Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics P2 Winter Semester > PHRM845-FINAL EXAM > Flashcards

PHRM845-FINAL EXAM Flashcards

Pharmacology of psychedelics and psychoactive inhalants

1
Q

What are psychedelics?

A

Produce non-ordinary and variable forms of conscious experiences. These include changes in mood, thoughts, and distorted perceptual sensations gradually only experienced in dreams.

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

What are hallucinogens?

A

-It has fallen into disfavor b/c these drugs rarely produce frank hallucinations at doses commonly used.

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

What are delusions?

A

-Fixed, false belief unresponsive to logic (logic will NOT take them out of it)
-Paranoia is a common manifestation
(ex: shooting their way into building to get breakfast)

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

What are hallucinations?

A

False perception arising from internal stimuli
-Creates a false reality (auditory or visual)
(ex: bears having tea party on roof)

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

What are illusions?

A

-Misperception of external stimuli
-Distorts reality (something is actually there)
(ex: bear is sitting in a chair–it is really a person)

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

What are the two classical psychedelics?

A

-Derivatives of phenethylamine
-Derivatives of tyramine

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

What are examples of dissociative psychedelics?

A

-Phencyclidine
-Ketamine
-Muscimol

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

Dimethyltryptamine (DMT)

A

-Naturally occurring classical psychedelic drug
-From Amazonian
-Aaron Rodgers popularized this

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

5-MeODMT

A

-Naturally occurring classical psychedelic drug
- 5-6x more potent than DMT
-Derivative of DMT
-Colorado River Toad has this

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

Psilocybin (psilocin)

A

-Naturally occurring classical psychedelic drug
-Magic mushrooms
-Psilocybin is a pro-drug of psilocin (via rapid dephosphorylation)

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

Mescaline combines MOA of ___ and ___

A

-LSD and MDMA

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Phenethylamine

A

-Amphetamine-like (stimulant and psychedelic activity)
~MDMA and bath salts
-Increases release of 5-HT> DA, NE
-Empathogens/Entactogens (more hallucinogenic than stimulatory)
-Lowest potency (~500 mg)
-Long lasting (10-12h)
-Cross tolerance to LSD due to similar MOA
~Suspected interaction with serotonin system

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

Most classical psychedelics are agonists of ____.
We want to pretreat with ___ antagonists to block psychedelic effects.
**Exception ____ stimulates 5-HT release

A

5-HT2A
5-HT2A
MDMA

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

Psychedelic drugs markedly increase ____ integration in the CNS.

A

-Global
**shows connectivity across regions of the brain

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Effects on the dimensions and subscales of the 5-dimension altered states of consciousness (5D-ASC) scale.
-What are the 3 main sections?

A

-Visionary restructuralization (sensory illusions)
-Oceanic boundlessness (highly pleasurable state of self dissolution)
-Thought disorder leading to unpleasant state (bad trip)–> anxious ego dissolution

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What is audio-visual synsthesiae?

A

-Hear something and see colors
-Enhanced visual perception
-Falls under visionary restructuralization (sensory illusions)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

What is spiritual experience?

A

-Can happen to pts even without a religious background
-Connected with world like never had before
-Falls under oceanic boundlessness (highly pleasurable state of self dissolution)

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

What is blissful state?

A

-Lost all cares/concerns
-Falls under oceanic boundlessness (highly pleasurable state of self dissolution)

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

What is disembodiment?

A

-Pt feels they are outside of their body
-Falls under thought disorder leading to unpleasant state (bad trip)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

What is impaired control and cognition?

A

-Pt cannot control themselves
-Falls under thought disorder leading to unpleasant state (bad trip)

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

Psychedelic drug use adverse effects:
Short term:_____

A

Physiological
-Tachycardia
-HTN
-Tremors
-Dry mouth
-Nausea
-Hyperthermia
**NOT life-threatening; bigger issue is how people respond

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

Psychedelic drug use adverse effects:
Acute dysphoric:_____

A

Reaction
-Terrifying thoughts (impeding doom; separating from body and won’t get back in)
-Fear of insanity
-Fear of losing control
-Fear of death
**Likely have 2 therapists

23
Q

Psychedelic drug use adverse effects:
3rd phase:____

A

Psychotic reaction
-Flashbacks (hallucinogen persisting perception disorder; can last for years and they are usually negative)
-Enduring changes in personality (whole world view might change; how do you get consent for that?)
-Exacerbate underlying psychotic disorder
-Instigate prolonged psychotic disorder
-Rate of psychosis after LSD is 1-5%

24
Q

Psychedelic drug use can lead to rapid development of ___ on the ____ consecutive day; marked attenuation of effect

A

tolerance; 3rd
-Frequent use can lead to mood changes
-No evidence of addictive potential

25
Q

Potential therapeutic uses of psychedelics

A

-Cancer related psychological distress
-PTSD
-Depression
-SUD (alcohol)

26
Q

Shortcomings of clinical trials for psychedelics

A

-Small sample size
-Lack of or inadequate controls (private companies providing $$ with little/no oversight)
-Many investigators/patients know which medication they received
-What is the proper control group?–controlled sensory input?
-Selection bias (those experienced with or comfortable with psychedelic drug use)

27
Q

Over ____ % of volunteers are excluded from psilocybin trials because of previous experience/family hx.
-How is the average person going to respond to them?

