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401 - Toxicology, Drug Abuse, Pharmacology > 32: Psychedelics > Flashcards

32: Psychedelics Flashcards

1
Q

LSD and psilocybin are similar in structure to

A

serotonin

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2
Q

actions of LSD and psilocybin include

  • binds to what receptors in brain?
  • reduces what pattern of thinking?
  • what factor is helpful for depression?
  • dcr activity in the ___________ network-waht does this mean?
A

Binds and activates 5HT receptors in brain
↑ neuroplasticity and pathways = ↓ rigid thinking patterns
↑ brain derived neurotropic factor = can be helpful for depression
↓ activity in default mode network = be more present and less daydreaming in the past/ present

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3
Q

psilocybin is a
1. naturally occuring prodrug
2. serotonin 2A receptor agonist
3. mushroom produced drug
4. all of the above

A

4

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4
Q

psilocybin route of admin

A

PO, tea (hot water conv to psilocin), IV

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5
Q

psilocybin onset of action

A

10-40 min, duration 2-6hrs

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6
Q

psilocybin dose

A

10-50mg (10-50g fresh mushrooms, 1-5g dried)
Most common therapeutic dose: 25mg

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7
Q

physical effects of psilocybin

pupils? HR? bp?

A

pupil dilation, ↑(at peak)/↓HR (caution with heart conditions), hyper/hypotension, nausea

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8
Q

psych effects of psilocybin

  • what is a good trip?
  • bad trip?
  • can it cause LT changes in personality if taken for more than how long?
  • how does it affect suicidal ideaiton?
A

disorientation, lethargy
Good trip: giddiness, euphoria, joy, connected to others, nature, and universe
Bad trip: depression anxiety paranoia (↑ risk of used with other drugs/ alcohol, used during emotional low, in unsupportive environment)
Potential LT changes in personality of user (openness, spiritually active), >1yr: reduced psych distress, suicidal ideation/ planning/ attempts

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9
Q

sensory effects of psilocybin

A

radiant colors, altered sense of time, animated sensory experiences

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10
Q

ADRs of psilocybin

  • how affects mental funcitonoing?
  • P_____
  • what kind of flashbacks?
A

impairment of mental functioning, psychosis (↑ risk in those prone- ex manic, BPD, schizo = must screen), flashbacks/ hallucinogen persisting perception disorder (HPPD- rare)

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11
Q

is it possible to OD on psilocybin

A

no

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12
Q

agitation from psilocybin can be treated with

A

BZDs and supportive care

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13
Q

name 2 clinical uses for psilocybin

A

MDD (esp tx resistant depression further along in research, better than SSRIs/ escitalopram), anxiety, end of life distress, tobacco cessation, alcohol use disorder, OCD, migraines, etc

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14
Q

what is an important factor in use of psilocybin clinically

A

Setting important- how you feel going into trip and the physical environment the therapy is done in

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15
Q

LSD is _______ derived

A

synthetically

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16
Q

what is the MOA of LSD (3)

  • binds to ____ receptors
  • incr what 2 NT signalling?
A

binds to most serotonin subtypes (cross activation), ↑ glutamate in cerebral cortex, ↑ D2 signaling

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17
Q

LSD onset, duration, metabolism, and excretion

A

onset 30-40min, duration 8-12h, metabolized by CYP450, excreted by kidneys

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18
Q

route of LSD

A

PO, SL, IV (less common)

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19
Q

common doses of LSD

A

40-500ug (dose v small = easy to take too much), clinical trials ~200ug

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20
Q

physical, psych, and sensory effects of LSD

A

Physical; pupil dilation, reduced appetite, wakefulness, others more varies

Psychological: similar to psilocybin

Sensory; similar to psilocybin (v animated)

More of an “outwards” experience than psilocybin (which is warmer, less isolating, not as forceful and allows building connections between people)

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21
Q

SEs of LSD

A

similar to psilocybin, some ↑ risk psychosis (not sig)

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22
Q

clinical uses of LSD (3)

A

alcohol withdrawal, depression, anxiety (preliminary)
Not as far along in trials as you need supervision for 12hrs

