CNS stimulants: Cocaine and nicotine

Question 1

Cocaine - signs of intoxication

Answer 1

Agitation, loquacity.
Altered tactile sensation (cocaine bugs), decreased fatigue, euphoria, grandiosity, hypervigilance, paranoia, aggressiveness.
Hyper/hypotension, tachycardia.
Chills, mydriasis, nausea, sweating, nystagmus, vomiting.

Question 2

Cocaine - treatment of intoxication

Answer 2

Lorazepam for agitation or seizures.

Support vital functions

Question 3

Cocaine - symptoms of withdrawal

Answer 3

Depression, drowsiness, dysphoria, fatigue, increased appetite, sleepiness.
Bradycardia.
Nightmares.

Question 4

Nicotine - symptoms of withdrawal

Answer 4

Anxiety, dysphoria, hostility, impatience, irritability, restlessness.
Decreased heart reate
Increased appetite.

Question 5

Cocaine - MOA

Answer 5

Inhibits neuronal reuptake of NE and DOP - increases synaptic concentrations.

Question 6

Cocaine - effect on respiration

Answer 6

High doses: Cheyne-Stokes respiration: irregulat breathing and apnea.

Question 7

Cocaine overdose

Answer 7

Tonic-clonic seizures, malignant encephalopathy, myocardial infarction.
Ventricular fibrillation, cardiac arrest.

Question 8

Management of cocaine withdrawal

Answer 8

Bromocriptine - reduce craving

Question 9

Nicotine - interactions

Answer 9

Accelerates metabolism of beta-blockers, benzodiazepines, opioids and theophylline.

Question 10

Nicotine - MOA

Answer 10

Activates nicotinic receptors in CNS and PNS.

Inhibits monoamine oxidase.

Question 11

Nicotine - signs of intoxication

Answer 11

Mild euphoria, increased arousal and concentration, improved memory, appetite suppression.