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DROGAS

ALUCINOGENAS O
SICOTOGENAS,
SICOTOMIMETICAS o
SICODELICAS
36

Grupo de sustancias naturales, sintéticas o semisinteticas
que producen cambios: conductuales, mentales,
emocionales, del comportamiento, de aprendizaje,
sensoperceptivos.
Acompañandose de trastornos motores (= sicoticos).

(alertex, curam)

PSICOFARMACOLOGIA
Subespecialidad medica de la Psiquiatria.
Estudio de drogas q tienen q ver con los
procesos mentales superiores como del
pensamiento, afectividad, memoria,
aprendizaje.

Psicofarmacos: Clasificacion:
- Sicotogenos o sicodislepticos
- Antisicoticos o neurolepticos
- Ansioliticos o tranquilizantes
- Antidepresores.

PSICOTOGENOS O ALUCINOGENOS
1. NATURALES (Plantas)

-

Erytroxilon coca = cocaina

rawolfIa = reserpina
mezcal o peyote = mezcalina
harmala, ayahuasca = harmina
cornezuelo centeno = LSD.

Psilocibe mexicana (hongos magicos) =

psilocibina y psilocina

- Salvia divinorum = salvinorin A
- Cannabis sativa = 9-THC

Derivados de anfetaminas: MDMA . Sinteticos: .PSICOTOGENOS O ALUCINOGENOS 2.Fenciclidina (PCP). . MDEA y MDA ext eva pild .

emocionales y del comportamiento. Cambios mentales. PSICOTOGENOS DEFINICION o Drogas q`realizacion inmediata y +intensa de las func N o procesos siquicos superiores.1. . Modificaciones del pensamiento = trastornos sicoticos. perceptuales.

• Origen AYAHUASCA Y HARMALA • Celebraciones mágico-religiosas • Tomar contacto con espíritus de sus antepasados .

alucinaciones . vértigo .Estructura quimica parecida simpaticomimeticos. embriaguez . Produce: .

Hoffman-Sandoz `43. Al cerrar los ojos surgian hacia mi figuras fantasticas. . de plasticidad extraordinaria e intensos colores”. Alcaloide del cornezuelo de centeno. “peculiar sensacion de vertigo e inquietud que me obligo … y cai en una singular embriaguez en la q predominaba mi imaginacion q se habia hecho exagerada.

Obtenida: MEZCAL O PEYOTE (apaches) (Lophophora williamsii) Peyotismo (rito religioso) “alivia todos los males de los mortales” .

Origen: “hongo mágico” “Psilocibe mexicana”. MEXICO y USA Son sicodislépticos 1.000 < potente que LSD .

Efecto dura < 1ho .• Origen: Planta+ “Salvia divinorum” . “hierba María u hojas de la pastora” • Usadas por Mazatecas OAXACA de México Practicas espirituales 200-10000 mcg = 50-250 mcg LSD.

. • Viene del Medio Oriente y la India.• Origen: “Cannabis sativa”.

EVA (MDEA) Metilenodioxietil anfetamina 4.3. DOB Bromodimetoxipropalamina .4metilenodioxianfetamina 2.ANFETAMINAS y FENCICLIDINA: 1. PILDORA DEL AMOR (MDA) Metilenodioxianfetamina 3. ÉXTASIS (MDMA) 5metoxi.

• Anestésico veterinario • Consumo epidémico en USA `50 • Anestésico general. pero abandonado por delirio al salir de la anestesia .

FARMACOS PSICOTOGENOS  EFECTOS FARMACOLOGICOS: 3: Siquicos. 1. SIQUICAS: sensibilidad para la percepcion de estimulos. ALT. neurovegetativos y ▼motores. Fase alucinogena: visuales. maravillosos paisajes . Fase excitacion psiquica con SS neurovegetativos:sensacion de tension interna ―mal viaje‖:.

