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UNIVERSIAD NACIONAL PEDRO RUIZ GALLO FACULTAD MEDICINA HUMANA

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U N I V E R S I A D N A C I O N A L P E D R O R U I Z G A L L OF A C U L T A D M E D I C I N A H U M A N A

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CARUAJULCA SALDAÑA MELISSA ELSI CHAFLOQUE CARHUAS JANE LADY CHAMBERGO RUIZ GUILLANA DEL FÁTIMA CHAPOÑAN TERRONES MIGUEL ÁNGEL RIVERA PAICO MAIRA LEONOR ROJAS RUIZ ROMMEL ADOLFO

A C U L T A D M E D I C I N A H U M A N A

UNIVERSIAD NACIONAL PEDRO RUIZ GALLO

INTEGRANTS

1.-Introduccion

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F A C U L T A D M E D I C I N A H U M A N ASelf-medication is a type of conduct that involves taking medications as the patient's own initiative, on the advice of the pharmacist or health of any person. There are many factors that influence this type of behavior, emphasizing social factors like peer pressure or our own families that we offer an alternative to solving our health problems based on their own experience. It also influences the low level of education of people especially the parents, which completely ignore the risk involved in self-medication.

Among the economic factors that influence self-medication include unemployment, poor working conditions and living standards of most people and especially the low income family that gives them access to health services which translates lack of prescription by a trained professional.

Among the cultural factors influencing the lack of access and limited availability of information allowing pharmaceutical companies to disseminate biased information that encourages people to consume drugs supposedly very safe, this also is coupled with poor health education with which have.

Self-medication is the act by which we medicate ourselves with no prescription, which some drugs lead to dependence and therefore the mass consumption of them.Self-medication with drugs that alter mood, usually respond to adaptive behavior, as an attempt to escape boredom, loneliness, stress, frustration.

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2.- Definition

3.-Self-Medication as an Explanation for Addiction

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Dependence occurs when there is an overuse of the substance that produces significant negative consequences over an extended period of time.Dependency, called dependency syndrome in the latest edition of the classification of diseases, ICD-10 (WHO, 1992), is defined as "a set of physiological manifestations, behavioral and cognitive in which drug use or a type of them, takes the highest priority for the individual, even bigger than any other type of behavior in the past had the highest value ...".Its causes are searching for people to reduce pain and anxiety but what is generated is increased tolerance or need for increasing amounts of drug addiction to get the desired effect, failure to attempt to stop drug addiction, and a weakening of their social activities.The negative consequences associated with drug addiction affect many different aspects of a person's life. These consequences are diverse, but we can divide them into two groups.

HealthDrug addiction causes or is involved in the emergence of diseases, damages and organic and psychological problems. Hepatitis, cirrhosis, depression, psychosis, paranoia are some of the disorders that drug addiction causes and can be fatal.

SocialWhen starting the drug addiction, the person is no longer able to maintain stable relationships and can destroy family relationships and warm atmosphere. Drug addiction can cause people to stop participating in the world, abandoning goals and your life revolves around drug addiction destroying your surroundings. Also affected the people around the adictoadiccion to drugs, especially those in their immediate environment, such as family and friends.

Poor performance at work or in the studio

It reaches the level of goals and plans to leave, using drug addiction as the only "solution".

Economic consequences

Use of drug addiction can be very expensive, leading to addiction to devote all

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its resources to maintain consumption, even steal the wealth of his family and friends.

Currently there are treatments that can overcome the problem of drug addiction. Continue reading the next section to learn how to overcome drug addiction.

Some people mistakenly believe that prescription medications are more powerful because it is necessary to have a prescription to buy. But it is also possible to abuse or become addicted to drugs to be sold freely,without prescription.For example, dextromethorphan (DXM) is present in some over-the-counter cough medicines. When you take the recommended amount of tablespoons or tablets, there is no problem. But the high doses can cause problems in the senses(

above all in the eye and ear) confusion, stomach pain, numbness, and even hallucinations.

Medicines from prescription that are abused more often are classified into three categories:

1.- Opioids

Examples: oxycodone (OxyContin), hydrocodone (Vicodin) and meperidine (Demerol).

