Addictive Substances & their Intoxication/Withdrawal States Flashcards
Alcohol MOA?
Sedative: CNS depressant. Increase the activity of GABA (inhibitor NT).
Symptoms of alcohol intoxication? What is the treatment?
anxiolysis, ataxia, disinhibition, death, slurred speech, sedation/stupor, respiratory suppression, coma. Tx: ABCs +/- restraints.
Symptoms of alcohol withdrawal? What is the treatment?
delirium, seizures, hallucinations, inc HR/BP, tremor, death, agitation/insomnia, GI upset (withdrawal symptoms usually present 7-8 hours from decreasing blood alcohol levels). Tx: ABCs. Benzodiazepines in decreasing doses until vitals signs & sx normalize. AEDs as needed. Thiamine for nutrition.
How do sedatives (alcohol, benzodiazepines, barbiturates) interact with their receptor?
The receptor is GABA-A and the NT is Cl-. Cl- can move through the channel only when GABA is bound. Sedatives can bind this channel and increase the conductivity of Cl- if Gaba is also bound. This increases Cl- transmission.
Symptoms of benzodiazepine/barbiturate intoxication? What is the treatment?
anxiolysis, ataxia, disinhibition, death, slurred speech, sedation/stupor, respiratory suppression, coma. Tx: ABCs. Benzodiazepines in decreasing doses until vitals signs & sx normalize. Reverse benzodiazepine specifically intoxication with flumazenil.
Symptoms of benzodiazepine/barbiturate withdrawal? What is the treatment?
delirium, seizures, hallucinations, inc HR/BP, tremor, death, agitation/insomnia, GI upset. Tx: Benzodiazepines until vitals signs & sx normalize.
How do stimulants interact with their receptor?
Block DAT, reverse DAT, increase VMAT2. Net effect: Increased DA in the mesolimbic system –> increased CNS arousal & excitability.
Symptoms of stimulant (cocaine, caffeine, nicotine, amphetamines) intoxication? What is the treatment?
Irritability, hyperreflexia, insomnia, racing heart, elevated mood/esteem, psychosis, appetite loss, inc BP/temp, dilated pupils, cardiac arrest, seizure, vasospasm. Tx: ABCs, use meds to reverse specific symptoms. Antipsychotics to treat psychotic symptoms, Benzodiazepines to decrease agitation.
Symptoms of stimulant (cocaine, caffeine, nicotine) withdrawal? What is the treatment?
increased/decreased sleep, Fatigue, increased appetite, anhedonia, depression. Tx: ???
How do opiates interact with their receptors?
These affect the Mu, Delta, & Kappa receptors (GPCRs that cause hyperpolarization via cAMP, increased K+ & decreased Ca2+). Mu (OP3, MOP) reduces pain and increases positive emotions. Rx opiates are full agoinsts here. Kappa mildly reduces pain.
Symptoms of opiate intoxication? What is the treatment?
Gag reflex loss, Constipation, Low HR/BP, Respiratory suppression, Elevated mood, Pupil Constriction. Tx: ABCs, Naloxone can reverse, substitution of a long-acting opiod in decreasing doses to decrease w/drawal symptoms (see below).
Symptoms of opiate withdrawal? What is the treatment?
Dilated pupils, muscle cramps, goose flesh/flushing, yawning, watery eyes, incr. HR/BP, GI distress, GI cramps, runny nose/sneezing. Tx: Methadone (full agonist replacement) or Buprenorphine (partial agonist replacement)
Symptoms of hallucinogen intoxication? What is the treatment?
Perceptual distortion, paranoia, hallucinations, hyperreflexia, flashbacks, racing heart, nystagmus, tremors, depersonalization. Tx: Supportive. Benzodiazepines can decrease agitation and Antipsychotics can treat psychotic symptoms (mostly for LSD, PCP, Psilocybin, Mescaline).
Symptoms of hallucinogen withdrawal? What is the treatment?
Few, if any.
Symptoms of cannabis intoxication? What is the treatment?
Elevated mood, expansive thought, panic, paranoia, pupil constriction, sedation, increased appetite, tachy, red conjunctiva Tx: Supporting, calming the patien down.
