150. Hallucinogens Flashcards
1
Q
4 Categories of hallucinogens
A
- Serontonergics
- Dissociatives
- Dextromethorphan
- Marijuana and synthetics
2
Q
Steps to manage PCP
A
- Take control early!!!
- Avoid oxygen and glucose testing until adequate chemical restraint
- Benzos Benzos Benzos Benzos Benzos
- Cooling for hyperthermia
- Correct electrolyte disturbances
- Watch out for Torsades
- Treat rhabdo aggressively
- May need intubation and paralysis to facilitate the above
3
Q
Peds Marijuana ingestion presentation
A
- Hypothermia, ataxia, nystagmus, tremor, tachycardia, injected conjunctiva, and labile affect
- Can have resp compromise
4
Q
4 isoxazole mushrooms
A
1. Amanita muscaria has a red or yellow cap, with “white warty structures” 2. Amanita pantherina 3. Amanita gemmata 4. Amanita cothurnata
5
Q
2 receptors of isoxazole mushrooms and effects
A
- glutamic acid (excitatory)
- Elation, giddiness, hyperactivity, muscle tremors, and distortion of space and time
- Begin approximately 30 minutes to 2 hours after ingestion
- Likely to be mediated by ibotenic acid - GABA (inhibitory)
- Tiredness and deep sleep, difficult to rouse
- Vivid hallucinations and manic excitement may oscillate with periods of deep sleep.
- Duration of effect = up to 12 hours
6
Q
What is Iboga?
A
Ibogaine = naturally occurring indole alkaloid
Found in the roots of the African rain-forest shrub Tabernanthe iboga.
Involve opioid, dopaminergic, serotonergic, glutaminergic, γ-aminobutyric acid (GABA)–ergic, glutamatergic, adrenergic, and cellular ion channel signaling systems.
Becoming popular as treatment for opiate withdrawal!!!
Increasing reports of sudden cardiac death, likely from prolonged QTC and PMVT
Tx torsades with Mg and possible overdrive pacing
7
Q
2 main classes of serotonergics and examples
A
Lysergamines
- LSD
- Tabs or some plants
Tryptamines
- synthetic or natural
- ayahuasca
- DMT
- Psilocybin
- PCP
8
Q
2 main dissociatives
A
PCP and ketamine
