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phencyclidine; phenylcyclohexyl piperidine (Sernylan, PCP, angel dust)
Tradename: Sernylan.
Pharmacokinetics:
1) t1/2 of 7-46 hours, increased to 3 days with overdose
2) acidication of urine to pH < 5.0 accelerates renal excretion
Adverse effects:
1) dissociative effects
- delirium, amnesia, paranoia, dysphoria [2]
2) ataxia, numbness
3) slurred speech
4) nystagmus observed when patient is awake & agitated
5) increased sensitivity to stimuli
6) mood is dose-dependent & variable from euphoria to depression
7) agitation
8) autonomic manifestations
- may occur at low doses < 5 mg
- hypertension, tachycardia, tachypnea, salivation, diaphoresis [2]
- may differ at high doses (> 10 mg)
- bradycardia, bradypnea, nausea/vomiting, blurred vision, drooling, dizziness
9) schizophrenia-like symptoms
- delusions, hallucinations, anxiety, paranoia, violence
10) status asthmaticus
11) coma
12) long-term abuse may result in memory impairment, speech impairment, depression, & weight loss
13) addiction & withdrawal can occur after chronic abuse
- manifestations of craving & compulsive PCP-seeking behavior*
* is the true addiction? (can they get sick as in addiction to opiates & can they die as in addiction to alcohol?)
Laboratory:
1) specimen: serum, plasma (heparin, EDTA), urine
2) methods:
a) serum/plasma: GLC, MS, GC-MS, RIA
b) urine: TLC, EIA, FPIA, GC-MS
1] cutoff for urine assays is 25 ng/mL
2] detectable in urine for 2 weeks
3] testing mandated by SAMHSA for federal employees
3) labs with Loincs
- phencyclidine in specimen
- phencyclidine in hair
- phencyclidine in milk
- phencyclidine in saliva
- phencyclidine in gastric fluid
- phencyclidine in meconium
- phencyclidine in stool
- phencyclidine in blood
- phencyclidine in serum/plasma
- phencyclidine in urine
- phencyclidine in vitreous fluid
Mechanism of action:
1) lipophilic, basic amine
2) appears to effect all neurotransmitter systems
3) NMDA receptor antagonist
Management:
- benzodiazepine or antipsychotic to manage symptoms [4]
Interactions
drug adverse effects of psychotropic agents
Related
NMDA receptor
General
dissociative anesthetic
hallucinogen; psychodysleptic
NMDA receptor antagonist
piperidine
Properties
INHIBITS: NMDA receptor
MISC-INFO: elimination route LIVER
KIDNEY
1/2life 7-46 HOURS
toxic-range >90 NG/ML
500-4000 NG/ML
protein-binding 65-80%
Database Correlations
PUBCHEM cid=6648
References
- Clinical Guide to Laboratory Tests, 3rd edition, NW Tietz
ed, WB Saunders, Philadelphia, 1995
- Sinert RO
Fast Five Quiz: Psilocybin and Other Hallucinogenic Drugs.
Medscape. September 07, 2021
https://reference.medscape.com/viewarticle/957547
- Brenner S, Thornton SL
PCP Toxicity
Medscape. Jan 23, 2021
https://emedicine.medscape.com/article/1010821-overview#showall
- NEJM Knowledge+ Psychiatry