Exam 5 (final) - Svensson psychedelics and psychoactive inhalants Flashcards
delusion definition
-fixed, false belief unresponsive to logic
-paranoia is a common manifestation
hallucination definition
-a false perception arising from internal stimuli
-creates a false reality (ex. - nothing is sitting in a chair across from them and they think a dog is sitting in the chair, or hear voices in head)
illusion definition
-a misperception of external stimuli
-distorts reality (ex. - someone is sitting in a chair across from pt and they think a dog is sitting in the chair)
classical psychedelics are derivatives of what 2 structures
-phenethylamine
-tryptamine
dissociative psychedelics are what 3 structures
-phencyclindine
-ketamine
-muscimol
tryptamine derived psychedelics
DMT
LSD
Ibogaine
5-MeO-DiPT
phenethylamine derived psychedelics
mescaline
MDA
MDMA
psilocybin is a prodrug of _____
psilocin
mescaline combines the actions of _____ and _____, two other psychedelics, but ends up being more _________ than stimulatory
LSD, MDMA, hallucinogenic
phenethylamine derived products MOA
increase release of 5HT, DA and NE
-5HT the most
most classical psychedelics are _______ (agonist or antagonist) of ________ receptors
agonists, 5HT2A
what is anxious ego-dissolution
thought disorder leading to unpleasant state (“bad trip”)
psychedelic drug use AE (or risks) - short term
physiologic usually
-tachycardia
-HTN
-tremors
-dry mouth
-N
-hyperthermia
psychedelic drug use AE (or risks) - acute dysphoric reaction (fear)
-terrifying thoughts
-fear of insanity
-fear of losing control
-fear of death
psychedelic drug use AE (or risks) - psychotic reaction
-flashbacks (usually negative)
-changes in personality
-exacerbate underlying psych disorder
-rate of psychosis after LSD is 1-5%
potential therapeutic uses of psychedelics
-cancer related stress
-PTSD
-depression
-SUD (alcohol)
dissociative psychedelics MOA
non-competitive antagonism of NMDA receptors (which are primarily postsynaptic) leads to:
-inhibition of GABA release
-disinhibition of glutamate release
(S) ketamine is 3-4x ______ (more or less) potent than racemic mixture
more
dextromethorphan is abused by _____% of high schoolers
4
normal dosing of dextromethorphan vs. ‘high’ inducing doses
<60mg vs. 100-600mg
PCP is ______ (more or less) potent than ketamine
more
PCP is not only an NMDA antagonist, but a ___ _______ _______ as well
D2 receptor agonist
PCP severe SE
severe dissociation and analgesia
-may lead to self-mutilation without recognition
muscimol is an _______ (agonist or antagonist) of ________
agonist, GABA-A channels
nitric oxide release (from misuse of ‘poppers’ or alkyl nitrites) can result in what 3 effects
smooth muscle relaxation
platelet inhibition
changes in gene expression
all from production of methemoglobinemia
what is likely responsible for euphoric response in volatile solvent misuse
GABA-A
what is sudden sniffing death syndrome
development of fatal arrhythmias within minutes of inhalation
risks of inhalant abuse
asphyxiation
suffocation
convulsions or seizures
coma
choking
fatal injury (from accidents like driving while high)
acute effects of volatile solvents (5)
-locomotor stimulation
-euphoria
-CNS depression
-slurred speech
-sedation
at commonly used doses, psychedelic agents induce ____ rather than ______
illusions, hallucinations
long term volatile solvent inhalation is ________ to those who inhale them recreationally and by occupational exposure
neurotoxic