23
Q

mescaline MOA

  • where does mescaline come from?
A

5HT2A/5HT2C receptor agonist

  • a cactus :)
24
Q

msecaline dose

A

200-400mg mescaline sulfate or 178-356mg mescaline hydrochloride
76mm button = 25mg mescaline

25
Q

onset, peak, and duratio nof mescaline

A

onset 45-90min, peak 4-6h, duration 8-14h

26
Q

mescaline is metabolized by _______ through ______

A

liver through MAO breakdown

27
Q

clinical uses of mescaline 2

A

alcohol use disorder, depression

28
Q

DMT is actually a combinatio nof

A

ayahuasca and P viridis (DMT)

29
Q

describe how the combo of ayahuasca and DMT work

A

Ayahuasca (vine Banisteriopsis caapi)= b-carbolines
Reversibly inhibit MAO to prevent breakdown of DMT orally and allow absorption + access to CNS

P. viridis = DMT
5HT (2A/1A/2C) agonist

30
Q

DMT is a _____ agonist

A

5HT (2A/1A/2C)

31
Q

duration of DMT tea

A

3hrs

32
Q

DDI with DMT

A

dangerous with any drugs that increase 5HT (serotonin sx)

33
Q

clinical uses of DMT

A

SUD, depression, anxiety
Potential therapeutic tool by enhancing self acceptance + allowing safe exposure to emotional events

34
Q

5-MAO-DHT is a psychedelic found in

A

plants and some toad secretions

35
Q

MDMA effects

A

Stimulant properties, capsules or tablets, club drug (raves, dances)
Trusting, loving, and warm feelings towards others
stronger touch sensations

36
Q

MDMA has the most benefit in ________ due to ______________________________

A

PTSD
↑ ability to trust, feel comfy, and be able to access traumatic memories to work through = v effective in talk therapy (out, whereas LSD and psilocybin are more introspective)

37
Q

MOA of MDMA

A

potent reuptake inhibitor of presynaptic 5HT, DA, NE

38
Q

MDMA onset and duration

A

Onset within 30-60min, duration of action 4-6hrs

39
Q

MDMA is metabolized in the _____ by _______

A

liver
CYP2D6

40
Q

MDMA dose

A

50-150mg

41
Q

MDMA ADR

A

jaw clenching (↑ NE), anxiety, GI disturbances, ↑ vitals (hyperthermia), sweating

42
Q

effects of ketamine and PCP

A

stimulant, depressant, hallucinogenic, anesthetic, analgesic
Dissociation from surroundings, time distortions

43
Q

K and PCP ADRs

A

paranoia, extremely aggressive behavior, confusion, slurred speech, muscle rigidity
PCP generally more dangerous than ketamine due to ↑ risk psychosis (↑ intense, ↑ violent/ self injurious behavior, ↑ resp depression)

44
Q

LT AEs of PCP and ADRs

A

speech problems, depression, memory loss, violent behavior, flashbacks, syndrome similar to schizophrenia, strong cravings

45
Q

clinical uses of ketatmine

A

TRD

46
Q

why do psychedelics have low abuse potential

A

Does not cause physical dependence or withrawl. Due to introspective, mystical, and spiritually meaningful effects (not so much pleasure) = most ppl need time to recover = ↓ chance of overuse

47
Q

psychedelics are not recommended in individuals with

A

hx or Fhx psychosis, mania, borderline personality disorder

48
Q

what are the risks of OD like with psychedelics

A

V low OD risk (less than OTCs like aspirin)

49
Q

psychedelics tend to interact with

A

antidepressants and antipsychotics

50
Q

effects of antidepressants with psychedelics

A

↑ risk serotonin sx (esp with ayahuasca)
↓ psychedelic effect (AD ↓ eff by effect on 5HT receptors)

51
Q

effects of antipsychotics with psychedelics

A

↓ psychedelic effects (b/c eff on 5HT receptors)
↑ risk AEs

52
Q

5 psychedelics metabolized by 2D6

A

psilocybin, ayahuasca, MDMA, LSD, mescaline

53
Q

what psychedelic is metabolized by 3A4

A

MDMA

401 - Toxicology, Drug Abuse, Pharmacology (32 decks)

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