Comprehensive Pharmacology and
Toxicology Review: Mechanisms,
Symptoms, Treatments, and Side Effects
of Stimulants, Hallucinogens,
Antidepressants, and Endocrine Drugs
for Exam Mastery Questions Provided
with A+ Graded Rationales Latest
Updated 2026
MOA and sx of Cocaine intoxication?
Blocks DA, NE, 5HT reuptake. Pupillary dilation, hallucinations (including tactile such as bugs)
"cocaine crawlies", paranoid ideations, angina, sudden cardiac death. Chronic use may lead to
perforated nasal septum due to vasoconstriction and resulting ischemic necrosis.
MOA and sx of Cocaine intoxication?
Blocks DA, NE, 5HT reuptake. Pupillary dilation, hallucinations (including tactile such as bugs)
"cocaine crawlies", paranoid ideations, angina, sudden cardiac death. Chronic use may lead to
perforated nasal septum due to vasoconstriction and resulting ischemic necrosis.
Tx for Cocaine intoxication?
α -blockers (Phenoxybenzamine, Phentolamine),
benzodiazepines. β -blockers not recommended.
Tx for Cocaine intoxication?
α -blockers (Phenoxybenzamine, Phentolamine),
benzodiazepines. β -blockers not recommended.
Sx of MDMA intoxication?
AKA Ecstasy. "Club drug" Sx of social closeness, distorted sensory and time perception, teeth
clenching. Life threatening effects include HTN, tachycardia, hyperthermia, hyponatremia (due
to increased fluid intake or ADH secretion), serotonin syndrome.
Sx of MDMA intoxication?
1|Page
,AKA Ecstasy. "Club drug" Sx of social closeness, distorted sensory and time perception, teeth
clenching. Life threatening effects include HTN, tachycardia, hyperthermia, hyponatremia (due
to increased fluid intake or ADH secretion), serotonin syndrome.
What drugs are considered Hallucinogens?
PCP, LSD, Marijuana
What drugs are considered Hallucinogens?
PCP, LSD, Marijuana
Sx of Marijuana (cannabinoid) intoxication?
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social
withdrawal, increased appetite "munchies", dry mouth, conjunctival injection, hallucinations.
Sx of Marijuana (cannabinoid) intoxication?
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social
withdrawal, increased appetite "munchies", dry mouth, conjunctival injection, hallucinations.
MOA and sx of Phencyclidine (PCP) intoxication?
Violence, impulsivity, psychomotor agitation, nystagmus,
tachycardia, hypertension, analgesia, psychosis, delirium, seizures. Trauma is most common
complication.
MOA and sx of Phencyclidine (PCP) intoxication?
Violence, impulsivity, psychomotor agitation, nystagmus,
tachycardia, hypertension, analgesia, psychosis, delirium, seizures. Trauma is most common
complication.
MOA and sx of Lysergic acid diethylamide (LSD) intoxication?
Action at 5-HT receptor. Visual hallucinations and
synesthesias (e.g., seeing sound as color), pupillary dilation, anxiety, paranoia, psychosis,
possible flashbacks.
MOA and sx of Lysergic acid diethylamide (LSD) intoxication?
Action at 5-HT receptor. Visual hallucinations and
synesthesias (e.g., seeing sound as color), pupillary dilation, anxiety, paranoia, psychosis,
possible flashbacks.
What is the typical presentation of Inhalant intoxication?
2|Page
,Young adult or teenager; Rapid onset belligerence, assaultiveness, apathy, impaired judgement,
blurred vision, coma. Resolution of sx can be just as rapid.
What is the typical presentation of Inhalant intoxication?
Young adult or teenager; Rapid onset belligerence, assaultiveness, apathy, impaired judgement,
blurred vision, coma. Resolution of sx can be just as rapid.
MOA of Selective Serotonin reuptake inhibitors (SSRIs)
Inhibit serotonin (5-HT reuptake). Takes 2-4 wks to have an effect. Wait 6 weeks before
switching.
MOA of Selective Serotonin reuptake inhibitors (SSRIs)
Inhibit serotonin (5-HT reuptake). Takes 2-4 wks to have an effect. Wait 6 weeks before
switching.