A

90%
-We don’t know

28
Q

MOA of dissociative psychedelics

A

-NMDA receptor antagonists
1. Inhibit GABA release
2. Disinhibition of glutamate release (increases glu levels)–>excitatory

29
Q

Overview of glutamate receptors
-(competitive/noncompetitive) antagonist that enters when channel is open
-NMDA receptors are primarily (presynaptic/postsynaptic)
-NMDA receptors can also bind ____

A

-Noncompetitive
-Post-synaptic
-Glycine

30
Q

Ionotropic glutamate receptors

A

-NMDA receptor antagonist
-Induces anesthesia AND analgesia
-Taken at high enough doses, don’t feel pain so pt can injure themselves and not know it

31
Q

Ketamine (‘Special K’)

A

-Prominent NMDA receptor antagonist
-Racemic mixture (S+ is more active)
-Fast and short acting (10-60 min)
-Esketamine recently FDA approved for tx resistant depression
-Used in opioid tolerant pts for chronic pain

32
Q

Dextromethorphan (DXM)

A

-Prominent NMDA receptor antagonist
-In cough syrup
-Also serotonin reuptake inhibitor
-Abused by ~4% of high schoolers
-Doses for cough suppression are <60 mg, while 100-600 mg are used to induce “high”

33
Q

Phencyclidine (PCP)

A

-NMDA antagonist
~More potent than ketamine
~Also DA D2 receptor agonist
-Cigarette dipped in liquid PCP (more severe interaction with ketamine)
~Nicotine or marijuana cigarette
~Effect is 4-6h
-Pts often unaware of cannabis laced with PCP
-Severe dissociation and analgesia
~Self-mutilation without recognition (dissociation)
-Provokes psychotic rxn
-Misuse associated with violence and suicide

34
Q

Muscimol

A

-Different from ‘magic mushrooms’
-GABA-A agonist–>can induce dissociative psychedelic effects
-In contrast, benzos and alcohol of allosteric modulators

35
Q

Psychoactive inhalants

A

-Often 1st substance of abuse with kids (easily accessible)

36
Q

Liquid psychoactive inhalant examples

A

-Paint thinner
-Paint remover
-Dry-cleaning fluids
-Gasoline
-Glue
-Correction, fluids
-Felt-tip markers

37
Q

Aerosol psychoactive inhalant examples

A

-Spray pain
-Deodorant
-Hair spray
-Vegetable oil spray
-Fabric protector spray

38
Q

Gases psychoactive inhalant examples

A

-Chloroform
-Nitrous oxide
-Whipped cream cans
-Butane lighters
-Propane tanks
-Refrigerants

39
Q

Nitrites psychoactive inhalant examples

A

-Leather cleaner
-Room deodorizer
-Food preservatives

40
Q

Inhalants can be misused in many ways. Provide ways of routes of administration

A

-Sniffing
-Huffing (gives highest concentration)–soak cloth and hold over face
-Bagging (spray into paper bag and breathe in)
-Dusting (put dust remover spray nozzle into mouth)

41
Q

Alkyl nitrites

A

-Commonly sold as “poppers”
-Marketed as cleaning solutions and room deodorizers
-Nitric oxide release results in smooth muscle relaxation, platelet inhibition, and change in gene expression
-Relaxes anal sphincter, enhances erections, and gives pt euphoria
-Highest abuse among gay men (25x)
-Methemoglobinemia is greatest risk

42
Q

Pharmacology of volatile solvents

A

-Widely used!
-Volatile solvents are liquid at room temp and evaporate readily when exposed to air

43
Q

Toluene

A

-Volatile solvent
-Model glues, correction fluids, lacquer thinners, plastic cements, spray paints

44
Q

Acetone

A

-Volatile solvent
-Nail polish remover
-Model glue
-Rubber cements

45
Q

Benzene

A

-Volatile solvent
-Cleaning fluids, rubber cements, tire tube repair kits

46
Q

Butane

A

-Volatile solvent
-Cigarette lighters, hair spray, spray paint

47
Q

Highest volatile solvent use is among ___

A

Adolescents, especially in isolated communities (access driven?)

48
Q

____ is the most characterized of the volatile solvents. Not a lot of research on it, but alters activity of a wide range of ion channels.

A

-Toluene
**GABA-A is the strongest channel that is potentiated

49
Q

Acute effects (min) of volatile solvents

A

-Locomotor stimulation
-Euphoria, exhilaration

50
Q

Effects of high dose (>3000 ppm) of volatile solvents

A

-CNS depression
-Slurred speech
-Disorientation
-Weakness
-Sedation

51
Q

Repeated exposure to toluene causes ___

A

Lipid accumulation

52
Q

Risks of inhalant abuse

A

-Asphyxiation: from repeated inhalations that lead to high concentrations of inhaled fumes, which displace available O2 in lungs
-Suffocation: from blocking air entering lungs when inhaling fumes from a plastic bag placed over the head
-Convulsions/seizures: from abnormal electrical discharges in the brain
-Coma: from brain shutting down all but most vital functions
-Choking: from inhaling vomit after inhalant use
-Fatal injury: from accidents including motor vehicle fatalities suffered while intoxicated

53
Q

Based on independent studies performed over a 10-year period in 3 different states, the number of inhalant-related fatalities in the US is approximately ____ per year.

A

100-200
**Not clear how frequently it causes fatality

54
Q

Sudden sniffing death syndrome

A

-Most concerning response
-Development of fatal arrhythmias within minutes of inhalation
-Compulsive use (some use it chronically)
-Neurotoxicity
~Brain is smaller and fills less of the space inside the skull

Therapeutics P2 Winter Semester (29 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions