Exam 4 - Hallucinogens

Question 1

In the early use of hallucinogens, what were they mainly used for? Where could they be found?

Answer 1

• often used in religious ceremonies, used to predict the future
• found in wide variety of plants like iboga plant, psilocybin mushroom, peyote cactus

Question 2

When was LSD discovered?

Answer 2

by Albert Hofmann in 1938

Question 3

What are the pharmacokinetics of LSD?

Answer 3

• peak plasma levels reached in 2 hours
• rapidly absorbed and crosses BBB
• half life ranges btwn 2-3 hours, and can last up to 12
• extremely potent, but has no confirmed LD

Question 4

What are the pharmacodynamics of LSD?

Answer 4

• partial serotonin agonist, creates sensory overload due to concentrations in prefrontal area, somatosensory areas, brain stem, etc
• hallucinogenic effects mediated by the 5-HT2A receptor

Question 5

What are the effects of serotonergic hallucinogens?

Answer 5

• activation of sympathetic nervous system
  
  • pupil dilation
  • increased HR and BP
  • increased temp and sweating
• magical thinking
• mood interferences

Question 6

What are the adverse effect of hallucinogens?

Answer 6

• acute panic or paranoid reaction
• hallucinogen persisting perception disorder (HPPD) - an element of the experience occurs a period of time later, flashback

Question 7

MDMA

Answer 7

• developed in 1914
• similar effects of amphetamines by influencing serotonin (depletes) and dopamine transmission
• produces no or few visual hallucinations

Question 8

What are the somatic effects of MDMA?

Answer 8

• dramatic increase in BP and temp
• sympathomimetic
• jaw clenching, suppressed appetite, restlessness, insomnia, impaired gait, restless legs, convulsions

Question 9

What are the adverse effects of MDMA?

Answer 9

• lack of energy/fatigue, difficulty concentrating
• can lead to death or kidney failure

Question 10

Neurotoxicity of MDMA

Answer 10

• can damage serotonin and dopamine axon terminals
• damage can continue up to 2 years after cessation

Question 11

MDMA psychiatric problems

Answer 11

• withdrawal can cause depression
• impairments in memory, both verbal and visual
• impairments in decision making

Question 12

Dissociative anesthetic hallucinogens

Answer 12

• PCP and ketamine
• awake but not cognisant

Question 13

Pharmacokinetics of PCP and ketamine

Answer 13

• antagonist for glutamate/NMDA receptors
• remains unmetabolized for more than 2 days, detectable in urine for several weeks

Question 14

Effects of PCP

Answer 14

• altered body image (depersonalization)
• aloneness/isolation
• cognitive disorganization
• drowsiness and apathy
• negativism/hostility
• euphoria/inebriation
• hypnagogic (dreamlike) states

Question 15

PCP intoxication - Acute brain syndrome

Answer 15

• disorientation, confusion, poor judgement, abstract/absence of thought

Question 16

PCP intoxication - Catatonic syndrome

Answer 16

rigidity or catalepsy, psychosocial withdrawal, excitement (agitation, violence)

Question 17

PCP intoxication - Toxic psychosis

Answer 17

hallucinations and/or delusions, w/ or w/o acute brain syndrome

Question 18

PCP intoxication - Coma

Answer 18

periods of coma that can last more than a day