.FARMACOS PSICOTOGENOS +Sensible al arte. pensamientos nobles y elevados sentimientos humanos (placentera). musica. creacion literaria.

personalidad desdobla).. .FARMACOS PSICOTOGENOS 2. Trastornos Personalidad: despersonalizacion (no ser el mismo. Su imagen humana distorcionada.

seudo alucinaciones).  Uso prl trastornos psicoticos persistentes =esquizofrenia. percepciones falsas.(destellos de color. .PSICOTOGENOS  Efecto tardio: Aparicion de trastornos visuales o retrospecciones.

PSICOTOGENOS 2. ataxia. TRAST. -Harmina = motores Temblores extremidades. exageracion de reflejos. marcha atras (raro H). MOTORES: -LSD = siquicos. Temblores y piloereccion (LSD) . Animales: saltos. contracciones espasmodicas.

somnolencia. taquicardia. .LSD: midriasis. mezcalina y LSD PA. parestesias. debilidad. . bochornos. . .Todas. NEUROVEGETATIVOS: . temperatura. salivacion.Tipo simpaticomimeticos: Harmina PA.LSD broncorelajacion.PSICOTOGENOS 3. TRAST.

. angustia.PSICOTOGENOS ―Aterrizaje”: ansiedad. soledad=gritos desesperados. panico.

Inhibiendo la liberación de serotonina 3. Antagonistas de R 5HT 2Ay 2C (en SUEÑO inductores y prl) .Alterando la transmisión SEROTONINERGICA en mesencefalo: triptofano 1. Agonistas de R presinapticos 5HT 2 2.

5-HT en todo el SNC 5HT-2C A. SUEÑO INDUCTORES y PRL .SEROTONINA. EFECTOS FISIOFARMACOLOGICOS 3.

SEROTONINA. AGRESIVIDAD Y VIOLENCIA 5HT-1B C. SNC B. EFECTOS FISIOFARMACOLOGICOS 3. CONTROL ANSIEDAD 5HT-1A (presinap) HIPOFUNCION= DEPRESION ENDOGENA .

 Muerte por insuficiencia respiratoria o suicidio. .  SI tolerancia a siquicos. NO dependencia fisica.PSICOTOGENOS EFECTOS ADVERSOS Panico temporal ―mal viaje‖  NO teratogenia / aberrac cromosomicas.  NO Sd retirada.

 TX de la intoxicacion: Diazepan o fenotiazinas (haloperidol 5 mg IM).  .PSICOTOGENOS USOS CLINICOS TRATAMIENTO Experimental en animales  Psicosis experimental en H con 50-100 mcg de LSD o 500 mg de mezcalina.

MARIHUANA o hachis (Cannabis sativa)    >Consumo en Mundo (250-320 millones).  . locuaz. ―alucinogeno ligero‖: fantasear. crear.700 AC. Actividad farmacologica x d9THC I EFECTOS FARMACOLOGICOS SIQUICOS: Sedacion excitacion y desinhibicion (alcohol)…. China 2.

apetito. ―Mal viaje‖ . audicion +fina imagenes visuales vividas. llanto o risa.MARIHUANA  Espectro amplio reacciones : euforia o desorientacion.  Fumar por 1ra vez o : reacciones sicoticas con despersonalizacion.  . alucinaciones. bienestar o apatia. perdida de la razon. Congestion conjuntival.  OTROS: Percepcion alterada del tiempo.

percepcion alterada tiempo. .MARIHUANA Intoxicacion CRONICA   *memoria.  Deterioro de la coordinacion  Deprime los reflejos medulares polisinapticos  anticonvulsivante.: SS MOTORES  Temblor muscular y ataxia. deterioro procesos perceptivos y discernimiento. Sindrome amotivacional.

EPOC.   conc testosterona con  contage espermatozoides.MARIHUANA Intoxicacion CRONICA OTROS:  Bronquitis y enfisema. . laringitis.  Afecta aprendizaje en niños.  Ca pulmonar (humo). Menstruaciones anormales y falta de ovulacion.

MECANISMO DE ACCION CB1 CB2 .9-THC.

