Addictive Substances and their Intox/Withdrawal States

Question 1

What’s up with the GABA-A receptor?

Answer 1

1. Can have activation through GABA, allowing CHLORIDE to enter neuron
2. Benzo can AMPLIFY response, but ONLY if GABA has been bound to the receptor!!
3. Alcohol is a GABA AGONIST!!

Question 2

Intoxication of EtOH and how to treat?

Answer 2

Not anxious, disinhibited (free floating), slurred speech, ataxia (not balanced), sedation/stupor (me on couch), respiratory suppression, coma, death;

Support, restrain, protect airway, ventilate!!!

Question 3

Withdrawal of EthOH and treat?

Answer 3

Agitated, insomnic (can’t sleep), TREMORS, GI upset, increased pulse, HR, BP, SEIZE, HALLUCINATIONS (things aren’t there), DELIRIUM tremens, DEATH (cardiovascular collapse); see symptoms 8 hours after withdrawal of EtOH;

Benzos until vital signs and withdrawal symptoms normalize

Question 4

Differences with intoxication/withdrawal of benzos and barbituates?

Answer 4

Intox: NO disinhibition; treat with flumazenil for BENZO (not usefull for EtOH or barbs)
Withdrawal: Just INCREASED HR, GI CRAMPS, hyperflexica

Question 5

Intoxication/withdrawal of stimulants, and treatment for intox?

Answer 5

Intox: elevated mood, esteem; irritability, insomnia, appetite loss, DILATED PUPILS, racing heart, increased BP and temp, hyperreflexia, psychosis, CARDIAC ARREST following vasospasm, seizure;
treat: supportive, and use meds like clonidine and trazodone to reverse specific intoxication symptoms

Withdrawal: Fatigue, anhedonia (inability to find joy/pleasure in activities you used to), depression, increased SLEEP, increased appetitie

Question 6

Opiates use what receptors and what will receptors help do? Chracteristics of said receptors? What do narcotic meds help do?

Answer 6

1. Mu, delta, kappa
2. Mu reduces pain, increases positive emotion; Kappa/delta allow mild analgesia
3. G-protein linked, cause neuronal hyperpolarization via cAMP reduction and increased K influx and decrease Ca efflux
4. Natural and synthetic, e.g. morphine and tramodol, that can activate Mu receptors to control pain and improve emotional state associated with pain

Question 7

Intox of opiates? Treat?

Answer 7

Intox: elevated mood, pupil CONSTRICTION, respiratory suppression, gag reflex loss, low HR and BP, constipated
Treat: supportive, protect airways and use HALOXONE

Question 8

Withdrawal issues with opiates? Treat?

Answer 8

W/drawal: restless, watery eyes, yawning, DILATED PUPILS, goose flesh/flushing (lack of ACh), runny nose, sneezing, increased HR and BP, GI distress and cramps, muscle cramps;
Treat: Methadone (full agonist replacement) or buprenorphine (partial agonist replacement)

Question 9

Hallucinogens are what? Treat? Intox?

Answer 9

1. PCP, LSD, mescaline, peyote, psilocybin
2. SUPPORTIVE
3. Perceptual distortion, hallucinations, depersonalization, NYSTAGMUS (PCP), tremors, hyperreflexia, racing heart, flashbacks, paranoia

Question 10

Cannibus intoxication?

Answer 10

Elevated mood, expansive thought, sedation, pupil CONSTRICTION, red conjunctiva, increased appetitie, panic, paranoia, increased HR, FORGETTING syndrome