What are the SSRIs
Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Escitalopram, Citalopram
What are the SSRIs
Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Escitalopram, Citalopram
S/E of SSRIs
Sexual dysfunction (anorgasmia, decreased libido), nausea,
S/E of SSRIs
Sexual dysfunction (anorgasmia, decreased libido), nausea,
MOA of SNRIs
Inhibit Serotonin (5-HT) and NE reuptake
MOA of SNRIs
Inhibit Serotonin (5-HT) and NE reuptake
What are the SNRIs
Venlafaxine, Desvenlafaxine, Duloxetine, Levomilnacipran, Milnacipran
What are the SNRIs
Venlafaxine, Desvenlafaxine, Duloxetine, Levomilnacipran, Milnacipran
3|Page
, S/E of SNRIs
BP
S/E of SNRIs
BP
What is Serotonin Syndrome
"Neuromuscular hyperactivity (clonus, hyperreflexia, hypertonia, tremor, seizure),
What is Serotonin Syndrome
"Neuromuscular hyperactivity (clonus, hyperreflexia, hypertonia, tremor, seizure),
Autonomic stimulation (hyperthermia, diaphoresis, diarrhea)
Autonomic stimulation (hyperthermia, diaphoresis, diarrhea)
Agitation
Agitation
Treatment: benzodiazepine to calm patient or cyproheptadine as antidote (5-HT2 receptor
antagonist)."
Treatment: benzodiazepine to calm patient or cyproheptadine as antidote (5-HT2 receptor
antagonist)."
MOA of Tricyclic antidepressants (TCAs)
Inhibit NE and Serotonin (5-HT) reuptake
MOA of Tricyclic antidepressants (TCAs)
Inhibit NE and Serotonin (5-HT) reuptake
What are the TCAs
Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
What are the TCAs
Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
Which TCA can be used to treat OCD
Clomipramine
Which TCA can be used to treat OCD
4|Page
Toxicology Review: Mechanisms,
Symptoms, Treatments, and Side Effects
of Stimulants, Hallucinogens,
Antidepressants, and Endocrine Drugs
for Exam Mastery Questions Provided
with A+ Graded Rationales Latest
Updated 2026
MOA and sx of Cocaine intoxication?
Blocks DA, NE, 5HT reuptake. Pupillary dilation, hallucinations (including tactile such as bugs)
"cocaine crawlies", paranoid ideations, angina, sudden cardiac death. Chronic use may lead to
perforated nasal septum due to vasoconstriction and resulting ischemic necrosis.
MOA and sx of Cocaine intoxication?
Blocks DA, NE, 5HT reuptake. Pupillary dilation, hallucinations (including tactile such as bugs)
"cocaine crawlies", paranoid ideations, angina, sudden cardiac death. Chronic use may lead to
perforated nasal septum due to vasoconstriction and resulting ischemic necrosis.
Tx for Cocaine intoxication?
α -blockers (Phenoxybenzamine, Phentolamine),
benzodiazepines. β -blockers not recommended.
Tx for Cocaine intoxication?
α -blockers (Phenoxybenzamine, Phentolamine),
benzodiazepines. β -blockers not recommended.
Sx of MDMA intoxication?
AKA Ecstasy. "Club drug" Sx of social closeness, distorted sensory and time perception, teeth
clenching. Life threatening effects include HTN, tachycardia, hyperthermia, hyponatremia (due
to increased fluid intake or ADH secretion), serotonin syndrome.
Sx of MDMA intoxication?
1|Page
,AKA Ecstasy. "Club drug" Sx of social closeness, distorted sensory and time perception, teeth
clenching. Life threatening effects include HTN, tachycardia, hyperthermia, hyponatremia (due
to increased fluid intake or ADH secretion), serotonin syndrome.
What drugs are considered Hallucinogens?
PCP, LSD, Marijuana
What drugs are considered Hallucinogens?
PCP, LSD, Marijuana
Sx of Marijuana (cannabinoid) intoxication?
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social
withdrawal, increased appetite "munchies", dry mouth, conjunctival injection, hallucinations.
