Page 434 - Veterinary Toxicology, Basic and Clinical Principles, 3rd Edition

Toxicity of Drugs of Abuse Chapter | 22 401

VetBooks.ir approximately 20% of the cost of cocaine and was that patients given supportive care recover within 24 h.
Atropine has not been found effective as a treatment in
nation’s fourth most popular drug, after marijuana, cocaine
humans (Deng et al., 2001).
and MDMA (Elwell, 2010). Mephedrone and MDPV are
sold in the United States as “bath salts” and “plant food”
under brand names such as “Ivory Snow,” “Red Dove,”
and “Vanilla Sky.”
HALLUCINOGENS AND DISSOCIATIVE
Mephedrone and MDPV are snorted or ingested. DRUGS
Clinical signs usually last a few hours, but can linger for
days (Elwell, 2010). Users report euphoria, increased The clinical effects of hallucinogenic and dissociative
energy, and talkativeness. Poison centers report agitation, drugs are unpredictable and dependent very much on the
confusion, tachycardia, hypertension, mydriasis, tremors, individual and his or her environment (Nichols, 2004).
fever, rhabdomyolysis, electrolyte abnormalities, renal Many compounds that alter consciousness have been
failure, seizures, psychosis, hypertension, and violent termed “hallucinogens,” though some, like marijuana and
behavior (Rech et al., 2015). Other reported adverse MDMA, only induce hallucinations under specific cir-
effects have included epistaxis, mydriasis, and cardiac cumstances or at very high doses. “Psychomimetic” is a
arrhythmias. Later, users experience fatigue, dizziness, term used to describe drugs that cause behavioral changes
and depression. mimicking psychosis, but this terminology is of limited
usefulness in veterinary medicine. “Psychedelic” is a term
commonly used by the media and translates from the
Betel quid Greek, more or less, as “mind revealing,” but again, this
Though not common in most areas of the United States, term is unlikely to be useful in veterinary medicine.
alkaloids of the areca nut are believed to be one of the Lysergic acid diethylamide (LSD), a synthetic product
most commonly used psychoactive substances in the similar to natural ergot alkaloids, is a common hallucino-
world after caffeine, ethanol, and nicotine. It is estimated gen that acts on serotonin receptors. Hallucinogens
that 10% 20% of the world’s population have access to with a similar mechanism of action include mescaline
“betel quid” containing these alkaloids, mostly in South and N,N-dimethyltryptamine (DMT), described below.
and Southeast Asia and the Asia Pacific regions. These Psilocybe spp. and related mushroom species contain the
products can also be purchased in US cities with large hallucinogen psilocybin. Vomiting was reported after
populations of Asian immigrants. Psilocybe spp. mushroom ingestion in a dog (Spoerk,
Palm trees of the genus Areca are cultivated in tropi- 2005). Behavioral changes in a horse suspected of ingest-
cal and subtropical areas of the world to produce betel ing Psilocybe spp. included fear and extreme aggression
quid (Deng et al., 2001). The nut of this palm tree may be with recovery in 48 h (Hyde, 1990). Symptoms of severe
ingested green, ripe, raw, baked, roasted, boiled, fermen- toxicosis in a colt included hyperexcitability, tremors,
ted, or processed with various sweeteners. It is most com- mydriasis, and bruxism. The colt was eventually eutha-
monly processed with leaves from the betel shrub, Piper nized because of traumatic injuries and weakness (Jones,
betle, and calcium hydroxide. Tobacco and various spices 1990). Symptoms of psilocybin in cats are similar to those
are sometimes added. The betel quid industry is worth described below with LSD (Jacobs et al., 1977). DMT is
hundreds of millions of dollars. Betel quid is produced produced by several plants including Psychotria viridis,
both regionally and under trade names such as Supari, used to produce a tea known as Ayahuasca in the tradi-
Mainpuri tobacco, mawa, pan masala and Gutka. Gutka is tional practices of the indigenous people of the Amazon,
illegal in some parts of India. Anadenanthera peregrina seeds, called yopo by native
Alkaloids present in areca nut include arecoline, people of the Amazon rain forest, and Phalaris spp. of
arecaidine, guvacine and guvacoline. These alkaloids bind grass, which grows around the world. 5-methoxy-N,
with muscarinic receptors, induce coronary vasospasms, N-dimethyltryptamine and/or N, N- (bufotenin) are seroto-
and have weak activity on nicotinic receptors in the nergic compounds produced in the parotid glands of
ganglia. various species of toads, along with bufodienolide glyco-
Oral submucosal fibrosis is a preneoplastic lesion sides, which are potent cardiac glycosides.
common in young people who use betel quid. Clinical Leaves of the plant Salvia divinorum are illegal to pos-
signs seen in inexperienced users and overdoses are more sess in some states of the United States and some
likely to be of interest to the veterinarian and include European countries. S. divinorum preparations are com-
mucosal irritation, nausea and vomiting, bronchoconstric- monly used to produce hallucinogenic effects, though by
tion, hypersalivation, lacrimation, urinary incontinence, a unique mechanism described below.
diarrhea, hypertension or hypotension, tachycardia, acute Dissociative anesthetics are so-called because they
myocardial infarction, and extrapyramidal symptoms. Most uncouple functions of the brain such as sensory/motor