Term
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Definition
| lysergic & diethylamide (LSD); psilocybin & psilocin; bufotenin; ibogaine |
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Term
| phenethylamine Hallucinogens |
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Definition
| have hallucinogenic actions but also produce amphetamine-like stimulant effects: mescaline, MDMA (ecstasy) |
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Term
| Sympathomimetic Effects of LSD |
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Definition
| pupillary dilation; increase in BP; tachycardia; piloerection; hyperflexia; tremors; increase in body temperature |
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Term
| Miscellaneous Somatic Effects of LSD |
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Definition
| dizziness; weakness; paresthesias; nausea |
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Term
| Subjective Psychic Changes of LSD |
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Definition
| anxiety; euphoria; giddiness; emotional lability; early stages perceived as pleasant |
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Term
| Hallucinogenic (psychogenic) effects of LSD |
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Definition
develops slowly over 1-3 hrs; sensory distortions - visual disturbances, hallucinations, synesthesias;
depersonalization (out of body experiences); difficulty differentiating drug effects from reality; anxiety, fear, paranoia, panic, emotional lability; panic reactions ("Bad trip"), psychotic rxns |
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Term
| Signs of Acute Poisoning (Bad Trip) with LSD |
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Definition
high margin of safety (relatively - ppl don't die from overdose but from individual's behavior while under influence);
panic reactions (common);
Symptoms: fear, panic, paranoia |
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Term
| Treatment of Acute Poisoning (Bad Trip) of LSD |
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Definition
Calm & reassure pt; Tx sensory input problems by putting pt in quite, dimly lit room;
Anxiolytics may help in severe cases; Use antipsychotics as LAST RESORT |
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Term
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Definition
| develops very rapidly (after only 2-3 doses) |
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Term
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Definition
| returns after drug free period |
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Term
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Definition
| found in hallucinogenic mushrooms; effects similar to LCD |
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Term
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Definition
| found in some mushrooms & in skin of some amphibians ("Toad Licking") |
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Term
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Definition
| found in buttons of peyote cactus, effects similar to LSD, more pronounced somatic autonomic changes |
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Term
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Definition
| has both hallucinogenic & stimulant effects, very common drug; can cause hyperthermia ("Saturday Night Fever") |
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Term
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Definition
| phenomenom that occurs with heavy use of hallucinogens; causes long-term alterations in neuronal functions that involve the user's memory of drug experience; memories may be triggerd by a wide variety of cues (sights, sounds, smells) |
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Term
| Hallucinogen Persisting Perception Disorder (HPPD) |
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Definition
| heavy LSD usage causes long term changes in processing of visual information |
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Term
| phencyclidine (PCP, Angel Dust, Ketamine) |
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Definition
originally developed as anesthetic but many adverse effects occurred (delirium, hallucinations, psychotic rxns); now it is a popular "club drug";
PKs: taken orally, snorted, injected, or smoked (most common);
Often mixed with marijuana;
Low doses: subjective feelings similar to marijuana (relaxation, sense of well-being, giddiness, psychomotor slowing);
Slightly Higher doses: amphetamine-like stimulant effects - restlessness, irritability, hostility;
Higher Doses: hallucinations, psychotic rxns, rage rxns;
Effects vary markedly from each individual - social withdrawal, isolation, cognitive disturbances, hyperflexia (increase muscle strength), signficant analgesic activity (feels no pain);
Acting crazy + feeling strong + feeling NO PAIN = BAD COMBO!!! |
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Term
| Symptoms of Acute PCP Poisoning |
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Definition
| slurred speech, ataxia, stupor, HYPERREFLEXIA, INCREASED MUSCLE TONE, HYPERTENSION, VERTICAL NYSTAGMUS, hostility, aggression, hallucinations, convulsions, cardiac & respiratory depression, coma & cardiovascular collapse |
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Term
| Treatment of Acute PCP Poisoning |
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Definition
1) calm & reassure pt (decrease sensory stimulation);
2) symptomatic support for psychotic rxns - use antipsychotics;
3) Support respiration
4) Use anticonvulsantss & antihypertensives PRN
5) Acidify urine to hasten excretion of drug |
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Term
| Symptoms of Withdrawal from PCP |
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Definition
| craving for drug; fear, anxiety, & restlessness |
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Term