Medical uses: opioids used as painkillers (to treat pain) or to relieve cough or diarrhea.

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4.- Dangers of self Medications

5.- Whats drugs are abused more?

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How they work: opioids bind to opioid receptors in the central nervous system (brain and spinal cord), which led to the brain does not receive pain messages.

2. Central nervous system (CNS) depressants

Examples: sodium pentobarbital (Nembutal), diazepam (Valium) and alprazolam (Xanax).

Medical uses: CNS depressants are used to treat anxiety, tension, panic attacks and sleep disorders.

How they work: CNS depressants slow down brain activity by increasing the activity of a neurotransmitter called GABA. As a result, achieved a drowsy or calming effect.

3.- Stimulants

Examples: methylphenidate (Ritalin), amphetamine/dextroamphetamine (Adderall).

Medical uses: stimulants can be used to treat narcolepsy and ADHD.

How they work: stimulants increase brain activity, which leads to a higher State of alert and higher levels of attention and energy.

Regardless of that consume illegal drugs or medications, abusers of these substances tend to have problems at school, at home, with friends or with the law. The chances that a person commits a crime, is the victim of a crime or have an

UNIVERSIAD NACIONAL PEDRO RUIZ GALLO

5.- Whats are dangers of abusing drugs?

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accident are greater when abused those substances, no matter to be of medications or drugs.

As well as the consumption of illegal drugs, the use of prescription drugs on prescription for purposes different from those who have been prescribed is associated with serious health risks.

The abuse of opioids can cause vomiting, mood changes, reduction in the capacity of thinking (cognitive function) and even decreased respiratory function, coma or death. This risk is greater when prescription drugs such as opioids are mixed with other substances such as alcohol, antihistamines, and CNS depressants.

CNS depressants also have their risks. If it reduces or interrupts its use too fast, seizures occur. Take depressants of the central nervous system with other drugs such as analgesics of prescription, some prescription drugs without a prescription for allergy and cold, or alcohol can slow the heart rate and respiration of a person, being able to get to cause death.

The abuse of stimulants (such as some medications for ADHD) can lead to heart failure or seizures. These risks increase when stimulants are mixed with other drugs, even with those who sold freely, as certain anticatarrales drugs. Take a stimulant in excessive amounts can lead a person to develop a dangerously high body temperature or irregular heart rhythm. Take several high doses of stimulants during a short period of time can make the person to become aggressive or paranoid. Although the stimulant abuse does not usually cause physical dependence or withdrawal, sensations that these substances cause in people who consume them can lead them to use them more and more frequently, becoming a habit difficult to abandon their consumption.

The dangers of abusing prescription medicines can be even worse if people take these drugs in a different way from which it should be used. The Ritalín may seem harmless because it prescribed even young children with ADHD. But if a person takes it unnecessarily or incorrectly, snorting it, or injecting it, the toxicity of the Ritalín can be very severeSome problems of the abuse of drugs

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The abuse of pain relievers

The pain is only a symptom and abusing painkillers, masking the manifestation of the Agency with respect to any underlying disease. While it is reasonable to look for a paleativo effect, we must not forget that although the symptom has assigned, the problem that generates the pain has not disappeared.

Abuse of antibiotics

Especially when they are consumed orally and through prolonged administrations, destroy not only the germs that you want to remove, but also the intestinal flora which can cause damage the immune system of the colon.

Abuse of laxatives

Prolonged use of laxatives leads to addiction and just hampers evacuation in a natural way. The use of laxatives should be limited to an occasional remedy.

And since there are many varieties of a same medicine, the dose of the medicinal product and the time that remains in the body may vary. If a person does not have prescription, may not know what specific drug you are taking.

Probably, the most common result of the abuse of prescription drugs addiction. Abusers of drugs may become addicts with as easily as those who consume illicit drugs. Why the many medications must be prescribed by a doctor is that some of them are addictive. Why most

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doctors not renew prescriptions, unless they can see the patient: want to look at it to make sure that it is not developing addiction.

