S15C182 - Halucinogens

Question 1

LSD

Answer 1

lysergic acid diethylamide

• effects via serotoninergic system, agonist at 5-HT2 R
• onset 30mins, lasts up to 12h
• sympathomimetic Sx: mydriasis, tachy, elevated BP and temp
• OD:coma, resp arrest, hyperthermia, coagulopathy
• tx: benzos, haldol

Question 2

Magic mushrooms

Answer 2

• psilocybin
• structurally related to LSD, act as 5-HT2 R agonists
• onset 30min, duration 6h
• mydriasis, tachy, hyperreflexia, n/v
  rare: Sz, hyperthermia, rhabdo, renal failure

Question 3

Mescaline

Answer 3

• peyote
• acts at 5-HT2 but much weaker than LSD
• SE: n/v, abdo discomfort, diaphoresis, dizzy, nystagmus, ataxia, h/a, resolve after 2h
• hallucinations x12h

Question 4

MDMA

Answer 4

• ecstasy
• related to amphetamines and mescaline
• serotonergic, 5-HT2a, dopamine, NE, Ach, alpha2 adrenergic effects
• releases: prolactin, oxytocin, ADHadrenocroticotrophic hormone
• effects: peace, euphoria, verbosity, social, sexual, alteration in colors or sensations of textures
• mydriasis, tachy, elevated BP, bruxism, dry mouth, ataxia
• mortality related to hyperthermia and hyponatremia
• also Sz, DIC, rhabdo, renal failure, serotonin syndrome
• Tx: benzos (tachy and HTN), nitroprusside if severe HTN, avoid BB, tx low Na, cool

Question 5

PCP

Answer 5

• phencyclidine
• related to ketamine
• wide range of Sx from catatonic to violent to depressed or stimulated
• combination of cholinergic and anticholinergic and sympathomimetic effects
• Sz are common, rhabdo, violent behaviours
• Tx: benzos, cooling, airway