5.10 pharmacology of psychedelics and psychoactive inhalants Flashcards
What is the definition of psychedelics?
- Agents that produce non-ordinary and variable forms of conscious experiences
- Includes changes in mood, thoughts, distorted perceptual sensations generally only experienced in dreams
What is the definition of delusion?
- Fixed, false belief unresponsive to logic
- Paranoia is a common manifestations
What is the definition of hallucination?
- A false perception arising from internal stimuli
- Creates a false reality
What is the definition of illusion?
- A misperception of external stimuli
- Distorts reality
What are the two classes of psychedelics?
- Classical psychedelics
- Dissociative psychedelics
What drugs are part of classical psychedelics?
- Derivatives of phenethylamine
- Derivatives of tyramine
What drugs are part of the dissociative psychedelics?
- Phencyclidine
- Ketamine
- Muscimol
What drugs are derivatives of phenethylamine?
- Mescaline
- MDA
- MDMA
What drugs are derivatives of typtamine?
- DMT
- 5-MeO-DiPT
- LSD
- Ibogaine
What is phenethylamine like?
Amphetamine like
What is the MOA of phenethylamine?
- Increase release of 5HT > DA, NE
- Empathogens/Entactogens: more hallucinogenic than stimulatory
What is the potency of phenethylamine?
Low potency (500 mg to get effect)
How long does the effects of phenethylamine last?
10-12 hours
Why does phenethylamine have a cross tolerance to LSD?
Suspected interaction with serotonin system
What is the MOA of most classical psychedelics?
Agonists of 5HT2A receptor
For classical psychedelics, what blocks their psychedelic effects? What is the one exception?
- Pretreatment w 5HT2A antagonists
- One exception: MDMA stimulates 5HT release
What are the sections of the 5-dimension altered states of consciousness (5D-ASC) scale?
- Visionary restructuralization
- Oceanic boundlessness
- Anxious ego-dissolution
What are the short term physiologic AEs of psychedelics use?
- Tachycardia
- HTN
- Tremors
- Dry mouth
- Nausea
- Hyperthermia
What are the acute dysphoric rxn AEs of psychedelics use?
- Terrifying thoughts
- Fear of insanity
- Fear of losing control
- Fear of death
What are the psychotic rxn AEs of psychedelics use?
- Flashbacks (hallucinogens persisting perception disorder)
- Enduring changes in personality
- Exacerbate underlying psychotic disorder
- Instigate prolonged psychotic disorder
- Rate of psychosis after LSD 1-5%
How fast does tolerance develop for psychedelics use?
Rapid development of tolerance - third consecutive day, marked attenuation of effect
Frequent use of psychedelics can lead to?
Mood changes
Are psychedelics addictive?
No evidence of addictive potential
What are potential therapeutic uses of psychedelics?
- Cancer related psychological distress
- PTSD
- Depression
- Substance use disorder (alcohol)
