Psychedelics Flashcards
___ - agents that produce non-ordinary and variable forms of conscious experiences. These include changes in mood, thoughts, and distorted perceptual sensations generally only experienced in dreams
- ___ : has fallen into disfavor as these drugs rarely produce frank hallucinations at doses commonly used
psychedelics
- hallucinogen
delusion
- fixed false belief unsresponsive to logic
- paranoia is a common manifestations
hallucination
- a false perception rising from internal stimuli
- creates a false reality
illusion
- misperception of external stimuli
- distorts reality
classical psychedelic drugs
derivatives of ___
derivatives of ___
- phenethylamine
- tyramine
dissociative psychedelic drugs (3)
- phencyclidine
- ketamine
- muscimol
narurally occuring classical psychedelic drugs
DMT - dimethyltryptamine
- ayahuasca vine
5-MeODMT
- 5-6x > DMT
- colorado river toad
psilocybin
- magic mushrooms, psilocybin is a prodrug of ___
- psilocin
mescaline combines MOA of LSD and MDMA
mescaline
phenethylamine
- amphetamine like - MDMA, bath salts
- increase release of ___ > DA, NE
- empathogens/entactogens
- more ___ than stimulatory
lowest potency (~500 mg)
___ lasting 10-12 hrs
cross tolerance to ___
- suspected interaction with ___ system
- 5-HT
- hallucinogenic
- long
- LSD
- serotonin
most classical psychedelics are agonists of the 5-HT ___ receptor
- pretreatment with antagonists blocks psychedelic effects
- exception: MDMA stimulates ___ release
5-HT2A
5-HT
psychedelic drugs markedly increase ___ integration in the CNS
global
- visionary restructuralization - sensory ___
- oceanic boundlessness - highly pleasurable state of self ___
- anxious ego-dissolution - thought disorder leading to unpleasant state ( __ ___ )
- illusions
- dissolution
- bad trip
Psychedelic Drug Use AE
short term physiologic
- tachycardia
- HTN
- tremors
- dry mouth
- nausea
- hyperthermia
acute ___ reaction
- terrifying thought
- fear of insanity
- fear of losing control
- fear of death
psychotic reaction
- ___ (hallucinogen persisting perception disorder)
- enduring changes in ___
- exacerbate underlying psychotic disorder
- rate of ___ after LSD 1-5%
- dysphoric
- flashbacks
- personality
- psychosis
Psychedelic Drug Use AE
- rapid development of ___ - 3rd consecutive day, marked attenuation of effect
- frequent use can lead to ___ changes
- no evidence of ___ potential
- tolerance
- mood
- addicitive
potential therapeutic uses
- ___ -related psychological distress
- PTSD
- resistant ___
- substance use disorder ( ___ )
shortcomings of clinical trials
- smal sample sice
- lack of inadequate controls
- what is the proper control?
- selection bias (those experienced with or comfortable with psychedelic drug use)
- cancer
- depression
- alcohol
dissociative psychedelics
in contrast to classical psychedelics, dissociatve psychedelics act as antagonists of ____ receptors
1) inhibition of ___ release
2) disinhibition of ___ release
NMDA
1) GABA
2) glutamate
overview of glutamate receptors
- NMDAR are primarily ___
- NMDAR can also bind ___
- postsynaptic
- glycine
prominent NMDA receptor antagonists
ionotropic ___ receptors
- NDMA receptor antagonist
- induce ___ and ___
ketamine
- racemic mixture, ___ (+) enantiomer is more active
- fast/short acting
- ___ recently FDA approved for treatment resistant ___
- used in opioid tolerant patients for chronic pain
___ (DXM)
- also serotonin reuptake inhibitor
- abused by 4% high schoolers
- doses for cough suppression are < 60 mg while 100-600 are used to induce high
- glutamate
- anesthesia, analgesia
- S
- esketamine, depression
- dextromethorphan
PCOL of PCP
1-(1-phenylcyclohexyl) piperidine_
- NDMA ___
- more potent than ___
- also dopamine receptor agonist
severe dissociation and analgesia
- self ___ without recognition (dissociation)
- misuse assocaited with violence and suicude
- antagonist
- ketamine
- mutilation
PCOL of Muscimol
- muscimol is an agonist of ___ channels and can induce dissociative psychedelic effects.
- In contrast, BZDs and alcohol are ___ modulators
GABA A
allosteric
inhalants
- volatile solvents (toluene, glue, kerosene, gasoline)
- aerosols, gases, sprays
- nitrire (poppers), nitrous oxide
- hydrocarbons, ketones
alkyl nitrites
- referred to as ___
- commonly cleaning solutions and room deodorizers
- ___ release results in smooth muscle ___ , relaxes anal sphincter, enhanced erections, euphoria
- gay men 25x more likely to abuse
- ___ is greatest risk
- poppers
- nitric oxide, relaxation
- methemoglobinemia
volatile solvents
highest frequency of use among adolescents, especially in isolated communities (access driven)
- ___ : model glues, correction fluids, lacquer thinners, plastic cements, spray paints (most characterized of volatile solvents)
- ___ : nail polish remover, model glue, rubber cements
- ___ : cleaning fluids, rubber cements, tire tube repair kits
- ___ : cig lighters, hair spray, spray paint
- toluene
- acetone
- benzene
- butane
risk of inhalant abuse
- asphyxiation - displacing oxygen
- suffocation - plastic bag over the head
- convulsions or seizures - abnormal electrical discharges in the brain
- coma - from the brain shutting down all the most viral functions
- choking - inhalation of vomit
- fatal injury - from car accidents, etc
sudden ___ death syndrome - development of fatal arrhythmias within minutes of inhalation
- compulsive use
- neurotoxicity
sniffing
