118. Substance Use Disorder Flashcards
Opioid Intoxication Sx
- Resp depression
- Constipation, Dry mouth
- Euphoria, mood changes
- Sedation
- Miosis (constriction)
- Flushing
- Impaired reflexes
Opioid Withdrawal Sx
- High pulse rate
- GI upset (v/d)
- Sweating
- Tremor
- Restlessness
- Yawning
- Mydriasis
- Anxiety/irritability
- Myalgias, arthralgias
- Piloerection
- Rhinorrhea, tearing (fluids leaving body)
Mood/Sleep disturbances may occur for 6-8mo!
Stimulant Intoxication sx
Think MANIA
- Euphoria, irritability, anger, tension
- Anxiety
- Psychomotor agitation
- Energy, less need for sleep
- Increased Sympathetic ANS Tone (Tachycardia, Hypertension, Mydriasis, Diaphoresis)
- Chest Pain, Arrythmias
- Seizures
Stimulant Withdrawal Sx
Think DEPRESSION
- Depression, Dysphoria
- Appetite stimulation
- Fatigue
- Sedation
- Cravings
- Irritability
- SUICIDALITY
Alcohol Withdrawal
- mechanism of NTs after prolonged drinking
- mechanism of stopping drinking
Prolonged drinking (stim GABA, block Glu)
- downregulation of GABA receptors
- Upregulation of NMDA receptors
- Inhibition of Catecholamines
Stopping Drinking - brain cannot adapt
- Decreased GABA signaling
- Increased Glu transmission and signaling
- Increased catecholamine release, increased DA transmission
Stages of Alcohol Withdrawal
I. Autonomic Instability - minor withdrawal
- Peak 24-48hrs
- GI upset, anorexia, HA, diaphoresis, palpitations
(increased adrenergic transmission)
II. Seizures
- Peak 12-48 hours
(decreased GABA, increased NMDA)
III. Hallucinosis
- Peak 12-24 hours
- usually visual hallucinations
(increased DA transmission)
IV. Delirium Tremens
- perception change, disorientation, ANS changes, agitation, diaphoresis
- 3-5 days after last drink
- death due to arrhythmias, complicating illness (vomiting, bleeding, pneumonia) = CV/resp collapse (15% mortality untreated)
PCP Intoxication (Class, mechanism, SE)
PCP (antagonizes NMDA), LSD
- aggression, irritability
- ataxia, rigidity, tremor, seizures (neuromuscular)
- dysarthria
- nystagmus
- dissociation/psychosis
- increased autonomics (mydriasis, tachycardia, vomiting, sweating, catatonia)
MDMA Intoxication (class mechanism, SE)
Hallucinogen
Increased 5HT transmission (more released, blocked reuptake, blocked metabolism)
- nausea, bruxism, dry mouth, less appetite, restless, HA
- Serotonin Syndrome: clonus, hyperthermia, htn, delirium, muscle aches, seizures
- aggression, poor impulse control
Cannabinoid Intoxication sx
Change in psychomotor behavior Impaired short term memory Appetite stimulation analgesia Risk factor for Psychosis!!
Cannabinoid Withdrawal sx
depression, anxiety, irritability
fatigue, concentration deficits, n/v
Cannabinoid Hyperemesis Syndrome: Recurrent Nausea/Vomiting (5x/hour)
- dehydration, relief with hot showers, usually several years of daily use
