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Hallucinogens and Drug Abuse (Dr. Peterson)
Terms in this set (125)
Perception of an external stimulus that has no basis in reality. The person is often aware that what they are seeing is not real
Perception of an external stimulus for which there is a basis in reality. The person is unaware that what they are seeing is not real, and you generally can not talk the person out of the delusions
A sensory perception in which an external stimulus is misperceived or misinterpreted
T/F: True hallucination are very common
False; they are rare
Spectrum of psychomimetics from hallucinations to delusions:
|Hallucinations| LSD --> Amphetamine poisons --> PCP/ketamine --> Anticholinergics |Delusions|
Poisons or toxins:
Substances that cause organic brain syndromes accompanied by hallucinations
Chemicals that are volatile at room temperature
Examples of some inhalants:
- Organic solvents (benzene, toluene, xylene)
- Nitrates: (amyl nitrate and butyl nitrate)
- Nitrous oxide
Organic solvents concentrate in the ____ and ___ where the cellular structure is ___.
Nitrates increase ____.
Intraoccular Pressure (IOP)
The use of nitrates are associated with increased risk of ____.
What are 4 physiological side effects of using inhalants?
1. Acute toxicity
2. Cardiac arrhythmia's
4. Sudden Sniffing Death (SSD)
How can inhalants alter your mental state? (CNS symptoms)
- exhilaration and lightheadedness
- Impaired judgement/perception (individual appears as though they're drunk on alcohol)
- Loss of consciousness or coma
Deleriants produce hallucinations associated with hallucinations without ___.
T/F: Many OTC drugs contain anticholinergics, and this can produce symptoms the patient may not be aware of.
Which two drugs represent dissociative anesthetics?
- Phencyclidine (PCP)
- Ketamine (Ketelar)
T/F: Of the dissociative anesthetics, only ketamine is used in humans and veterinary medicine.
What are the dose-related symptoms associated with each "state" of PCP ingestion? (4 states)
1. Stimulated, activated state
2. Bizarre and aggressive behavior
3. Unresponsive and catatonic
4. Seizures and coma
What is the general MOA of PCP?
Noncompetitive antagonist of NMDA and glutamate
- May have some activity at opiate sigma receptors
T/F: PCP is active by all routes of administration
The effects of PCP may last 7-10 days due to its _____ and _____.
PCP has _____ tolerance and physical dependence (limited or high).
T/F: Animals will self administer PCP?
What symptoms are associated with a low dose of dextromethorphan (DXM)>
Low dose = 100-300 mg
- mild stimulant effect with distorted visual perceptions
- Dream like feeling, with empathy towards others
What symptoms are associated with a high dose of dextromethorphan (DXM)?
High dose = 200-400 mg
- Induce dissociation of the mind from the body (like PCP and ketamine)
- Dissociative effects are due to noncompetitive antagonism of NMDA receptors
T/F: Dextromethorphan has physiological dependence?
False; but psychological dependence is implicated
There are no signs and symptoms of withdrawal reported for DXM
GBL gets metabolized to ____ in the body.
T/F: GBL is an active compound?
GHB is an endogenous neurotransmitter metabolized from ____.
GHB causes... (4 things)
- Enhanced sensory perceptions
- Social closeness
MOA for LOW doses of GHB?
Binds to GABA-B receptors
GABA-B inhibits GABA neurons in the VTA which allows and increase inDA neuron activity to the N. Accumbens
T/F: There is both physical and psychological tolerance to GHB?
GHB may be cross-tolerant and cross-sensitive to ___ and ___.
- Sedative hypnotics
General side effects of hallucinogens (3 categories)
- Perceptual distortions (single to complex hallucinations in more than one modality)
- Produce psychotic episodes that looks like a schizophrenic state
Indoleamkylamines are based on the the structure of ___.
T/F: LSD tolerance develops very rapidly?
T/F: Physical dependence is associated with LSD?
