Psychedelics - PCP (Phencyclidine) Final Exam Study Guide PDF

Summary

This document provides a study guide on psychedelics, focusing specifically on PCP. It covers topics such as its effects, mechanisms of action, and routes of administration. It is designed for students taking a final exam on the subject.

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Psychedelics: PCP (Phencyclidine): Overview: Type: Synthetic drug. Developed: 1963, initially marketed as an analgesic and anesthetic. Medical Use: ○ Advantages: Safe and effective as an anesthetic; it did not depress blood pressure (BP), heart rate (HR), or respira...

Psychedelics: PCP (Phencyclidine): Overview: Type: Synthetic drug. Developed: 1963, initially marketed as an analgesic and anesthetic. Medical Use: ○ Advantages: Safe and effective as an anesthetic; it did not depress blood pressure (BP), heart rate (HR), or respiration. ○ Discontinuation in Humans: Adverse recovery reactions: Confusion, disorientation, agitation, and hallucinations upon regaining consciousness. ○ Restricted to veterinary use after adverse reactions in humans. Street Use: Emerged on the street the same year its medical use was discontinued. Street Names: Includes Crystal, Angel Dust, Hob, and others Psychedelics: PCP (Phencyclidine) Routes of Administration: Forms of PCP: Powder, tablet, capsule, and liquid. Routes of Administration: 1. Oral: Ingested directly. 2. Intranasal: Snorted as a powder. 3. Smoked: Powder may be sprinkled on cigarettes or cannabis. 4. Injected: Less common but possible with liquid form. Pharmacokinetics: Half-Life: Long, lasting up to 3 days. Detectability: Remains detectable in urine for several days due to slow elimination. Psychoactive Metabolites: ○ PCP is metabolized in the liver into active metabolites that may prolong or intensify effects. ○ These metabolites interact with the central nervous system (CNS), contributing to prolonged behavioral and psychological effects. Effects Duration: Typical Effects: Last 4-6 hours, but reports suggest effects may persist for days or even weeks in some cases. After-Effects: Amnesia: ○ Users may experience partial or total memory loss for events and actions during intoxication. ○ This retrograde amnesia can make it difficult for users to recall their behavior or surroundings Psychedelics: PCP (Phencyclidine) Mechanisms of Action: Key Mechanisms: 1. Antagonist at NMDA Receptors: ○ Glutamate and Aspartate Blockade: NMDA (N-methyl-D-aspartate) receptors are critical for learning, memory, and excitatory neurotransmission. PCP blocks these receptors, leading to disrupted neural communication and dissociation from reality. ○ Dopamine (DA) Increase: This blockade indirectly increases dopamine release in: Nucleus Accumbens: Related to reward and pleasure. Prefrontal Cortex: Associated with decision-making and cognition. Basal Ganglia: Involved in movement and motivation. 2. Inhibits Serotonin Reuptake: ○ Increases serotonin levels in the cortex, enhancing mood and contributing to hallucinogenic effects. 3. Agonist at Opiate Receptors: ○ Partial activation of opiate receptors contributes to analgesic (pain-relieving) effects and possible feelings of euphoria. 4. Agonist at Adenosine Receptors: ○ Adenosine receptor activation influences sedation, pain perception, and neural inhibition, adding to PCP’s complex profile of effects. Summary of Effects: Dissociation: Caused by NMDA receptor antagonism. Hallucinations: Due to serotonin reuptake inhibition and altered cortical activity. Euphoria: Linked to dopamine increases and opiate receptor activity. Analgesia (Pain Relief): Opiate receptor agonism contributes to this effect. Cognitive Disruption: Altered dopamine and NMDA activity impair learning, memory, and decision-making Psychedelics: PCP (Phencyclidine) Effects: Low Dose (5 mg): Euphoria: Sense of well-being. Alcohol-like effects: ○ Slurred speech. ○ Motor incoordination, clumsiness, staggering. ○ Drowsiness. ○ Tingling or numbness of extremities. Moderate Dose (10 mg or more): Physical Effects: ○ Increased heart rate (HR) and blood pressure (BP). ○ Sweating. ○ Nausea. ○ Pupil dilation. ○ Analgesia (reduced pain sensitivity). Visual and Sensory Changes: ○ Blurred or double vision. ○ Nystagmus: Involuntary eye movements. ○ Prolonged visual stare. ○ Feeling of detachment from surroundings or one's own body. Cognitive Effects: ○ Amnesia: Memory loss during intoxication. ○ Perception of floating or being in space. ○ Changes in body image (e.g., feeling one's body is distorted). Comparison to LSD: ○ No colorful imagery or synesthesia (blending of senses). ○ Effects are more detached and psychotic-like. High Dose (10-15 mg or more): Behavioral Effects: ○ Frenzied motor activity or catatonic stupor (immobility). ○ Sudden mood changes: From laughter to crying without cause. ○ Disorientation and confusion. ○ Delusional thoughts, often paranoid. ○ Repetitive or stereotyped movements. Physical and Cognitive Effects: ○ Psychotic-like behavior: Detachment and paranoia. ○ Blank, doll-like stare. ○ Ability to withstand significant pain. Severe Effects and Hospitalization: Duration: Psychotic behavior usually subsides as drug levels decline but may require hospitalization. Treatment: ○ Antipsychotics (e.g., Haldol) for delusions and agitation. ○ Barbiturates or benzodiazepines to calm restlessness or prevent seizures. ○ Gastric lavage (washing out the stomach) if recently ingested. Post-Acute Symptoms: ○ Depressed mood lasting for weeks after recovery. ○ Average hospital stay: Approximately 2 weeks High Dose Toxicity (20 mg or more): Respiratory Effects: ○ Respiratory depression: Slowed or impaired breathing. ○ Pulmonary edema: Fluid accumulation in the lungs. Neurological Effects: ○ Generalized seizures: Uncontrolled electrical activity in the brain. Fetal and Neonatal Effects: During Pregnancy: ○ Slows fetal growth. ○ Precipitates labor: May cause early delivery. ○ Leads to fetal distress during labor. In Infants Exposed In Utero: ○ Neuromuscular issues: Muscle stiffness and tremors. ○ Behavioral problems: Irritability. Attention deficits lasting several years. Animal Studies (Rats): Brain Cell Death: ○ High doses lead to widespread loss of brain cells in animal studies, suggesting potential for long-term cognitive and neurological damage Psychedelics: PCP (Phencyclidine) Tolerance and Dependence: Tolerance: Development: ○ Onset: Within 2-3 weeks of daily use. ○ Progression: First-time users: Experience effects from just a few puffs of a PCP-laced cigarette. Chronic users: May need to smoke 2 joints at a time to achieve the same effects. ○ Dose-Specific Tolerance: No tolerance develops to anti-convulsant effects at low doses. Mechanism: ○ Mechanism for tolerance is not clearly understood. Dependence: Psychological Dependence: ○ Characteristics: Strong craving and habitual use develop over time. ○ Contributes to repeated use despite harmful consequences. Physical Dependence: ○ Withdrawal Syndrome: No clear evidence of a withdrawal syndrome in humans Psychedelics: Ketamine Usage in Depression in Canada, Study: Prevalence of Depression: Occurrence: Affects 1 in 10 Canadians during their lifetime. Treatment Resistance: ○ Approximately 1/3 of individuals with depression do not respond to standard treatments (Treatment-Resistant Depression, TRD). Ketamine for TRD: Research Focus: ○ Extensive research at universities and labs exploring ketamine's impact on TRD. ○ Notable findings show significant symptom relief in some patients. Ketamine Clinic in Canada: ○ Location: Prince Albert, Saskatchewan. ○ Established: 2016. ○ Patients: Approx. 100 patients received ketamine infusions for TRD. ○ Results: Improved everyday functioning and reduced symptoms. Patients experienced relief but were not "cured." Ketamine Study: Participants: ○ 20 males, aged 18-60 years. ○ Met ICD-10 criteria for "severe depressive episode." Protocol: ○ Administered 6 doses of ketamine over 2 weeks. Findings: ○ Immediate effects: Significant improvement in anxiety and depression within 1 hour of the first dose. ○ Long-term effects: Continued improvement over several weeks in: Anxiety Depression Overall severity of illness

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