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B&B Week 9 Flashcards > Lecture 61: Hallucinogens > Flashcards

Lecture 61: Hallucinogens Flashcards

1
Q

What are the types of hallucinogens?

A
  1. LSD
  2. PCP
  3. MDMA
  4. Anticholinergics
    - put them in constraints
    - stop anticholinergic medications
  5. Inhalants
    - only hallucinogen that causes brain damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What are the types of hallucinogens?

A
  1. LSD
  2. PCP
  3. MDMA
  4. Anticholinergics
    - put them in constraints
    - stop anticholinergic medications
  5. Inhalants
    - only hallucinogen that causes brain damage
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What is acid?

A

LSD, Lysergic Acid Diethylamide

This is the drug that the CIA tested on men about to fuck prostitutes LOL

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What are the clinical manifestations of LSD?

A
  1. Perceptual distortions
    • micropsia (you think people are smaller than you)
    • macropsia (you think people are bigger than you)
  2. Derealization, depersonalization
  3. Visual hallucinations
  4. Synesthesia
    • hearing colors
    • seeing smells
  5. Euphoria or lability
  6. Ego fragmentation
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is the mechanism of LSD?

A

Involves serotonergic systems
Not exactly known…FUCK YOU
Acts through the 5HT-2 or the serotonin 2 recept0r

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What is the significance of 5HT-2 or serotonin 2 receptor?

A

The main mechanism thought to underlie LSD

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What are the consequences of acid?

A

No evidence of permanent cognitive change
Unmasks psychiatric vulnerabilities
State of panic and fear of imminent insanity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the treatment for acid?

A
  1. Ride the wave…hold their hand lol
  2. Reassurance and support
  3. Benzodiazepines
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is Peyote cactus? Psilocybin mushrooms?

A

Mescaline, hallucinogen that is similar to acid

Mushrooms also have the same manifestations as acid

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is Wet? Angel dust? Peace? Hog?

A

Phenyclidine (PCP)

-originally an anesthetic agent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

What are the clinical manifestations of PCP?

A
  1. Euphoria, PEACEFUL floating
  2. disconnected from world
  3. oblivious to surroundings
  4. flat affect
  5. uncommunicative
    Initial effect is 5 minutes vs. 45 minutes for acid
  6. slurred speech,
  7. VERTICAL NYSTAGMUS
  8. DELUSIONS and perceptual disturbances
  9. Feelings of numbness in hands and feet, makes it so that you cant walk
  10. distortions of body image, space and time
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is the association between nystagmus and PCP?

A

PCP leads to VERTICAL nystagmus

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What intravenous anesthetic is similar to PCP?

A

Ketamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What are the consequences of PCP?

A
  1. hyperacusis
  2. amnesia
  3. hostility, muscle rigidity
  4. convulsions
  5. excessive salivation without a gag reflex
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the mechanism of PCP?

A 
NMDA receptor ANTAGONIST
-blocks glutamate
	DA, 5HT, K, Na channel receptos may be implicated
No clear evidence of brain damage
Long period of clearing for 2-3 weeks marked by
	-dulled thinking
	-dulled reflexes
	-loss of impulse
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is the treatment for PCP?

A
  1. Benzos (seizure prophylaxis)
  2. Antipsychotic for paranoia (Haldol)
  3. Gastric suction (if in coma)
  4. Acidification of urine to increase excretion
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is NOT effective treatment for PCP?

A

Reassurance and support DOESN’T WORK

-because patient is DETACHED from reality

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Is there physiological dependence for hallucinogens?

A

No, there is no tolerance/withdrawal

-but could be a psychological dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

What are the clinical manifestations of MDMA (methyleneDioxyMethamphetamine)?

A
  1. Euphoric and loving feeling
  2. Loss of boundaries and defense mechanisms
    • loss of distinction between self and others
    • decreased sense of separation from others
  3. Disinhibition
    • decreases defensiveness
  4. Promotes intimacy
  5. Cognitive distortions
    • slowed mentation
    • cognitive apathy
  6. Perceptual distortions
    • intensified visual perceptions
    • possibility of visual hallucinations
  7. Increased anxiety
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is bruxism?

A

Characterized by grinding of teeth and clenching of jaw

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

What is the underlying mechanism of MDMA?

A

Inhibition of SERT
Vesicular release of BOTH dopamine and serotonin
Increase dopa and serotonin
Not well characterized

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

What are the detrimental effects of MDMA?

A 
Evidence of destruction of serotonergic pathways
Greater risk of serotonin
Also
Increased BP
Increased HR
Dry mouth
Bruxism (grinding teeth) and dehydratioin
-seizures
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

What is the treatment for MDMA?

A
  1. Care sought for dehydration

2. Reassurance, support and education

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

What are types of anticholinergics?

A
  1. Atropine
  2. Benadryl
  3. Diphenhydramine (Tylenol)
  4. Tricyclic antidepressant
  5. Benztropine
  6. Over the counter sleep aids
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

What causes the adverse effects of TCA?

