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PHRM 845 > 5.10 pharmacology of psychedelics and psychoactive inhalants > Flashcards

5.10 pharmacology of psychedelics and psychoactive inhalants Flashcards

1
Q

What is the definition of psychedelics?

A
  • Agents that produce non-ordinary and variable forms of conscious experiences
  • Includes changes in mood, thoughts, distorted perceptual sensations generally only experienced in dreams
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2
Q

What is the definition of delusion?

A
  • Fixed, false belief unresponsive to logic
  • Paranoia is a common manifestations
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3
Q

What is the definition of hallucination?

A
  • A false perception arising from internal stimuli
  • Creates a false reality
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4
Q

What is the definition of illusion?

A
  • A misperception of external stimuli
  • Distorts reality
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5
Q

What are the two classes of psychedelics?

A
  • Classical psychedelics
  • Dissociative psychedelics
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6
Q

What drugs are part of classical psychedelics?

A
  • Derivatives of phenethylamine
  • Derivatives of tyramine
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7
Q

What drugs are part of the dissociative psychedelics?

A
  • Phencyclidine
  • Ketamine
  • Muscimol
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8
Q

What drugs are derivatives of phenethylamine?

A
  • Mescaline
  • MDA
  • MDMA
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9
Q

What drugs are derivatives of typtamine?

A
  • DMT
  • 5-MeO-DiPT
  • LSD
  • Ibogaine
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10
Q

What is phenethylamine like?

A

Amphetamine like

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11
Q

What is the MOA of phenethylamine?

A
  • Increase release of 5HT > DA, NE
  • Empathogens/Entactogens: more hallucinogenic than stimulatory
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12
Q

What is the potency of phenethylamine?

A

Low potency (500 mg to get effect)

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13
Q

How long does the effects of phenethylamine last?

A

10-12 hours

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14
Q

Why does phenethylamine have a cross tolerance to LSD?

A

Suspected interaction with serotonin system

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15
Q

What is the MOA of most classical psychedelics?

A

Agonists of 5HT2A receptor

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16
Q

For classical psychedelics, what blocks their psychedelic effects? What is the one exception?

A
  • Pretreatment w 5HT2A antagonists
  • One exception: MDMA stimulates 5HT release
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17
Q

What are the sections of the 5-dimension altered states of consciousness (5D-ASC) scale?

A
  • Visionary restructuralization
  • Oceanic boundlessness
  • Anxious ego-dissolution
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18
Q

What are the short term physiologic AEs of psychedelics use?

A
  • Tachycardia
  • HTN
  • Tremors
  • Dry mouth
  • Nausea
  • Hyperthermia
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19
Q

What are the acute dysphoric rxn AEs of psychedelics use?

A
  • Terrifying thoughts
  • Fear of insanity
  • Fear of losing control
  • Fear of death
20
Q

What are the psychotic rxn AEs of psychedelics use?

A
  • Flashbacks (hallucinogens persisting perception disorder)
  • Enduring changes in personality
  • Exacerbate underlying psychotic disorder
  • Instigate prolonged psychotic disorder
  • Rate of psychosis after LSD 1-5%
21
Q

How fast does tolerance develop for psychedelics use?

A

Rapid development of tolerance - third consecutive day, marked attenuation of effect

22
Q

Frequent use of psychedelics can lead to?

A

Mood changes

23
Q

Are psychedelics addictive?

A

No evidence of addictive potential

24
Q

What are potential therapeutic uses of psychedelics?

A
  • Cancer related psychological distress
  • PTSD
  • Depression
  • Substance use disorder (alcohol)
25
Q

What is the MOA of dissociative psychedelics?

A
  • Act as noncomp antagonists of NMDA receptors
  • Inhibition of GABA release and disinhibition of glutamate release
26
Q

What are ionotropic glutamate receptors?

A

NMDA receptor antagonist

27
Q

What does ionotropic glutamate receptors induce?

A

Anesthesia and analgesia

28
Q

What is ketamine?

A
  • NMDA receptor antagonist
  • S+ mixture is more active
29
Q

How fast does ketamine act?

A

Fast and short acting (10-60 min)

30
Q

What is esketamine approved for?

A

FDA approved for tx resistant depression

31
Q

What is ketamine used for?

A

Used in opioid tolerant pts for chronic pt

32
Q

What is dextromethorphan?

A
  • NMDA receptor antagonist
  • Also serotonin reuptake inhibitor
33
Q

What is dextromethorphan used for?

A
  • Cough suppression at <60 mg
  • Induces high at 100-600 mg
34
Q

What is phenycycline (PCP)?

A
  • NMDA antagonist
  • More potent than ketamine
  • Also dopamine D2 receptor agonist
35
Q

What can PCP cause?

A
  • Severe dissociation and analgesia (self-mutilation without recognition)
  • Provokes psychotic rxns
36
Q

What is mucimol?

A

Agonist of GABAa and induce dissociative psychedelic effects

37
Q

What are alkyl nitrates?

A
  • Commonly sold as ‘poppers’
  • Marketed as cleaning solutions and room deodorizers
38
Q

What does alkyl nitrates cause?

A
  • Nitric oxide release results in smooth muscle relaxation
  • Relaxes anal sphincter, enhanced erections, europhia
39
Q

What is the greatest risk with alkyl nitrates?

A

Methemoglobinemia

40
Q

What happens to volatile solvents at room temp and in contact w air?

A

Liquid at room temp and evaporate readily when exposed to air

41
Q

What contains toluene?

A
  • Model glues
  • Correction glues
  • Lacquer thinners
  • Plastic cements
  • Spray paints
42
Q

What contains acetone?

A
  • Nail polish remover
  • Model glue
  • Rubber cements
43
Q

What contains benzene?

A
  • Cleaning fluids
  • rubber cements
  • Tire tube repair kits
44
Q

What contains butane?

A
  • Cigarette lighters
  • Hair spray
  • Spray paint
45
Q

What are risks of inhalant abuse?

A
  • Asphyxiation
  • Suffocation
  • Convulsions or seizures
  • Coma
  • Choking
  • Fatal injury
46
Q

What is sudden sniffing death syndrome?

A

Development of fatal arrhythmias within minutes of inhalation

47
Q

What can compulsive use of inhalants possibly cause?

A

Neurotoxicity

PHRM 845 (48 decks)

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