Sx of Marijuana (cannabinoid) intoxication?
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social
withdrawal, increased appetite "munchies", dry mouth, conjunctival injection, hallucinations.
MOA and sx of Phencyclidine (PCP) intoxication?
Violence, impulsivity, psychomotor agitation, nystagmus,
tachycardia, hypertension, analgesia, psychosis, delirium, seizures. Trauma is most common
complication.
MOA and sx of Phencyclidine (PCP) intoxication?
Violence, impulsivity, psychomotor agitation, nystagmus,
tachycardia, hypertension, analgesia, psychosis, delirium, seizures. Trauma is most common
complication.
MOA and sx of Lysergic acid diethylamide (LSD) intoxication?
Action at 5-HT receptor. Visual hallucinations and
synesthesias (e.g., seeing sound as color), pupillary dilation, anxiety, paranoia, psychosis,
possible flashbacks.
MOA and sx of Lysergic acid diethylamide (LSD) intoxication?
Action at 5-HT receptor. Visual hallucinations and
synesthesias (e.g., seeing sound as color), pupillary dilation, anxiety, paranoia, psychosis,
possible flashbacks.
What is the typical presentation of Inhalant intoxication?
2|Page
,Young adult or teenager; Rapid onset belligerence, assaultiveness, apathy, impaired judgement,
blurred vision, coma. Resolution of sx can be just as rapid.
What is the typical presentation of Inhalant intoxication?
Young adult or teenager; Rapid onset belligerence, assaultiveness, apathy, impaired judgement,
blurred vision, coma. Resolution of sx can be just as rapid.
MOA of Selective Serotonin reuptake inhibitors (SSRIs)
Inhibit serotonin (5-HT reuptake). Takes 2-4 wks to have an effect. Wait 6 weeks before
switching.
MOA of Selective Serotonin reuptake inhibitors (SSRIs)
Inhibit serotonin (5-HT reuptake). Takes 2-4 wks to have an effect. Wait 6 weeks before
switching.
What are the SSRIs
Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Escitalopram, Citalopram
What are the SSRIs
Fluoxetine, Fluvoxamine, Paroxetine, Sertraline, Escitalopram, Citalopram
S/E of SSRIs
Sexual dysfunction (anorgasmia, decreased libido), nausea,
S/E of SSRIs
Sexual dysfunction (anorgasmia, decreased libido), nausea,
MOA of SNRIs
Inhibit Serotonin (5-HT) and NE reuptake
MOA of SNRIs
Inhibit Serotonin (5-HT) and NE reuptake
What are the SNRIs
Venlafaxine, Desvenlafaxine, Duloxetine, Levomilnacipran, Milnacipran
What are the SNRIs
Venlafaxine, Desvenlafaxine, Duloxetine, Levomilnacipran, Milnacipran
3|Page
, S/E of SNRIs
BP
S/E of SNRIs
BP
What is Serotonin Syndrome
"Neuromuscular hyperactivity (clonus, hyperreflexia, hypertonia, tremor, seizure),
What is Serotonin Syndrome
"Neuromuscular hyperactivity (clonus, hyperreflexia, hypertonia, tremor, seizure),
Autonomic stimulation (hyperthermia, diaphoresis, diarrhea)
Autonomic stimulation (hyperthermia, diaphoresis, diarrhea)
Agitation
Agitation
Treatment: benzodiazepine to calm patient or cyproheptadine as antidote (5-HT2 receptor
antagonist)."
Treatment: benzodiazepine to calm patient or cyproheptadine as antidote (5-HT2 receptor
antagonist)."
MOA of Tricyclic antidepressants (TCAs)
Inhibit NE and Serotonin (5-HT) reuptake
MOA of Tricyclic antidepressants (TCAs)
Inhibit NE and Serotonin (5-HT) reuptake
What are the TCAs
Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
What are the TCAs
Amitriptyline, nortriptyline, imipramine, desipramine, clomipramine, doxepin, amoxapine
Which TCA can be used to treat OCD
Clomipramine
Which TCA can be used to treat OCD
4|Page
