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Some structure activity relationships of phencyclidine derivatives as anticholinergic agents in vitro and in vivo.

Phencylidine derivatives exhibit multiple interactions with cholinergic systems: they block nicotinic and muscarinic receptors,and inhibit both acetyl and butyrylcholinesterase. In peripheral tissue, the net pharmacological effects of the phencyclidines is antiacetylcholine activity. The dissociation constants measured in isolated smooth muscle and from competition experiments for the muscarinic high-affinity binding sites in brain homogenates (Kd = 10(-5) - 10(-6) M) are 3--4 orders of magnitude lower than those of anticholinergic glycolate esters. However, phencyclidines have comparable potency to that of d-tubocurarine in blocking the nicotinic receptor in the isolated frog rectus abdominis (Kd = 10(-6) M). Brain uptake experiments of (3H) labeled phencyclidine showed that during the time period in which central effects are observed with these drugs their concentration in brain reaches values close to the Kd (10(-5) - 10(-6) M). This finding, and the cross tolerance observed in vivo between phencyclidine and other centrally acting cholinergic drugs supports the possible involvement of cholinergic interactions in the psychotropic action of phenyclidine derivatives. Quantum chemical calculations of the interaction pharmacophores of drugs in the phencyclidine series have indicated the molecular determinants for the interaction of these drugs with the muscarinic receptor. The calculations revealed that these drugs can match the reactivity characteristics of ACh and the semi-rigid muscarinic agonist 3-acetoxyquinuclidine, but their rigid molecular frame will be conductive to antagonistic rather than agonistic activity when the drug-receptor complex is formed. The identification of a "cholinergic interaction pharmacophore" for these drugs by quantum mechanical calculations made possible the suggestion of other active phencyclidine derivatives, e.g. p-NH2 and p-OH analogs which proved to be equipotent to phencyclidine. The inactivity of the p-NO2 derivative was also predicted on this basis and served as an additional confirmation of the theoretical criterion for activity; the difference between the activities of the ethynyl and cyano derivatives was explained by the modification of the cholinergic interaction pharmacophore. On the basis of these theoretical predictions, electrophysiological studies were carried out by the others and the results prompted the suggestion that "physostigmine is of potential value in the treatment of post-operative patients emerging from ketamine anesthesia and in the treatment of phencyclidine overdosed patients".

Animals

Plasma phencyclidine pharmacokinetics in dog and monkey using a gas chromatography selected ion monitoring assay.

Phencyclidine was determined by gas chromatography selected ion monitoring in six dogs and seven monkeys. Aliquots of venous blood were taken over 4 h in the monkey after 1.1 mg kg-1 and over 24 h in the dog after 1.0 mg kg-1 of phencyclidine i.v. Pentadeuterated phencyclidine was used as the internal standard. In the electron impact mode the most abundant fragments in the mass spectrum of phencyclidine were m/e 91 and 200, and 96 and 205 in the [2H5]phencyclidine spectrum. These fragments were used to quantitate the amount of phencyclidine present. In both species, a complex exponential decline of plasma phencyclidine was found in most animals that fit a two compartment open model. In monkeys, the mean half-life (beta phase) was 2.36 h and in the dog it was 2.86 h. Compared with the monkey, the dog considerable emergence delirium. The two species had rather different pharmacokinetics which may be relevant to the observed differences in degree of anesthesia and recovery.

Animals

Interaction of phencyclidine ("angel dust") with a specific receptor in rat brain membranes.

[3H]Phencyclidine binds to synaptic membranes from rat brain in a saturable, reversible, and selective fashion, with a dissociation constant Kd of 0.25 microM and a maximal binding capacity of 2.4 pmol/mg of membrane protein--i.e., 250 pmol/g of brain. The binding activity is concentrated in synaptosomal fractions, is higher in cerebral cortex and corpus striatum than in other parts of the rat brain, and is not detectable in the spinal cord. Only molecules of the phencyclidine series and ketamine are able to bind to the phencyclidine receptor. [3H]Phencyclidine bound to its receptor is not displaced by the classical neurotransmitters or neuromodulators. There is a good correlation between the apparent affinities of a series of phencyclidine analogs for the phencyclidine receptor and the pharacological activities of these analogs as measured by the rotarod assay.

Animals

Phencyclidine abuse. Clinical findings and concentrations in biological fluids after nonfatal intoxication.