SISTEMA CANNABINOIDE Marihuana Tetra-Hidro-Cannabinol (THC) • 9-THC marcado demostraron Recps diferentes a los conocidos. • CB1: Inhibe liberación de NA. cerebelo. En linfocitos. GABA. medula). • CB2: relacionado con sistema inmune. • 2 Receptores: CB1 y CB2 • En todo SNC (+hipocampo. • Ligando anandamida apetito y tolerancia alcohol  Antagonista Rimonabant xa Tx hiperfagia. hipotálamo. Mo y bazo. Acth. Facilita libración de NO. .

Accion: 2-3 horas!.MARIHUANA  FARMACOCINETICA. Fumar  THC x alveolos  sangre y tejido (adiposo x semanas)  Metaboliza higado y plasma  x orina (metabolitos inactivos). Efectos inmediatos (10-20m). Deposito en TCS x sem .

?) . Irritabilidad • Náuseas • Vomito •Agitación. Cólicos No dependencia Física Si Tolerancia TX sintomatico. Teratogenica en animales (h. Insomnio • Congestión de las conjuntivas • Náusea.Primeras experiencias causan: En fumadores de hierba pertinaces a dosis alta produce S. diazepam. RETIRADA •Inquietud.

 peso .SIDA (apetito y  s.Glaucoma. . .Dolor cronico.Nausea-vomito .MARIHUANA USOS  Expectativas: . .Espasticidad o esclerosis multiple. . inmune).Adiccion a otras drogas (alcohol) .

SIDA o fibromialgia son consumidores terapéuticos de algunas de las asociaciones de usuarios de cannabis que hay en España. que se administra con un aerosol bajo la lengua.28/07/2010      El cannabis acaba de ganar parte de su espacio legal como sustancia terapéutica. se les administra el Sativex. explica Xavier Montalbán. ha recibido hoy la autorización de las autoridades sanitarias españolas para paliar la espasticidad en los enfermos de esclerosis múltiple. . Sin embargo. que no sustituye a los antiespasmódicos orales actuales. Este extracto de cannabis. director del Centro de Esclerosis Múltiple de Cataluña (Cemcat). cerca de un 60%". Así se aseguran la calidad de la marihuana que consumen.Sanidad aprueba un medicamento con cannabis para la esclerosis Sativex está indicado para pacientes con espasticidad que no mejoran con su medicación habitual Barcelona . "Son muchos los pacientes que no reaccionan ante la medicación habitual. en las investigaciones se ha comprobado que añadiendo el compuesto de cannabis la mitad de estos pacientes resistentes logran controlar la espasticidad asociada a su enfermedad. Enfermos de cáncer. Dos de sus principios activos (entre ellos el THC) forman parte de la composición de Sativex. pero que sí mejora su respuesta. Se trata de un medicamento complementario. que ha participado en los ensayos del fármaco. además del antiespasmódico. sí que hay mejora en los enfermos a los que. Colectivos de enfermos crónicos a los que no les han funcionado los tratamientos convencionales defienden el consumo del cannabis para mitigar los síntomas de la enfermedad o los efectos secundarios de otros tratamientos como náuseas o vómitos. En concreto.

AJULÍNICO (derivado del 9THC) en esclerosis multiple y antiinflamatorio.USOS 3. . NAUSEA Y VOMITO (en Tx anti-Ca) 2. ANTIINFLAMATORIO ESCLEROSIS MÚLTIPLE 1. Tx OBESIDAD DRONABINOL (Marinol) NABILONA (Cesamet) RIMONABANT (Antag CB1) ÁC.

.USOS CONTRARESTAR ALCOHOL SR 141716 para contrarrestar adiccion alcohol.

píldora de la paz”. tabletas. . inyecciones. polvo de los ángeles.Derivado ARILCICLOHEXILAMINAS Se la conoce: “PCP. -Se presenta en forma de polvo.

Somnolencia DOSIS TÓXICAS + 20 mg Deprime el centro respiratorio DOSIS MODERADA Hipertensión Taquicardia Muerte Hipertonicidad =sicoticoesquizofrenico-suicidio Contracciones mioclónicas Nistagmus Ataxia .DOSIS MENORES Viaje de placer con sentimientos de tranquilidad Percepción > de estímulos externos DOSIS ALTAS 5-10 mg Agresiva Confusión Estupor Mirada extraviada Excitación Postura catatónica Alucinaciones Convulsiones Apatía.