T/F: Psychological dependence occurs very rarely with LSD use?
LSD is cross-tolerant to ___ and ___.
LSD is NOT cross-tolerant to these hallucinogenic effects or ____, ___, ___ or ___.
Flashbacks from LSD use are now called ___,
Hallucinogen Persisting Perception Disorder (HPPD)
There is a reasonably good correlation between _____ partial agonist activity and _____ in humans.
Where are psilocybin and psilocin found?
Compared to LSD how potent are psilocin and psilocybin?
1/400th the potency of LSD
Phenylethylamines are hallucinogens based on the structure of ____.
What is another name for mescaline?
Where can mescaline be found?
T/F: Mescaline can induce vomiting?
Which drug has the street name STP for serenity, tranquility, and peace?
T/F: MDMA is just MDA with a methyl group added to the terminal nitrogen?
MDMA has a _____ effect similar to amphetamine but a more selective affinity for ____.
What are some effects of taking MDMA?
- Enhanced sensory perception
- Dry mouth
- Visual hallucinations
What are some street names for MDMA?
- Love drug
- Hug drug
T/F: MDMA is active by all routes of administration?
T/F: MDMA inhibits its own metabolism
True (This means that the more you take the longer the effects will last)
T/F: There is little physical dependence associated with MDMA?
MDMA is know to lesion ____ neurons, which is associated with long term deficits in ____ and ___ as well as enhanced ___ and ___ states.
What plant does marijuana come from?
What is the active agent in marijuana?
THC (Delta9- tetrahydrocannabinol)
What are the flowering tips of the marijuana plant called?
What is hashish?
The dried resinous exudate of the sensimellia
T/F: The cannabinoid receptors are TM receptors that are G-protein linked?
Which receptor is the predominant cannabinoid receptor in the brain?
CB1 receptors are largely found in the _____ and not the ____ and this may explain the relatively low toxicity of marijuana.
Selective CB1 antagonist
Reported to be useful in smoking cessation and weight loss in obese patients
Adverse effect of Rimonabant?
May induce suicidal depression
What are 2 of our endocannabinoids?
Anandamide and 2-arachidonylglycerol are derivative of ____.
The endocannabinoids act is ______ in that they are released from the ______ to inhibit presynaptic _____ or ____ release.
What are the major differenced between marijuana and other hallucinogens? (4 differences)
1. Hallucinations only occur at high doses
2. Sedation that is not seen with LSD
3. No sympathomimetic side effects
3. No cross-tolerance to LSD
What are the physiological side effects of marijuana?
- Increased appetite
- Increased peripheral vasodilation
- Conjunctiva reddening
- Dry mouth
What are the perceptual effects of marijuana?
- Enhances the non-dominant senses, touch, taste and smell
- Subtle visual and auditory stimuli that were previously ignored may take on a navel quality
What are the psychic effects of marijuana?
- Slowed sense of time
- Dream like state
- Paranoia and anxiety (depending on the environment)
Clinical version of THC
What is the active metabolite of THC?
T/F: The metabolite of THC is more active than the original drug?
THC is an agonist at ____ and ___ receptors.
What is the half life of THC?
T/F: Tolerance may develop to many of the effects of cannabis/THC?
T/F: Cannabis has limited physical dependence?
Psychological dependence of marijuana occurs in _____ cases.
What are some medical uses for THC or synthetic analogs?
- Appetite stimulant
What is the synthetic form of THC?
Nabilone (Cesamet) - synthetic THC analog
T/F: If someone is using THS or synthetic THC for a medical illness, they can also expect to experience the psychoactive effects of THC.
What are the adverse effect of marijuana?
