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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
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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
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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

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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
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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

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6
Q

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

A

The main mechanism thought to underlie LSD

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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

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8
Q

What is the treatment for acid?

A
  1. Ride the wave…hold their hand lol
  2. Reassurance and support
  3. Benzodiazepines
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9
Q

What is Peyote cactus? Psilocybin mushrooms?

A

Mescaline, hallucinogen that is similar to acid

Mushrooms also have the same manifestations as acid

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10
Q

What is Wet? Angel dust? Peace? Hog?

A

Phenyclidine (PCP)

-originally an anesthetic agent

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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
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12
Q

What is the association between nystagmus and PCP?

A

PCP leads to VERTICAL nystagmus

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13
Q

What intravenous anesthetic is similar to PCP?

A

Ketamine

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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
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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
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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
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17
Q

What is NOT effective treatment for PCP?

A

Reassurance and support DOESN’T WORK

-because patient is DETACHED from reality

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18
Q

Is there physiological dependence for hallucinogens?

A

No, there is no tolerance/withdrawal

-but could be a psychological dependence

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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
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20
Q

What is bruxism?

A

Characterized by grinding of teeth and clenching of jaw

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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

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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
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23
Q

What is the treatment for MDMA?

A
  1. Care sought for dehydration

2. Reassurance, support and education

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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
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3
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25
What causes the adverse effects of TCA?
Anticholinergic Antisympathetic Antihistamine Usually MOA INCREASES serotonin and dopamine
26
What are the clinical manifestations of anticholinergics?
1. Delirium - waxing and waning of consciousness (presents differently when attending comes around) - impulsivity - impaired judgement - hallucinations 2. Hallucinogenic effects - misperceptions - dysphoria
27
What are the Toxic effects of anticholinergics?
- fever - warm dry skin - tachycardia - dilated pupils - decreased peristalsis
28
What is the treatment for anticholinergics?
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)
29
Why do you give antipsychotic vs. benzo for anticholinergic treatment?
Benzos make you more DISINHIBITED | Antipsychotic like Haldol works
30
Why is it important to know anticholinergics?
``` 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
What is MOA of anticholinergics?
Blocks acetylcholine in central and peripheral nervous system
32
What are types of inhalants (Huffing)?
1. toluene 2. gasoline 3. kerosene 4. CCL4 5. Flurocarbon propellants 6. amyl/butyl nitrates
33
Who are more at risk for inhalants?
Women than men
34
What are the clinical manifestations of inhalants?
1. stimulation and disinhibition 2. NYSTAGMUS as well 3. muscular incoordination 4. Perceptual distortions 5. Frank hallucinations
35
What hallucinogens cause nystagmus?
1. PCP | 2. inhalants
36
What is the mechanism of inhalation?
Similar to alcohol | Through the GABA-A receptor
37
What are the consequences of inhalants?
People become DUMB 2. demyelination and cerebellar atrophy 3. impairments in memory, attention 4. organ damage
38
What is the only hallucinogen that causes brain damage?
Inhalants | Demyelination and Cerebellar atrophy
39
What is acid?
LSD, Lysergic Acid Diethylamide | This is the drug that the CIA tested on men about to fuck prostitutes LOL
40
What are the clinical manifestations of LSD?
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
What is the mechanism of LSD?
Involves serotonergic systems Not exactly known…FUCK YOU Acts through the 5HT-2 or the serotonin 2 recept0r
42
What is the significance of 5HT-2 or serotonin 2 receptor?
The main mechanism thought to underlie LSD
43
What are the consequences of acid?
No evidence of permanent cognitive change Unmasks psychiatric vulnerabilities State of panic and fear of imminent insanity
44
What is the treatment for acid?
1. Ride the wave…hold their hand lol 2. Reassurance and support 3. Benzodiazepines
45
What is Peyote cactus? Psilocybin mushrooms?
Mescaline, hallucinogen that is similar to acid | Mushrooms also have the same manifestations as acid
46
What is Wet? Angel dust? Peace? Hog?
Phenyclidine (PCP) | -originally an anesthetic agent
47
What are the clinical manifestations of PCP?
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
What is the association between nystagmus and PCP?
PCP leads to VERTICAL nystagmus
49
What intravenous anesthetic is similar to PCP?
Ketamine
50
What are the consequences of PCP?
1. hyperacusis 2. amnesia 3. hostility, muscle rigidity 4. convulsions 5. excessive salivation without a gag reflex
51
What is the mechanism of PCP?
``` 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
What is the treatment for PCP?
1. Benzos (seizure prophylaxis) 2. Antipsychotic for paranoia (Haldol) 3. Gastric suction (if in coma) 4. Acidification of urine to increase excretion
53
What is NOT effective treatment for PCP?
Reassurance and support DOESN’T WORK | -because patient is DETACHED from reality
54
Is there physiological dependence for hallucinogens?
No, there is no tolerance/withdrawal | -but could be a psychological dependence
55
What are the clinical manifestations of MDMA (methyleneDioxyMethamphetamine)?
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
What is bruxism?
Characterized by grinding of teeth and clenching of jaw
57
What is the underlying mechanism of MDMA?
Inhibition of SERT Vesicular release of BOTH dopamine and serotonin Increase dopa and serotonin Not well characterized
58
What are the detrimental effects of MDMA?
``` Evidence of destruction of serotonergic pathways Greater risk of serotonin Also Increased BP Increased HR Dry mouth Bruxism (grinding teeth) and dehydratioin -seizures ```
59
What is the treatment for MDMA?
1. Care sought for dehydration | 2. Reassurance, support and education
60
What are types of anticholinergics?
1. Atropine 2. Benadryl 3. Diphenhydramine (Tylenol) 4. Tricyclic antidepressant 5. Benztropine 6. Over the counter sleep aids
61
What causes the adverse effects of TCA?
Anticholinergic Antisympathetic Antihistamine Usually MOA INCREASES serotonin and dopamine
62
What are the clinical manifestations of anticholinergics?
1. Delirium - waxing and waning of consciousness (presents differently when attending comes around) - impulsivity - impaired judgement - hallucinations 2. Hallucinogenic effects - misperceptions - dysphoria
63
What are the Toxic effects of anticholinergics?
- fever - warm dry skin - tachycardia - dilated pupils - decreased peristalsis
64
What is the treatment for anticholinergics?
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
Why do you give antipsychotic vs. benzo for anticholinergic treatment?
Benzos make you more DISINHIBITED | Antipsychotic like Haldol works
66
Why is it important to know anticholinergics?
``` 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
What is MOA of anticholinergics?
Blocks acetylcholine in central and peripheral nervous system
68
What are types of inhalants (Huffing)?
1. toluene 2. gasoline 3. kerosene 4. CCL4 5. Flurocarbon propellants 6. amyl/butyl nitrates
69
Who are more at risk for inhalants?
Women than men
70
What are the clinical manifestations of inhalants?
1. stimulation and disinhibition 2. NYSTAGMUS as well 3. muscular incoordination 4. Perceptual distortions 5. Frank hallucinations
71
What hallucinogens cause nystagmus?
1. PCP | 2. inhalants
72
What is the mechanism of inhalation?
Similar to alcohol | Through the GABA-A receptor
73
What are the consequences of inhalants?
People become DUMB 2. demyelination and cerebellar atrophy 3. impairments in memory, attention 4. organ damage
74
What is the only hallucinogen that causes brain damage?
Inhalants | Demyelination and Cerebellar atrophy

B&B Week 9 Flashcards (8 decks)

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