Chapter 7 Pt 4 Flashcards
what is dextromethorphan
opioid common in COUGH SYRUP
what is a common cause of morbidity from street heroin use
infection secondary to needle sharing
what is seen in opioid intoxication
nausea vomiting sedation decreased pain perception decreased GI motility pupil CONSTRICTION constipation slurred speech respiratory depression (can be fatal)
opioids effects on what mediated addictive and rewarding properties
dopaminergic systems
what are the most commonly used opioids
prescription (not heroin)
MAOI and what opioid can cause serotonin syndrome (hyperthermia, confusion, muscular rigidity)
MEPERIDINE
what opioid is exception to opioids causing miosis
MEPERIDINE (demerol)
Demerol Dilated pupils
what is the classic triad of opioid overdose
Rebels Admire Morphine
Respiratory depression
Altered mental status
Miosis
what is treatment of choice for opioid overdose
naloxone
what is seen in opioid withdrawal
ANXIETY INSOMNIA ANOREXIA PILOERECTION RHINORRHEA N/V/F DILATED pupils YAWNIGN abdominal cramps dysphoria insomnia lacrimation weakness sweating arthralgia/myalgia
how does naltrexone work
competitive opioid antagonist
precipitates withdrawal if used w.in 7 days of heroin
eating large amounts of what can cause a positive UDS for opioids
poppy bengals or muffins
what is methadone
long-acting ovoid receptor agonist
administered 1x/day
significantly REDUCES MORBIDITY and MORTALITY in opioid dependent persons
causes QTc PROLONGATION
what is “GOLD-STANDARD” treatment in pregnant opioid dependent women
methadone
what is buprenorphine
partial opioid receptor agonist
sublingual prep that is SAFER THAN METHADONE
what are some hallucinogenic drugs of abuse
psilocybin (mushrooms)
mescaline (peyote)
LSD
do not cause physical dependence or withdrawal
can rarely develop psychological dependence
what is an LSD flashback
a recurrence of symptoms mimicking prior LSD trip that concurs spontaneously and lasts for minutes to hours
what is seen in hallucinogen intoxication
illusions, hallucinations, body image distortion, synesthesia labile affect dilated pupils tachycardia hypertension hyperthermia tremors incoordination sweating palpitations
how long does hallucinogen intoxication last
6-12 hours usually but can be days
may have “bad trip” that consisted of marked anxiety, panic, and psychotic symptoms (paranoia, hallucinations)
how is hallucinogen intoxication treated
monitor for dangerous behavior and reassure patient
use BENZOS first-line for agitation
what is the most commonly used illicit substance the world
cannabis
active ingredient is THC (tetrahydrocannabinol)
what do cannabinoid receptors in the brain do
inhibit adenylate cyclase
what is dronabinol
pill form of THC that is FDA-approved for certain indications
what is seen in marijuana intoxication
euphoria anxiety impaired motor coordination perceptual disturbances (slowed time) mild tachycardia anxiety CONJUNCTIVAL INJECTION dry mouth increased appetite
chronic marijuana use can cause what
respiratory problems (asthma, chronic bronchitis)
suppression of immune system
cancer
possible effects on reproductive hormones
what is treatment for marijuana intox
supportive, psychical intercentions
what are withdrawal symptoms of marijuana
irritabiliy anxiety resltessness aggression strange dreams depression headaches sweating chills insomnia decreased appetite
what is treatment of marijuana withdrawal
supportive and symptomatic
