Pharmacokinetics And Pharmacodynamics Of Smoked Drugs Of Abuse

在过去的十年里，美国对某些滥用药物的管理方式发生了戏剧性的转变。例如，静脉注射海洛因历来是人们青睐的给药方法。这种情况正在改变，因为有越来越多的报告称，对海洛因的鼻腔给药和烟熏给药。这些变化的原因可能包括社会和环境因素，如吸烟的方便和方便，避免针灸传播的疾病，以及不同给药途径可能产生的药理差异。与可卡因不同的是，在美国，烟草(尼古丁)和大麻(四氢大麻酚)几乎总是通过吸烟来服用。给药途径是特定药物毒性和成瘾性的决定因素。吸烟路线导致严重的发病率和死亡率。研究考察了给药途径(鼻腔、静脉和吸烟)对可卡因、甲基苯丙胺、大麻、海洛因和尼古丁的药代动力学参数和药物诱导的行为和生理效应的影响。在给药前和给药后定期收集生理和行为指标。同时采集血液样本，用气相色谱/质谱仪和液相色谱/质谱仪对药物和代谢物进行分析。主观效果和认知和精神运动表现的行为测量通过不同的途径进行评估，以比较反应的大小，包括虐待倾向的测量。通过研究通过替代途径给药后的血药浓度，可以确定药物的生物利用度，这是选择途径的一个重要因素。生理反应因作用部位药物浓度的速度、幅度和持续时间不同而不同。鼻腔给药的特点是血浆浓度较低，药理作用起效较慢，通常比其他给药途径观察到的药效要低。这些发现表明，与通过静脉或鼻腔给药的同等剂量的可卡因相比，烟熏可卡因(“可卡因”)具有更高的滥用倾向和更大的依赖产生特性。其他研究发现，吸烟剂量的海洛因、可卡因和尼古丁的点赞分数相似。总而言之，这些研究表明，吸烟的给药途径与高水平的滥用责任有关，药物的滥用潜力不是药物的固有属性，但可能因药物的给药方式而异。

A dramatic shift has occurred over the last decade in the route of administration of certain drugs of abuse in the United States. For example, the intravenous route for heroin has historically been the favored method of drug administration. This is changing with increased reports of intranasal and smoked administration of heroin. The reasons for these changes may include social and environmental factors such as the ease and convenience of smoking, avoidance of needle-transmitted diseases, and possible pharmacologic differences produced by the different routes of administration. In contrast to cocaine, tobacco (nicotine) and cannabis (tetrahydrocannabinol) have almost always been administered via smoking in the United States. The route of drug administration is a determinant of the toxicity and addictiveness of a given drug. The smoked route results in significant morbidity and mortality. Studies examine the influences exerted by routes of administration (intranasal, intravenous, and smoked) on pharmacokinetic parameters and drug-induced behavioral and physiologic effects of cocaine, methamphetamine, cannabis, heroin and nicotine. Physiological and behavioral measures are collected before and periodically after drug administration. Concurrent blood specimens are collected and analyzed by gas chromatography/mass spectrometry and liquid chromatography/mass spectrometry for drugs and metabolites. Behavioral measures of subjective effects and cognitive and psychomotor performance are evaluated by the different routes to compare magnitude of responses including measures of abuse liability. Investigation of plasma concentrations following administration of drugs by alternative routes permits determination of drug bioavailability, an important factor in route selection. Physiologic responses vary according to the speed, magnitude and duration of drug concentrations at the site of action. Intranasal administration was characterized by lower plasma concentrations and a slower onset of pharmacologic effects that were generally of lower magnitude than those observed by other routes of administration. These findings suggest that smoked cocaine ("crack") has a higher abuse liability and greater dependence-producing properties than equivalent doses of cocaine administered by the intravenous or intranasal route. Other studies found that liking scores were similar for smoked doses of heroin, cocaine, and nicotine. Together, these studies indicate that the smoked route of drug administration is associated with high levels of abuse liability and that a drug's abuse potential is not an inherent property of the drug, but can vary depending on how the drug is delivered.