FENCICLIDINA  1er Trimestre embarazo: abortos espontaneos y defectos congenitos!!.  MEC ACCION. Bloqueo R NMDA de glutamato. ? .

Glutamato AMPA .Ac..metil-d.GLU GLU GLU TERMINAL PRESINÁPTICA GLU x GLU .. Aminociclopentanodicarboxilico NMDA .-Ac. aminometilisoxazolpropiónico ACPD .aspartato KAINATO AMPA ACPD NMDA TERMINAL POSTSINÁPTICA ..N.

.Diazepam 10 mg IM DEPENDENCIA sicológica pero NO física (=Anfet. 9-THC y coca). .Hidralazina en el caso de hipertensión arterial. .Haloperidol 5 mg IM en □ sicóticos.Intoxicación Aguda Medidas generales: proteccion de conducta irregular (lesiones. . Succión de secreciones Fenciclidina TOLERANCIA Ventilación x depresión respiratoria. 100 mg-1g/d !!. suicidio y muerte).

New Jersey — have passed laws eliminating criminal penalties for using marijuana for medical purposes. Baltimore. federal law enforcement has the authority under the CSA to arrest and prosecute physicians who prescribe or dispense marijuana and patients who possess or cultivate it. Raich) made clear that regardless of state laws. and possessing marijuana for any purpose.. J. Vermont.D.3 and the American Medical Association (AMA) recently adopted a resolution urging review of marijuana as a Schedule I controlled substance.S. Hoffmann. they violate federal law if they prescribe or dispense marijuana and may be charged with "aiding and abetting" violation of the federal law if they advise patients about obtaining it.Medical Marijuana and the Law Diane E.  . Rhode Island. Although physicians may recommend its use under First Amendment protections of physician–patient communications. J. the AMA has joined the Institute of Medicine. Criticizing the patchwork of state laws as inadequate to establish clinical standards for marijuana use.1 Medical experts have also taken a fresh look at the evidence regarding the therapeutic use of marijuana. the American College of Physicians. April 22. New Mexico. dispensing. Volume 362 (16):1453-1457. noting it would support rescheduling if doing so would facilitate research and development of cannabinoid-based medicine. and at least a dozen others are considering such legislation. until recently. The U. Hawaii. Restrictive federal law and. Colorado. NEJM. as set forth in the 2002 federal appeals court decision Conant v. 2010  From the University of Maryland School of Law. Nevada. States have led the medical marijuana movement largely because federal policymakers have consistently rejected petitions to authorize the prescription of marijuana as a Schedule II controlled substance that has both a risk of abuse and accepted medical uses.2. Washington. The federal Controlled Substances Act (CSA) classifies marijuana as a Schedule I drug — one with a high potential for abuse and "no currently accepted medical use" — and criminalizes the acts of prescribing.D. Montana. Fourteen states — California. Walters. and most recently. legal landscape surrounding "medical marijuana" is complex and rapidly changing. and patient advocates in calling for changes in federal drug-enforcement policies to establish evidence-based practices in this area. and Ellen Weber. Oregon. aggressive federal law enforcement have hamstrung research and medical practice involving marijuana. Michigan. Maine. A 2005 Supreme Court decision (Gonzales v. Alaska.

