogluteal, rectus femoris, or vastus lateralis muscles. Although the
dorsogluteal site, or the buttock's upper outer quadrant, is a common site chosen traditionally for
intramuscular injections by healthcare professionals, it poses a potential risk of injury to the
superior gluteal artery and sciatic nerve.[3] On the other hand, the ventrogluteal site, or the
anterior gluteal site, targets the gluteus medius muscle and avoids these potential complications;
thus, it is recommended.
Subcutaneous injections are another form of the parental route of medication and are
administered to the layer of skin referred to as cutis, just below the dermis and epidermis layers.
Subcutaneous tissue has few blood vessels; therefore, the medications injected undergo
absorption at a slow, sustained rate. Subcutaneous medication can be administered to various
sites, including the upper arm's outer area, abdomen avoiding a 2-inch circle around the navel,
the front of the thigh, the upper back, or the upper area of the buttock behind the hip bone.
The intraarterial route is not commonly used for drug administration. Injection of contrast
material after an arterial puncture is done for angiography. The other uses of this route are for the
administration of regional chemotherapeutic agents and for the treatment of malignant tumors of
the brain.
Other Routes of Medication
A transnasal drug route facilitates drug absorption by passive diffusion across the single-
layered, well-vascularized respiratory epithelium directly into the systemic circulation.
An inhaled medication is delivered rapidly across the large surface area of the respiratory tract
epithelium. Drugs absorbed into the pulmonary circulation enter directly into the systemic
circulation via the pulmonary vein, bypassing the first-pass metabolism. The particle size of the
inhaled medication is usually 1 to 10 µm for effective delivery. The efficacy of drug delivery to
the lungs depends not only on the drug particle size and morphology but also on the patient’s
respiratory physiology, such as tidal volume and tracheal inspiration velocity.
A vaginal route is an underexplored drug delivery route that is not commonly used but has the
advantage of bypassing the first-pass effect and can serve as an effective method for local and
systemic therapy. The venous plexuses from the vagina communicate with the vesical, uterine,
and rectal venous plexuses and drain into the internal iliac veins. The veins from the middle and
upper vagina drain directly into the inferior vena cava and bypass the hepatoportal system.
The transdermal route can deliver drugs through the skin. The common methods of
administration through this route are local application formulations like transdermal ointments
and gels, drug carriers like nanoparticles and liposomes, and transdermal patches.
The intraosseous route is useful especially in neonates for the administration of fluids and
drugs when both peripheral and central venous accesses have failed. Clinical trials are now being
conducted on its usefulness in the administration of drugs in out-of-hospital cardiac arrest. It is
also used for the administration of prophylactic antibiotics for regional surgeries.