Phencyclidine concentrations were measured in the plasmas of 22 patients with nonfatal phencyclidine intoxication using gas-liquid chromatography with a nitrogen detector. Concentrations found ranged from less than 10 to 812 micrograms/l, and except for the systolic blood pressure (r = 0.60, P less than 0.05), showed no significant correlation with the physical findings. The most common physical findings were combativeness-agitation (64%), depressed level of consciousness (50%), hypertension (43%), moiosis (43%), and tachycardia (43%). Phencyclidine concentrations measured in the erythrocytes of seven of the patients were generally higher than concentrations in the corresponding plasmas (erythrocyte:plasma concentration ratios ranged from 3.1 to 37.9), suggesting that the binding of phencyclidine to plasma proteins is low. Erythrocytic concentrations also showed no significant correlation with either the physical findings or the plasma concentrations of phencyclidine. For 15 unselected urines the concentrations of phencyclidine showed no significant correlation with urinary pH.

Adolescent

Phencyclidine use among youth: history, epidemiology, and acute and chronic intoxication.

Phencyclidine use appears to be in a growth phase nationally. Factors contributing to the increasing popularity include the user's ability to control the dosage, an understanding of the immediate effects, and its availability. Those most at risk appear to be young Caucasian males. Phencyclidine-related problems are often like tips of icebergs, the underlying causes of which are hidden from public view. The problems often surface in the form of speech difficulties, memory loss, thinking disorders, personality changes, paranoia, severe depression, violence, accidents, suicides and homicides. Of particular concern to law enforcement personnel is the upsurge in phencyclidine-related violent crimes and carrying of weapons by users to protect themselves from their imagined persecutors. The evidence currently available supports the assumption that if there is a solution to the problem of phencyclidine abuse, that solution is prevention. Therefore, medical personnel and others within the helping professions must be alerted to the fact that phencyclidine is not just another drug problem. The findings from users we have already studied strongly suggest that phencyclidine is not an "upper" or a "downer," but perhaps an "insideouter", with longer term implications.

Adolescent

Transplacental disposition of phencyclidine in the pig.

1. Phencyclidine concn in plasma of pregnant and non-pregnant sows and in umbilical cord and neonatal plasma was determined by g.l.c. after a single intramuscular dose of phencyclidine hydrochloride. 2. The rate of elimination of the drug, as determined from plasma phencyclidine concn, was unchanged by pregnancy. 3. Phencyclidine concn in piglet plasma was approx. 10-fold higher than in maternal sow plasma and declined more slowly (t 1/2 about 6 h) than the concn. in adult sows (t 1/2 about 2 h). 4. Studies of phencyclidine uptake by piglet and sow plasma in vitro indicate that the higher concns in piglet plasma are due to a marked affinity of piglet plasma proteins for the drug, although both total protein and albumin concn is lower than in sow plasma.

Aging

Phencyclidine-associated acute rhabdomyolysis.

Phencyclidine (PCP) is a dissociative veterinary anesthetic and tranquilizer that at present is being abused as a psychedelic and hallucinogenic agent with increasing frequency. The cases of two young patients suffering from phencyclidine toxicity are reported. In each, central nervous system depression was accompanied by an acute dystonic motor reaction resulting in acute rhabdomyolysis and myoglobinuria. Skeletal muscle injury was felt to be the result of excessive involuntary isometrimc motor activity rather than a direct effect of phencyclidine on skeletal muscle. Patients suffering from phencyclidine intoxication should be screened for acute rhabdomyolysis. Phencyclidine intoxication should be included in the differential of nontraumatic rhabdomyolysis and should be considered among the potential causes of acute myoglobinuric renal failure.

Acute Disease

The effects of phencyclidine on amphetamine stereotypy in rats.

In two separate experiments a 9 point rating scale was used to assess the effects of various doses of phencyclidine on the behavioral stereotypy produced by d-amphetamine in rats. A dose of phencyclidine (2.5 mg/kg) which had no effect when given alone, enhanced the behavioral effects of 1 and 3 mg/kg of d-amphetamine. Higher dises (5 and 10 mg/kg) of phencyclidine produced some stereotypy when given alone but they also produced ataxia which confounded the rating of their other behavioral effects. These higher doses did not enhance the effects of d-amphetamine. This study provides further evidence that phencyclidine may have dopaminergic activity similar to amphetamine.

Animals

Phencyclidine deaths.

The potential for a pharmacologic "overdose" and the cause of death associated with phencyclidine abuse is discussed. Nineteen deaths associated exclusively with phencyclidine intoxication have been documented. In 13 cases the immediate cause of death was asphyxia by drowning or trauma with lower levels of phencyclidine present suggesting behavioral toxicity. In two cases, the presence of phencyclidine in high concentrations constituted the only finding, and the probable cause of death was primary respiratory depression accompanied by seizure activity. A secondary drug effect or concurrent disease process may have contributed to the death of the remaining four individuals.

Adolescent

On the interaction of drugs with the cholinergic nervous system. II. Cross-tolerance between phencyclidine derivatives and cholinergic drugs.