| Hazards of Long-term PCP Use |
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Definition
| psychosis; cognitive impairment |
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Term
| marijuana (hashish, reefer, pot, Mary Jane, cannabis, weed, etc.) - main active ingredient: THC |
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Definition
| PKs: usually smoked, sometimes eaten when mixed with foods; very lipid soluble --> rapidly absorbed, distributes to brain & fatty tissue --> accumulates in fat & is slowly released overtime; Duration of action: 2-3 hrs, metabolites present for several wks; |
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Term
| Pharmacological Effects of Marijuana |
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Definition
relaxation, increased sense of well being, giddiness; sedation, drowsiness; memory & cognitive impairment, confusion; psychomotor slowing, loss of coordination, decreased ability to perform complex tasks;
High doses: hallucinations, paranoia, psychotic rxns;
increased appetite; tachycardia, postural hypotension; reddening of conjunctiva; decreases intraocular pressures; inhibition of vomiting reflex |
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Term
| Toxic Effects of Marijuana |
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Definition
suppression of immune function; lowering of testosterone levels (decreased libido, gynecomastia); teratogenic effects (decreased birthweight, birth defects, learning disabilities in offspring); "Amotivational syndrome"; damage to lungs (due to smoke);
Severe poisoning is rare: unpleasant psychological effects - paranoia, fear, panic, hallucinations, psychotic rxns; |
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Term
| Treatment of Marijuana Poisoning/Intoxication |
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Definition
| symptomatic: calming & reassuring pt, reduce sensory input; anxiolytics or antipsychotics may be used in severe cases |
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Term
| Tolerance & Physical Dependence with Marijuana |
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Definition
| NO withdrawal; some degree (little to none) of tolerance; |
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Term
| Medical Uses of Cannabinoids (THC [Dronabinol], marijuana) |
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Definition
| prevention of nausea & vomiting during cancer chemotherapy; prevention of "wasting" in AIDS pts; treatment of glaucoma & asthma (not approved yet) |
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Term
| Acetylcholinesterase Inhibitors - rivastigmine [Exelon], donepezil [Aricept], galantamine [Reminyl], tacrine [Cognex] |
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Definition
drugs used to tx Alzheimer's dx;
MoA: acetylcholinesterase inhibitors
drugs that cause: salivation, sweating, nausea, diarrhea, intestinal cramping, urinary incontinence, bradycardia, bronchoconstriction; |
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Term
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Definition
MoA: NMDA receptor antagonist that acts by blocking excitatory actions of glutamate at NMDA receptors in hippocampus & frontal cortex;
Use: tx of Alzheimer's dx
improves cognitive function & may prevent some excitoneurotoxic effects of glutamate;
SEs: fairly well tolerated - increased BP, dizziness, GI distress, cough |
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Term
| vitamin E [alpha-tocophenol], selegiline/deprenyl [Eldepryl] |
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Definition
| antioxidants, MOA-Is that are reported to reduce some of degenerative changes & slow progression of Alzheimer's |
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Term
| Amytropic Lateral Sclerosis (ALS, Lou Gehrig's Disease) |
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Definition
progressive, fatal neurodegenerative dx characterized by progressive muscle weakness, disability, paralysis & eventual death within 3-5 yrs;
Pathology: combination of upper & lower motor neuron deteroriation with astrocytic glial cells replacing neurons; involves a combination of oxidative stress & glutamate excitotoxicity;
Tx: riluzole [Rilutek] & symptomatic support (muscle relaxants, antidepressants, anticonvulsants) |
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Term
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Definition
| only drug currently available that is able to slow progression of amytropic lateral sclerosis (ALS, Lou Gehrig's Dx); acts by inhibiting release of glutamate from nerve endings & reducing "excitotoxicity", available as "orphan drug"; most beneficial if started early during course of dx |
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Term
| Side Effects of Stimulant Drugs in Tx of ADHD |
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Definition
| suppression of appetite --> slowed growth; sympathomimetic effects (HTN, tachycardia); tremors; emotional lability; significant abuse potential |
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Term
| methylphenidate (Ritalin) |
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Definition
mainstay drug for tx of ADHD;
mild stimulant activity (less than amphetamine);
relatively short duration of action but now found in sustained release form |
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Term
| d-amphetamine, d,l-amphetamine & their salts (Adderal, Adderall XR) |
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Definition
| powerful stimulants reserved for pts who DO NOT show adequate response to methylphenidate in tx of ADHD; Schedule II drug |
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Term
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Definition
| SNRI - selective NE reuptake inhibitor; non-stimulating agnet used to tx ADHD in adults & children; not as effective as amphetamines; Concerns about serious hepatotoxicity |
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