Hallucination agents

Another injectable anesthetic widely used in feline and primate practice is ketamine hydrochloride [1867-66-9]. Ketamine, a derivative of phencychdine, can be chemically classified as a cyclohexamine and pharmacologically as a dissociative agent. Analgesia is produced along with a state that resembles anesthesia but in humans has been associated with hallucinations and confusion. For these reasons, ketamine is often combined with a tranquilizer. The product is safe when used in accordance with label directions, but the recovery period may be as long as 12—24 h. 

The Class I agents have many similar side effects and toxicities. The anticholinergic side effects include dry mouth, constipation, and urinary hesitancy and retention. Common gastrointestinal (GI) side effects include nausea, vomiting, diarrhea, and anorexia. Cardiovascular adverse effects are hypotension, tachycardia, arrhythmias, and myocardial depression, especially in patients with congestive heart failure. Common central nervous system (CNS) side effects are headache, dizziness, mental confusion, hallucinations, CNS stimulation, paraesthesias, and convulsions. 

Psychotomimetic drags can be defined as chemical agents that reliably and dose-dependently induce a psychosis, often including hallucinations and delusions in normal individuals. Implicit in this term is a mimicking of naturally occulting psychosis. 

The atypical antipsychotics are the preferred agents for the treatment of psychosis (hallucinations, delusions, and suspiciousness) and the disruptive behaviors (agitation and... 

A casualty with known exposure to carbon monoxide blood agents, who was initially unconscious but has regained consciousness or a casualty who shows neurological abnormalities such as dizziness, confusion, or hallucinations, has cardiac arrhythmias, bronchospasm or complains of severe headache, difficulty in breathing or chest pain. If available, breath measurement indicates that the blood carbon monoxide level exceeds 20%. 

Other examples cited by Goodman include the poisoning of 200 French soldiers by Chinese reformers in Hanoi on 27 June 1908, all of whom recovered. One of the intoxicated soldiers saw ants on his bed, a second fled to a tree to escape from a hallucinated tiger and a third took aim at birds in the sky. Another incident was the abortive attempt by Soviet agents in 1959 to poison the staff of Radio Free Europe in Munich by putting atropine in saltshakers in the cafeteria. A double agent foiled this effort. 

Central Motor restlessness, progressing to maniacal agitation, psychic disturbances, disorientation, and hallucinations. Elderly subjects are more sensitive to such central effects, in this context, the diversity of drugs producing atropine-like side effects should be borne in mind e.g., tricyclic antidepressants, neuroleptics, antihistamines, antiarrhythmics, antiparkinsonian agents. 

Bromocriptine (Parl el) [Antiparkinsonian Agent/Dopamine Receptor Agonist] Uses Parkin on Dz, hyperprolactinemia, acromegaly, pituitary tumors Action Direct-acting on the striatal dopamine receptors X prolactin secretion Dose Initial, 1.25 mg PO bid titrate to effect, w/ food Caution [B, ] Contra Severe ischemic heart Dz or PVD Disp Tabs, caps SE X BP, Raynaud phenomenon (vasospastic disorder resulting in discoloration of the fmgers/toes), dizziness, N, hallucinations Interactions T Effects W/ erythromycin, fluvoxamine, nefazodone, sympathomimetics, antihypertensives X effects W/ phenothiazines, antipsychotics EMS Monitor BP may cause intolerance to EtOH OD May cause NA, severe hypotension give IV fluids symptomatic and supportive... 

Memantine (Namenda) [Anti Alzheimer Agent/NMDA Receptor Antagonist] Uses Mod/ evere Alzheimer Dz Action N-methyl-D-aspartate recqjtor antagonist Dose Target 20 mg/d, start 5 mg/d, t 5 mg/d to 20 mg/d, wait >1 wk before t dose use doses if >5mg/d Caution [B, /-] Hqjatic/mild-mod renal impair Disp Tabs, sol SE Dizziness Interactions t Effects W amantadine, carbonic anhydrase inhibitors, dextromethorphan, ketamine, Na bicarbonate t effects W/ any drug, herb, food that alkalinizes urine EMS Use NaHCOs w/ caution OD May cause restlessness, hallucinations, drowsiness, and fainting symptomatic and supportive... 

The withdrawal syndrome from ethanol includes anxiety, insomnia, possibly convulsions and visual hallucinations (delirium tremens - the Dts). It is treated or better still prevented by a calm environment, adequate (but not excessive) hydration, and careful monitoring, with the added use of anticon-vulsive/sedative agents, mainly benzodiazepines to prevent or treat convulsions. The preventive effects of benzodiazepines on withdrawal morbidity has been clearly demonstrated. There do not seem to be major differences between benzodiazepines, such as chlordiazepoxide or diazepam or others. Because of the abuse potential in these highly susceptible patients, these should be rapidly weaned, and proper prevention of relapse instituted. Other drugs such as meprobamate and clomethiazole (Hemineurin) are commonly used in some countries. The effectiveness... 

Tricyclic antidepressants are cardiotoxic, inducing tachycardias and an increased tendency for ventricular arrhythmias with high doses. This dose dependent cardiotoxicity gives these agents a low therapeutic index. Overdoses are characterized by cardiac conduction disturbances, hyperpyrexia, hypertension, confusion, hallucinations, seizures and coma and there is a high mortality rate in suicide attempts. Depressed patients should therefore not be given more than one week supply of these drugs. 

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