Self-Medication of Migraine Headaches with Freebase Cocaine

Introduction

Cocaine is a commonly abused drug with a

high potential for adverse consequences.

Although the etiology of cocaine

dependence is complex, the self-

medication hypothesis asserts that certain

persons initiate cocaine use in order to

medicate themselves for an underlying

psychiatric disorder (Khantzian, 1985). This

hypothesis is supported in part by

diagnostic studies which suggest a high

prevalence of psychopathology in cocaine

abusers (Gawin & Kleber, 1986; Weiss,

Mirin, Michael, & Sollogub, 1986).

Additional support is provided by a number of case reports which describe

patients who apparently used cocaine to self-medicate either affective

disorders or attention deficit disorder. In most of these case reports, specific

pharmacotherapy for the psychiatric disorder resulted in dramatic

improvement in the cocaine dependence.

History and background

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6.-Case Report

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The patient was a 29 year old man who

began having headaches at age 23. The

headache was described as a throbbing

pain over the right temple that lasted

between four hours and four days.

Headaches were preceded by blurred

vision, flashing purple and clear lights,

and were associated with nausea. They

occurred between one and four times per

month. During a headache, the patient

preferred to lie still in a dark, quiet room

until it subsided. If he took a combination

of ergotamine and caffeine early in the

course of a headache, he sometimes

obtained relief.

He avoided taking more than two pills during an episode and so used the

medication suboptimally. Previous trials with propanolol and amitriptyline were

unsuccessful in treating his migraines.

He first tried smoking freebase cocaine at age 27 at the urging of a friend who

suggested that it might help a headache he had at the time. Indeed, he noticed

immediate and complete relief lasting between five and fifteen minutes, after

which the euphoric peak subsided and his headache returned. He found that he

could sustain relief with each additional “hit off the pipe” for another five to

fifteen minutes, after which the headache returned again.

He repeated this pattern for the next three headaches he had. After his fourth

episode of smoking cocaine, he began to use cocaine even when he did not

have a headache. The cocaine never brought on a migraine headache if he did

not already have one at the beginning of use.

Gradually, his use of cocaine escalated until he was consuming between 10 to

14 grams every two weeks at a cost of $1000.

Typically, he experienced little or no craving between paydays; but as soon as

he had his paycheck in hand, he felt an intense desire to obtain and use

cocaine. Within the, one month prior to admission, the patient lost his job and

marriage due to cocaine use.

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Treatment

The patient was treated on a specialized inpatient ward for substance abuse.

The treatment consisted of individual and group therapy that was

supplemented by drug education. An ergotamine preparation was prescribed

for the headaches, and instructions were given for optimal use. During the 28

days of inpatient treatment, the patient remained free of cocaine and

experienced only one headache, which was mild and responded to four hours

of bedrest. Following the inpatient program, he was discharged to a half-way

house for recovering substance abusers.

Discussion

More importantly, the case illustrates cocaine use which apparently began as a

self-treatment for headaches and culminated in a full-blown cocaine

dependence.

When planning the treatment strategy for the patient, it was helpful to

consider:

The factors that initiated cocaine use

The factors that perpetuated addictive use.

An examination of the phenomenology of cocaine dependence suggests that

the factors involved in perpetuating addictive use may be quite distinct from

those involved in initiating use. The lives of patients dependent on cocaine

become increasingly organized around thinking about, obtaining, using, and

recovering from the effects of the drug. Their relationship with the chemical

eventually supersedes prior relationships with other people and activities. In

this patient, for example, compulsive use continued despite adverse

consequences such as marital, job, and financial losses. Initially, however,

when self-medication was his motive, he was able to terminate his cocaine use

when the migraine symptoms subsided.

Other patients who are purely self-medicating their psychiatric symptoms

should manifest a similar pattern of controlled use. By contrast, his addictive

use was related to new symptoms, such as craving, which occurred in the

absence of migraines.

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Dependent cocaine users often report profound euphoria with immediate use

alternating with equally profound dysphoria, craving, and other withdrawal

symptoms when the acute effects subside.

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