A symmetrical cross-tolerance was found between two phencyclidine derivatives--phencyclidine and cyclohexamine--and also between two cholinergic drugs--physostigmine and oxotremorine. On the other hand, mice rendered tolerant to the phencyclidine derivatives showed cross-tolerance to these cholinergic drugs, but no cross-tolerance was observed in the opposite direction. The applicability of such experiments to the elucidation of neurochemical interactions of centrally acting drugs is discussed.

Animals

The chemical restraint of apes and monkeys by means of phencyclidine or ketamine.

The anesthetic effects of two drugs, namely, Phencyclidine and Ketamine, used alone or in combination with atropine, were compared during clinical and experimental procedures on different primate species ranging from gorillas, orangutans, white-faced and dwarf chimpanzees, baboons, cercopithecus monkeys to new--world monkeys. It is concluded that both these anesthetics are very good and safe drugs for restraint and anesthesia. Ketamine appeared to be superior to Phencyclidine for use among apes and monkeys in so far as it is shorter acting, has wider safety margin and shorter recovery time, provides better muscle relaxation and is practically without side effects. But Phencyclidine has definite advantage in so far as it is needed is smaller quantity to produce comparable effect of anesthesia.

Animals

Phencyclidine-related deaths in Los Angeles County, 1976.

Concentrations of phencyclidine in blood and liver are presented in five fatal cases occurring in Los Angeles County in 1976. Eleven other deaths in which phencyclidine contributed to death are described; acute psychotic reactions were observed in some of these cases. Two cases involved the drowning of individuals whose swimming capabilities may have been diminished from the effects of PCP. One case is presented in which a 20-year-old male took a massive overdose of phencyclidine for suicidal purposes.

Accidents

Anaesthesia for studies of the cerebral circulation: a comparison of phencyclidine and althesin in the baboon.

The effects of phencyclidine on cerebral blood flow, cerebral metabolic rate for oxygen and carbon dioxide reactivity were compared with those of Althesin in six baboons. Under similar and stable levels (Stage 1) of electroencephalographic activity cerebral blood flow and the cerebral metabolic rate for oxygen were significantly less during the infusion of Althesin when compared with the values obtained during the infusion of phencyclidine. Reactivity to carbon dioxide was present and similar during the infusion of either drug.

Alfaxalone Alfadolone Mixture

Phencyclidine-induced psychosis.

During a 13-month period, 9 patients with phencyclidine-induced psychosis were admitted to Darnall Army Hospital. They exhibited hostility agitation, and tangentiality and had delusions of influence and religious grandiosity. Six subjects reported auditory hallucinations, and 4 were disoriented in at least 1 sphere. Despite treatment with antipsychotic medication, the psychotic episodes often persisted for more than 30 days. Our clinical finding of prolonged psychotic reactions, together with previous reports of the effects of phencyclidine, suggests that phenycyclidine provides an intriguing drug model for schizophrenia.

Adolescent

Psychiatric sequelae of phencyclidine abuse.

Phencyclidine use has been noted to produce a psychosis of several week's duration in a small fraction of users. Descriptions of the premorbid personalities of those who became psychotic resemble descriptions of LSD and marijuana users who experienced prolonged psychiatric difficulty. In addition, the psychosis produced can often be recognized as a "hallucinogen" psychosis. Certain features of the phencyclidine psychosis, namely the neurologic abnormalities, dose-related severity of symptoms, and regularity of the length of illness, are not noted with other psychedelic drugs, leading to the conclusion that PCP psychosis is a drug effect rather than a brief functional psychosis precipitated by the disintegrating PCP experience. However, the infrequent occurrence of psychosis in the (apparently) large exposed population still suggests that this is a combination of drug effect and vulnerable, pathologic personality.

Adolescent

Phencyclidine sedation as a technique for handling rhesus monkeys: effects on LH, GH, and prolactin secretion.

Rhesus monkeys, sedated with phencyclidine hydrochloride (Sernylan), were quieted for prolonged periods of time, while maintaining somatic reflexes, muscle tone, and respiration. Brief daily periods of sedation did not interfere with the menstrual cycle. Prolonged sedation, however, interfered with the experimentally estrogen-induced LH surge, but not with the inhibitory action of estrogen on LH tonic secretion. Pulsatile release of LH, GH, and prolactin persisted even under prolonged sedation. The secretion of prolactin in response to the administration of TRH was increased in animals sedated with phencyclidine.

Animals

Phencyclidine use in delinquent males committed to a training school.

Delinquent males committed to a training school were interviewed to determine the extent and the effects of phencyclidine use. Nine of 109 (8%) drug using subjects knowingly had used phencyclidine in the past. These nine subjects were multiple drug abusers of other substances and had started taking drugs at an average age of 9.38 years which was significantly younger than non PCP users. Six of the nine PCP users had committed proven offenses against persons and in four cases violent actions were directly attributed to PCP use. Suicide attempts were made by five (55%) of the PCP users which was significantly more frequent than suicide attempts made by non PCP users.

Adolescent