registered patients with identification cards may be arrested but can use the defense that they have a demonstrated medical need for marijuana. but if prosecuted can assert that the quantity they possess is reasonably related to their needs. the federal law remains unchanged. In most states where patients have identification cards. regulations require that physicians discuss the risks with their patients. The amounts range from 1 oz and 6 plants in Alaska to 24 oz and 15 plants in Washington. however." California's original medical-marijuana ballot initiative did not specify an allowed quantity. yet the lack of relevant clinical trials of smoked cannabis makes it difficult for physicians to comply with the law. In Canada. however. but the maximum amount for a 30-day period is 2 oz — making a "60-day supply" in New Jersey just 4 oz. Medical experts emphasize the need to reclassify marijuana as a Schedule II drug to facilitate rigorous scientific evaluation of the potential therapeutic benefits of cannabinoides and to determine the optimal dose and delivery route for conditions in which efficacy is established.  Reliance on state laws as the basis for access to medical marijuana also leaves patients and physicians in a precarious legal position. Such patients can be arrested. although such disclosure is generally required for patients who are minors. Subsequent legislation set limits. and future administrations could return to previous enforcement practices. This research could provide the basis for regulation by the Food and Drug Administration. which apply to individuals who register and thereby gain protection from arrest. Although the current Justice Department may not prosecute patients if they use marijuana in a manner consistent with their states' laws. the first country to decriminalize medical marijuana. make this more rational route of approval unlikely and perpetuate the development of state laws that lack consistency or consensus on basic features of an evidencebased therapeutic program.  . In states debating new legislation.  The laws also vary in terms of whether they establish a registry and issue identification cards for qualifying patients. unregistered but "qualifying" patients who meet other requirements of the law may also use this defense. but the California Supreme Court recently struck down the limits as they apply to unregistered patients who possess amounts of marijuana acceptable under the original ballot initiative. a disparity that underscores the absence of standards. instead permitting an amount reasonably related to the patient's medical needs. In some states. they are protected from arrest and prosecution. Eleven of the 14 states have a registry. and Maine and New Jersey will soon.  Missing from many state laws is a requirement that physicians recommending medical marijuana to adult patients provide the rudimentary disclosure of risks and benefits necessary for informed consent. physicians must provide patients with written instructions specifying the amount of marijuana to be dispensed by legally sanctioned treatment centers. one sixth of that in Washington. although the quantities allowed are not derived from clinical trials or pegged to a medical condition. Current roadblocks to conducting clinical trials. Under the New Jersey law. they are inadequate to advance effective treatment.Most of the statutes also limit the amount of marijuana that patients or caretakers can possess or cultivate. an amount that Washington considers to be a "60-day supply. And in a few states. policymakers are grappling with questions that only scientific research can answer: For what conditions does marijuana provide medicinal benefits? Are there equally effective alternatives? What are the appropriate doses for various conditions? How can states ensure quality and purity?  Although state laws represent a political response to patients seeking relief from debilitating symptoms.

This change in the Justice Department's prosecutorial stance paved the way for states to implement new medical-marijuana laws." Definitions of "debilitating medical condition" vary by state but typically include HIV–AIDS.Nevertheless. .S. quality. New Jersey's new law prohibits such cultivation but provides for the establishment of alternative treatment centers that will "fill" a physician's written instruction for a certain quantity of marijuana. Most laws are silent on whether patients or their caregivers may buy or sell marijuana or whether dispensaries are permitted. glaucoma. cachexia. epilepsy and other seizure disorders. purity. Most laws protect "qualifying" patients. but not use. packaging. dosing. the Department of Justice issued a memorandum to U. an oral recommendation) from their physician indicating that they might or would "benefit from the medical use of marijuana" or that the "potential benefits of medical use of marijuana would likely outweigh the health risks. severe and chronic pain. Attorneys stating that federal resources should not be used to prosecute persons whose actions comply with their states' laws permitting medical use of marijuana. in one case. They also allow a patient's "caregiver" — an adult who agrees to assist with a patient's medical use of marijuana — to possess. and other conditions. California permits dispensing through cooperatives or collectives. muscle spasms from multiple sclerosis or Crohn's disease. who are variously defined as those who have received a diagnosis of a debilitating medical condition and have written documentation (or. severe nausea. All the state laws allow patients to use and possess small quantities of marijuana for medical purposes without being subject to state criminal penalties. they do little to advance the development of standards that address the potency. and labeling of marijuana. All but two states allow additions to this list if approved by the state health department. Virtually all permit patients or caregivers to cultivate marijuana. Although the current state laws facilitate access. but until recently most other states did not — a situation that is changing with the enactment of some recent laws and amendments. in October 2009. and states are now attempting to design laws that balance concerns about providing access for patients who can benefit from the drug with concerns about its abuse and diversion. marijuana. cancer.