- Acute Panic (if the person is in a threatening situation)
- Amotivational Syndrome
- Carcinogenic (tar)
More drug is needed to elicit the same response
Reduced response is elicited by the same dose
Genetically determined lack of sensitivity to a drug
Dispositional, metabolic, and pharmacokinetic tolerance
Less drug gets to the site of action due to increased metabolism or elimination
(This is the major form of tolerance to barbiturates)
Cellular, functional, and pharmacodynamic tolerance
The same amount of drug gets to the site of action but the response is reduced due to change in cellular receptors or related intracellular mechanism
T/F: Opiates elicit increase in lethal dose while barbiturates do not?
Behavioral or learned tolerance
Individual learns to compensate for drug effect
Rapidly developing pharmacodynamic tolerance
(Best example is alcohol)
Develops when environmental cues are consistently associated with drug administration. The body makes physiological adjustments to the drug even before the drug is administered
Reverse tolerance or sensitization
Intermittent exposure causes progressive increase in sensitivity to the drug
(Examples: Opiate post-addicts, physchostimulant post-addicts)
Physical or physiological dependence
Altered physiological state resulting from chronic drug use
Withdrawal or abstinence syndrome
Adverse physiological and psychological effects of stopping a drug that induces physical dependence. Substance specific syndrome.
2 things that will determine the severity of withdrawal/abstinence syndrome?
1. Degree of physical dependence
2. Duration of drug action (e.g. long-acting drugs will have a milder withdrawal)
Mild abstinence syndromes resulting from drugs that cause low levels of physical dependence. Some drugs are not addictive (e.g. antidepressants, antipsychotics, B-blockers)
Individual feels that the effects of the drug are necessary to maintain optimal state of well-being. May occur with or without physical dependence/tolerance.
Characterized by craving
______ is the basis for compulsive drug use and addiction.
Extreme form of psychological dependence
Characteristics of drug dependence?
- Compulsive, out of control drug use
- Drug use continues despite adverse health effects
- Associated with unproductive, deviant behavior
Older term implying compulsive use and physical dependence. (Term is coming back into use now). Should imply drug dependence
T/F: Being physically dependent means you're addicted to a drug.
Drug abuse or substance abuse
Recurrent use of illegal substance or harmful substances
(Things not being used for their legitimate purpose)
Patient who becomes "addicted" to available prescription drugs
What percentage of patients will become medical addicts?
Classes of abused drugs (8 classes)
2. General CNS Depressants
3. CNS Stimulants
Which classes of abused drugs are the most likely for compulsive use of addictive proportions?
- General CNS Depressants
- CNS Stimulants
Which classes of abused drugs have well characterized physical withdrawal?
- General CNS Depressants
Which classes of abused drugs may exhibit the rebound phenomenon?
- CNS Stimulants
What are the different patterns of drug usage (4 patterns/classes).
2. Social use
3. Situational or circumstantial use
4. Compulsive use/Drug dependence/Addiction
Experimentation (Drug usage)
Basic human behavior and may include up to 10 experiences with the drug
Social Use (Drug usage)
Drug use that is socially acceptable for special settings. Tends not to lead to heavier drug use.
Situational or Circumstantial Use (Drug usage)
State dependency: when an individual muses a drug state in specific situations
May lead to situational compulsive use in which the individual believes the drug must be present in certain situations
Compulsive Use/Drug Dependence/Addiction (Drug usage)
- The individual's life is centered around the use of the drug
- Extreme drug seeking behavior
- "Wanting without liking"
T/F: Situational use and compulsive use represent psychological dependence?
Drugs are ____ of behavior.
Drug induced euphoria or other pleasurable side effects
Induces approach behaviors
Drug relieves anxiety or dysphoria
The drug is rewarding because it eliminated adverse effects
Drug induced adverse effects
Punishment induces AVOIDANCE
Conditioning or secondary reinforcement
When previous neutral stimuli become positive reinforcement. This is a major factor in drug relapse
_____ drugs tend to have a greater abuse potential.
Rapid acting/Short acting
The _____ the brain concentration increases, the _____ the abuse potential
D2 receptors inhibit the activity of ______ neurons in the shell of the ______, and this results in drug reinforcement.
GABAnergic medium spiny
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