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Hallucinogenic agents
3.27.07
39
Other
Not Applicable
03/29/2007

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Term
what does LSD stand for?
Definition
lysergic acid diethylamide
Term
which drugs are most available?
Definition
pot, cocaine
Term
what is LSD's MoA?
Definition
involves the serotonergic systems (post-synaptic 5HT-2 receptor) THis starts a cascade effect. (other than that, we don't know)
Term
wHAT IS LSD's Route of Admin?
Definition
orally (powder, solution, capsule)
Term
Dose"
Definition
25-35 ug are very hallucinogenic
Term
What is LSD's halflife?
Definition
3 hours
Term
When can the effect of an oral dose be detected?
Definition
30-60 minutes
Term
What are the CNS effects?
Definition
Euphoria;;;;
Labile mood;
Visual hallucinations;
Synesthesias;
Ego fragmentation -
(initially a decrease in normal ego defenses
BUT ego can become overwhelmed æ depersonalization)
Term
what is synesthesia?
Definition
overflow of one sesory modality to another "see music" :hear colors"
Term
what is ego fragmentation?
Definition
Ego fragmentation -
(initially a decrease in normal ego defenses
BUT ego can become overwhelmed æ depersonalization)
Term
what is a bad trip?
Definition
Temporary episode of panic - “Bad trip”
Most common is a state of acute panic often
accompanied by a fear of imminent insanity.
Term
what can LSD preciptate?
Definition
Precipitation of serious depression, paranoid behavior or prolonged psychotic reaction resembling schizophrenia
Term
If psychotic, what can LSD do?
Definition
Exacerbation of existing psychotic states or
conversion of pre-morbid state to frank psychosis
Term
What is HPPD?
Definition
Hallucinogen Persisting Perceptual Disorder:
Flashbacks:
Treatment
Diazepam, Lorazepam
Interpersonal - reassurance and support
Term
what does PCP stand for?
Definition
phencyclidine
Term
what was PCP's previous licit indication?
Definition
Previous clinical use - general anesthetic to produce dissociative anesthesia-
produced analgesia
amnesia
suppression of laryngeal reflexes
little CV effect
little muscle relaxation
Term
what is PCP's MoA?
Definition
Acts as antagonist of NMDA-glutamate
receptors

In animal studies, profound memory
disturbances are linked to this receptor
antagonism

affinity related to ability to produce
PCP-like effects
Term
what other receptors are involved?
Definition
Presynaptic monoamine receptors - both DA and 5-HT involved.
Sigma receptor,
K+ and Na+ channel receptors
Term
what is the time course?
Definition
Time course - onset within 5 minutes, plateau in about one-half hour and remain there from 4-6 hours;
recovery may take 24-48 hours.
Term
what are the CNS effects?
Definition
CNS Effects:

Effects of PCP: 5 mg dose:
sense of intoxication-”euphoria”; “peaceful floating sensation;” “speedy” feeling,
uncommunicative, oblivious, very labile affect,
slurred speech, nystagmus, rolling gait,
feelings of numbness in hands and feet,
feelings of depersonalization,
disordered thoughts,
distortions of space and time perceptions,
Term
what are PCP's side effects?
Definition
Distortions of body image;

Changes in perception of body consistency;

Delusions - auditory and visual hallucinations
Term
what are the effects of larger doses of PCP?
Definition
Larger doses:
drowsiness ---> stupor ---> coma;
feelings of isolation;
hyperacusis; sensitivity to external stimuli;
amnesia;
bizarre, hostile or unusual behavior;
muscle rigidity;
repetitive movements;
excessive salivation WITH loss of gag reflex;
fever;
increased blood pressure and heart rate
Term
what are the toxic effects?
Definition
Toxicity:
hostility toward others;
confusional periods;
coma, convulsions;
psychotic states - nearly identical to acute schizophrenia;
behavioral problems - talking down is
rarely successful;
paranoia
Term
PCP tx?
Definition
Treatment:
Diazepam, Lorazepam - for seizure activity;
Antipsychotic agents - for psychotic states;
Acidification of urine - to increase excretion;
May require physical restraint - CAREFUL;

In cases of extreme overdose with coma - continuous gastric suction, intubation and maintenance of vital functions
Term
What properties does exstacy have?
Definition
stimulant and hallucinagenic
Term
what does MDMA stand for?
Definition
MDMA (methylenedioxymethamphetamine)
(Ecstasy)
Term
What is its MoA?
Definition
Believed to be both dopaminergic and serotonergic.
Term
what are possible side effects?
Definition
There is known to be increased blood pressure, increased heart rate, dry mouth, bruxism
Term
CNS effects?
Definition
CNS effects:
Euphoria - “a loving feeling”;
Loss of boundaries;
less aware of own boundaries; less distinction
between self and others; decreased sense of
separation from others;
Decrease or loss of inhibitions;
decreased defensiveness;
“Promotes intimacy”
Term
what are the cognitive effects?
Definition
Cognitive changes:
shift in form and content;
slowed thoughts, generalized mental slowing;
decreased desire to do mental or physical tasks
Term
What are the perceptual changes associated with MDMA?
Definition
Perceptual changes:
Visual perceptions are primarily intensified but there may be change in content leading to frank visual hallucinations;
Altered time perception;
Altered perception of spatial relationships;
Increased Anxiety
Term
what are chronic effects?
Definition
Chronic effects - still not known in man. BUT in experimental animals, including non-human primates,
there has been long-lasting, if not permanent, destruction of CNS serotonin pathways. Current evidence in human subjects who have used MDMA also shows permanent destruction of serotonin pathways.
Term
what are some examples of anticholinergics?
Definition
ATROPINE, DIPHENHYDRAMINE, TRICYCLIC
ANTIDEPRESSANTS, MANY OVER-THE -COUNTER SLEEP AIDS, BENZTROPINE
Term
what are the side effects of antichol?
Definition
Generally, a side effect rather than the desired effect but occasionally used for the hallucinogenic effects.

Accompanied by delirium, manifested by waxing and waning consciousness, impulsivity, and impaired judgment.

Also accompanied by physiologic signs of anticholinergic toxicity
fever; warm, dry skin; fixed dilated pupils; tachycardia; decreased peristalis; and atonic bladder.
Term
How do you treat an antichol od?
Definition
Gastric lavage,
Parenteral physostigmine
Term
what are examples of inhalants/
Definition
Toluene;
Gasoline;
Kerosene;
Carbon tetrachloride;
Fluorocarbon propellants;
Amyl or Butyl nitrates;
Nitrous oxide;
Term
what is the MoA of inhalants?
Definition
Very similar to to effects of alcohol, including
actions through the GABA-A receptor complex
Term
what are the effects of inhalants?
Definition
Stimulation and disinhibition;
Nystagmus;
Muscular incoordination;
Perceptual distortions --> ? Frank hallucinations
Term
what happens with chronic use of inhalants?
Definition
Toxic effects on various organ systems
depends on agent of choice;

CNS damage - related to demyelination,
cerebellar atrophy;

Impairments in memory, attention, concentration
and non-verbal intelligence ;
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