A

Anticholinergic
Antisympathetic
Antihistamine
Usually MOA INCREASES serotonin and dopamine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
26
Q

What are the clinical manifestations of anticholinergics?

A
  1. Delirium
    • waxing and waning of consciousness (presents differently when attending comes around)
    • impulsivity
    • impaired judgement
    • hallucinations
  2. Hallucinogenic effects
    • misperceptions
    • dysphoria
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
27
Q

What are the Toxic effects of anticholinergics?

A
  • fever
    • warm dry skin
    • tachycardia
    • dilated pupils
    • decreased peristalsis
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
28
Q

What is the treatment for anticholinergics?

A
  1. discontinue offending agent
  2. Protect patient against involuntary harm to self or others
    • chemical and physical restraints
    • give them an antipsychotic rather than benzo
  3. gastric lavage (stomach pumping)
  4. Parenteral Physostigimine (reverse saturation of cholinergic receptors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
29
Q

Why do you give antipsychotic vs. benzo for anticholinergic treatment?

A

Benzos make you more DISINHIBITED

Antipsychotic like Haldol works

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
30
Q

Why is it important to know anticholinergics?

A 
Syndrome due to common medications! 
So that when you see anticholinergic symptoms, like delirium, you stop them
Drugs include
1. Atropine
2. Benadryl
3. Diphenhydramine (in Tylenol)
4. Tricyclic antidepressant
5. Benztropine
6. Over the counter sleep aids
31
Q

What is MOA of anticholinergics?

A

Blocks acetylcholine in central and peripheral nervous system

32
Q

What are types of inhalants (Huffing)?

A
  1. toluene
  2. gasoline
  3. kerosene
  4. CCL4
  5. Flurocarbon propellants
  6. amyl/butyl nitrates
33
Q

Who are more at risk for inhalants?

A

Women than men

34
Q

What are the clinical manifestations of inhalants?

A
  1. stimulation and disinhibition
  2. NYSTAGMUS as well
  3. muscular incoordination
  4. Perceptual distortions
  5. Frank hallucinations
35
Q

What hallucinogens cause nystagmus?

A
  1. PCP

2. inhalants

36
Q

What is the mechanism of inhalation?

A

Similar to alcohol

Through the GABA-A receptor

37
Q

What are the consequences of inhalants?

A

People become DUMB

  1. demyelination and cerebellar atrophy
  2. impairments in memory, attention
  3. organ damage
38
Q

What is the only hallucinogen that causes brain damage?

A

Inhalants

Demyelination and Cerebellar atrophy

39
Q

What is acid?

A

LSD, Lysergic Acid Diethylamide

This is the drug that the CIA tested on men about to fuck prostitutes LOL

40
Q

What are the clinical manifestations of LSD?

A
  1. Perceptual distortions
    • micropsia (you think people are smaller than you)
    • macropsia (you think people are bigger than you)
  2. Derealization, depersonalization
  3. Visual hallucinations
  4. Synesthesia
    • hearing colors
    • seeing smells
  5. Euphoria or lability
  6. Ego fragmentation
41
Q

What is the mechanism of LSD?

A

Involves serotonergic systems
Not exactly known…FUCK YOU
Acts through the 5HT-2 or the serotonin 2 recept0r

42
Q

What is the significance of 5HT-2 or serotonin 2 receptor?

A

The main mechanism thought to underlie LSD

43
Q

What are the consequences of acid?

A

No evidence of permanent cognitive change
Unmasks psychiatric vulnerabilities
State of panic and fear of imminent insanity

44
Q

What is the treatment for acid?

A
  1. Ride the wave…hold their hand lol
  2. Reassurance and support
  3. Benzodiazepines
45
Q

What is Peyote cactus? Psilocybin mushrooms?

A

Mescaline, hallucinogen that is similar to acid

Mushrooms also have the same manifestations as acid

46
Q

What is Wet? Angel dust? Peace? Hog?

A

Phenyclidine (PCP)

-originally an anesthetic agent

47
Q

What are the clinical manifestations of PCP?

A
  1. Euphoria, PEACEFUL floating
  2. disconnected from world
  3. oblivious to surroundings
  4. flat affect
  5. uncommunicative
    Initial effect is 5 minutes vs. 45 minutes for acid
  6. slurred speech,
  7. VERTICAL NYSTAGMUS
  8. DELUSIONS and perceptual disturbances
  9. Feelings of numbness in hands and feet, makes it so that you cant walk
  10. distortions of body image, space and time
48
Q

What is the association between nystagmus and PCP?

A

PCP leads to VERTICAL nystagmus

49
Q

What intravenous anesthetic is similar to PCP?

A

Ketamine

50
Q

What are the consequences of PCP?

A
  1. hyperacusis
  2. amnesia
  3. hostility, muscle rigidity
  4. convulsions
  5. excessive salivation without a gag reflex
51
Q

What is the mechanism of PCP?

