Pharm 29 Cannabinoids And Hallucinogens

Front 1

Delta-9-tetrahydrocannabinol

Back 1

THC, marijuana

Front 2

Marijuana: What is it?

Back 2

Mixture of seeds, stem upper leaves and flowering top of Cannabis sativa. Has 3.5-20% THC.

Front 3

THC: Pharmacokinetics
List two routes of administration and time to peak plasma levels, distribution, absorption, duration, elimination.

Back 3

1) Smokes: peak plasma in 10 min, lipid soluble --> leaves plasma quickley, 50% absorbed, lasts 2-3 hours, but can be detected in urine for 3-4 weeks
2) Orally, onset much longer, 2-3 hrs, duration 6-8 hrs.

Front 4

THC: Mechanism of action
1) What two cannabinoid receptors does THC act at? What do we know about the actions of these receptors based on location and other ligands.
2) What other system does THC affect, how do we know this (what blocks its effects here)?

Back 4

1) CB-1 receptor in cortex, hippocampus, and cerebellum. Naturally bound by anandamine, function unclear
CB-1 R in periphery, may explain other effects of THC
2) Also acts on DA system --> increase in DA in Nacc. Blocked by naloxone, which blocks dopamine enhancing effects of heroine as well --> THC may act by activating endogenous opioid system (Endorphins acting on mu receptors)

Front 5

THC: Drug effects
1) CNS

Back 5

1) Mood changes: altered consciouness, mild euphoria, relaxation, social changes, short term memmory down, as is distance perception.
Mild paranoia
Visual hallucinations at higher doses
Associated with earlier onset Schizophrenia

Front 6

THC:
2) Other Physiologic effects

Back 6

2) Dry mouth, red eyes, decreased motor coordination, temperature, muscle strength and balance, tremors.
-less common: nausea, headache, nystagmus, lowered BP, impaired immune system
-Acutely dilates bronchioles but chronically constricts bronchioles and worsens breathing problems.
-Increases HR and urine frequency

Front 7

THC: Dependence
1) Mechanism
2) Sxs

Back 7

May be related to enhanced formation of corticotropin releasing factor (CRP).
2) Signs of stress

Front 8

Marinol
1) Other name
2) Drug class
3) Effects

Back 8

1) dronabinol
2) Oral THC for medical use
3) antimimetic after chemotherapy, appetite stimulant, muscle relaxant, thought to decrease pressure in glaucoma (may actually be a bad thing), alleviation of neuropathic pain.

Front 9

MDMA
1) aka
2) drug class
3) Therapeutic uses

Back 9

1) Ecstacy
2) Hallucinogen
3) current studies underway for use in pain and anxiety in terminal cancer patients

Front 10

LSD
1) Drug class

Back 10

1) Hallucinogen

Front 11

Hallucinogens
1) Drugs
2) Mechanism of action
3) Tolerance
4) Dependence

Back 11

1) MDMA (ecstacy) and LSD
2) Bind at 5HT2a receptor
3) Develops rapidly (3-4 days) --> addiction does not occur. Tolerance disapears in 1 wk and can cross tolerance occurs among other hallucinogens
4) not a problem, no withdrawal syndrome

Front 12

MDMA: Stimulant and Psychedelic properties
1) Compared to cocaine?
2) Sequence of experiences typical
3) Adverse effects
4) Thirst
5) Long term effects

Back 12

a) No high like cocaine
b) Sudden amphetamine rush, then psychedelic effect, than adverse effects
c) decreased ability to perform tasks, decreased appetite, inability to have sex, depressed mood, prolonged headaches, loss of serotonin axons in heavy users --> persists for months
4) Suppression of thirst --> hyperthermia, arrhythmias, or death
Overcompensation --> hyponatremia, seizures and death
5) Sleep, mood, anxiety disturbances, increased impulsiveness, memory and attention problems. Can last 2 yrs after use.

Front 13

Hallucinogens
5) What does it cause

Back 13

Increased awareness of sensory input, synesthesia, out of body experiences, flashbacks.

Front 14

Phenylcyclidine
1) aka
2) Mechanism of action
3) Intoxication

Back 14

1) PCP
2) Non-competitive antagonsim at NMDA receptor complex via blocking NMDA associated Ca channel. Binds "PCP-binding site".
Also binds sigma opioid receptor
3) a) relaxation, euphoria
b) dysphoria, anxiety, emotional liability, paranoia
c) slowing of time perception
d) numbness
e) agitation, violence
f) tachycardia, flushing, drooling miosis
g) dizziness, uncoordination, slurred speech, nystagmus

Front 15

Phenylcyclidine
4) Toxic effects and correspondingTreatment of toxicity

Back 15

4) a)psychosis, muscular rigidity --> txt with benzodiazapines
b) Seizures -->diazepam for convulsions
c) Rhabdomyolysis, respiratory depression and hypotension --> no specific txt
d) txt in general include: gastric suction (to prevent enterohepatic recirculation) acidification of urine

Front 16

Ketamine
1) Drug class
2) Mechanism of action

Back 16

1) Arycyclohexamine, like PCP
2) Binds "PCP binding site" on NMDA receptor, non-competitive.