Psychedelics

Question 1

___ - 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

Answer 1

psychedelics
- hallucinogen

Question 2

delusion

Answer 2

• fixed false belief unsresponsive to logic
• paranoia is a common manifestations

Question 3

hallucination

Answer 3

• a false perception rising from internal stimuli
• creates a false reality

Question 4

illusion

Answer 4

• misperception of external stimuli
• distorts reality

Question 5

classical psychedelic drugs

derivatives of ___
derivatives of ___

Answer 5

• phenethylamine
• tyramine

Question 6

dissociative psychedelic drugs (3)

Answer 6

• phencyclidine
• ketamine
• muscimol

Question 7

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 ___

Answer 7

• psilocin

Question 8

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

Answer 8

• 5-HT
• hallucinogenic
• long
• LSD
• serotonin

Question 9

most classical psychedelics are agonists of the 5-HT ___ receptor
- pretreatment with antagonists blocks psychedelic effects
- exception: MDMA stimulates ___ release

Answer 9

5-HT2A
5-HT

Question 10

psychedelic drugs markedly increase ___ integration in the CNS

Answer 10

global

Question 11

• visionary restructuralization - sensory ___
• oceanic boundlessness - highly pleasurable state of self ___
• anxious ego-dissolution - thought disorder leading to unpleasant state ( __ ___ )

Answer 11

• illusions
• dissolution
• bad trip

Question 12

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%

Answer 12

• dysphoric
• flashbacks
• personality
• psychosis

Question 13

Psychedelic Drug Use AE

• rapid development of ___ - 3rd consecutive day, marked attenuation of effect
• frequent use can lead to ___ changes
• no evidence of ___ potential

Answer 13

• tolerance
• mood
• addicitive

Question 14

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)

Answer 14

• cancer
• depression
• alcohol

Question 15

dissociative psychedelics

in contrast to classical psychedelics, dissociatve psychedelics act as antagonists of ____ receptors
1) inhibition of ___ release
2) disinhibition of ___ release

Answer 15

NMDA
1) GABA
2) glutamate

Question 16

overview of glutamate receptors

• NMDAR are primarily ___
• NMDAR can also bind ___

Answer 16

• postsynaptic
• glycine

Question 17

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

Answer 17

• glutamate
• anesthesia, analgesia
• S
• esketamine, depression
• dextromethorphan

Question 18

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

Answer 18

• antagonist
• ketamine
• mutilation

Question 19

PCOL of Muscimol

• muscimol is an agonist of ___ channels and can induce dissociative psychedelic effects.
• In contrast, BZDs and alcohol are ___ modulators

Answer 19

GABA A
allosteric

Question 20

inhalants

• volatile solvents (toluene, glue, kerosene, gasoline)
• aerosols, gases, sprays
• nitrire (poppers), nitrous oxide
• hydrocarbons, ketones

Answer 20

Question 21

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

Answer 21

• poppers
• nitric oxide, relaxation
• methemoglobinemia

Question 22

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

Answer 22

• toluene
• acetone
• benzene
• butane

Question 23

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

Answer 23

sniffing