A 
NMDA receptor ANTAGONIST
-blocks glutamate
	DA, 5HT, K, Na channel receptos may be implicated
No clear evidence of brain damage
Long period of clearing for 2-3 weeks marked by
	-dulled thinking
	-dulled reflexes
	-loss of impulse
52
Q

What is the treatment for PCP?

A
  1. Benzos (seizure prophylaxis)
  2. Antipsychotic for paranoia (Haldol)
  3. Gastric suction (if in coma)
  4. Acidification of urine to increase excretion
53
Q

What is NOT effective treatment for PCP?

A

Reassurance and support DOESN’T WORK

-because patient is DETACHED from reality

54
Q

Is there physiological dependence for hallucinogens?

A

No, there is no tolerance/withdrawal

-but could be a psychological dependence

55
Q

What are the clinical manifestations of MDMA (methyleneDioxyMethamphetamine)?

A
  1. Euphoric and loving feeling
  2. Loss of boundaries and defense mechanisms
    • loss of distinction between self and others
    • decreased sense of separation from others
  3. Disinhibition
    • decreases defensiveness
  4. Promotes intimacy
  5. Cognitive distortions
    • slowed mentation
    • cognitive apathy
  6. Perceptual distortions
    • intensified visual perceptions
    • possibility of visual hallucinations
  7. Increased anxiety
56
Q

What is bruxism?

A

Characterized by grinding of teeth and clenching of jaw

57
Q

What is the underlying mechanism of MDMA?

A

Inhibition of SERT
Vesicular release of BOTH dopamine and serotonin
Increase dopa and serotonin
Not well characterized

58
Q

What are the detrimental effects of MDMA?

A 
Evidence of destruction of serotonergic pathways
Greater risk of serotonin
Also
Increased BP
Increased HR
Dry mouth
Bruxism (grinding teeth) and dehydratioin
-seizures
59
Q

What is the treatment for MDMA?

A
  1. Care sought for dehydration

2. Reassurance, support and education

60
Q

What are types of anticholinergics?

A
  1. Atropine
  2. Benadryl
  3. Diphenhydramine (Tylenol)
  4. Tricyclic antidepressant
  5. Benztropine
  6. Over the counter sleep aids
61
Q

What causes the adverse effects of TCA?

A

Anticholinergic
Antisympathetic
Antihistamine
Usually MOA INCREASES serotonin and dopamine

62
Q

What are the clinical manifestations of anticholinergics?

A
  1. Delirium
    • waxing and waning of consciousness (presents differently when attending comes around)
    • impulsivity
    • impaired judgement
    • hallucinations
  2. Hallucinogenic effects
    • misperceptions
    • dysphoria
63
Q

What are the Toxic effects of anticholinergics?

A
  • fever
    • warm dry skin
    • tachycardia
    • dilated pupils
    • decreased peristalsis
64
Q

What is the treatment for anticholinergics?

A
  1. discontinue offending agent
  2. Protect patient against involuntary harm to self or others
    • chemical and physical restraints
    • give them an antipsychotic rather than benzo
  3. gastric lavage (stomach pumping)
  4. Parenteral Physostigimine (reverse saturation of cholinergic receptors)
65
Q

Why do you give antipsychotic vs. benzo for anticholinergic treatment?

A

Benzos make you more DISINHIBITED

Antipsychotic like Haldol works

66
Q

Why is it important to know anticholinergics?

A 
Syndrome due to common medications! 
So that when you see anticholinergic symptoms, like delirium, you stop them
Drugs include
1. Atropine
2. Benadryl
3. Diphenhydramine (in Tylenol)
4. Tricyclic antidepressant
5. Benztropine
6. Over the counter sleep aids
67
Q

What is MOA of anticholinergics?

A

Blocks acetylcholine in central and peripheral nervous system

68
Q

What are types of inhalants (Huffing)?

A
  1. toluene
  2. gasoline
  3. kerosene
  4. CCL4
  5. Flurocarbon propellants
  6. amyl/butyl nitrates
69
Q

Who are more at risk for inhalants?

A

Women than men

70
Q

What are the clinical manifestations of inhalants?

A
  1. stimulation and disinhibition
  2. NYSTAGMUS as well
  3. muscular incoordination
  4. Perceptual distortions
  5. Frank hallucinations
71
Q

What hallucinogens cause nystagmus?

A
  1. PCP

2. inhalants

72
Q

What is the mechanism of inhalation?

A

Similar to alcohol

Through the GABA-A receptor

73
Q

What are the consequences of inhalants?

A

People become DUMB

  1. demyelination and cerebellar atrophy
  2. impairments in memory, attention
  3. organ damage
74
Q

What is the only hallucinogen that causes brain damage?

A

Inhalants

Demyelination and Cerebellar atrophy

B&B Week 9 Flashcards (8 decks)

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