Cognitive Disorders, Subtance Related

Question 1

Intoxication: Dis-inhibition, emotional liability, slurred speech, ataxia, agression blackouts hallucinations, memory impairment, impaired judgement, coma. 1. Drug? 2. Withdrawal? 3. Rx?

Answer 1

1. Alcohol 2. Tremor, tachycardia, hypertension, malaise, nausea, seizures, DTs, agitation. 3. Benzo taper and Haloperidol for hallucinations and psychotic symptoms.

Question 2

Intoxication: Euphoria leading to apathy, CNS depression, constipation, pupillary constriction, respiratory depression. 1. Drug? 2. Withdrawal? 3. Rx for intoxication? 4. Rx for withdrawal?

Answer 2

1. Opiods. 2. Dysphoria, insomnia, anorexia, myalgias, fever, lacrimation, diaphoresis, dilated pupils, rhinorrhea, pilorection, nausea, vomiting, stomach cramps, diarrhea, yawning.
2. Naloxone/Naltrexone. 4. Clonidine.

Question 3

Intoxication: Psychomotor agitiation, impaired judgement, hypertension, pupillary dilation, tachy, fever, diaphoresis, anxiety, angina, euphoria, prolonged wakefulness/attention, arrhythmias, delusions, seizures, hallucinations. 1. Drug? 2. Withdrawal 3. Rx?

Answer 3

1. Amphetamines 2. Post use crash with anxiety, lethargy, headache, stomach cramps, hunger, fatigue, depression, dysphoria, sleep disturbance, nightmares. 3. Haloperidol for severe agitation.

Question 4

Psychomotor agitation, euphoria, impaired judgement, tachy, pupillary dilation, hypertension, paranoia, hallucinations, sudden death. ECG changes from ischemia. 1. Drug? 2. Withdrawal 3. Rx?

Answer 4

1. Cocaine 2. Postuse crash with hypersomnolence, depression, malaise, severe craving, angina, suicidality, increase appetite, nightmares, cocaine bugs. 3. Haloperidol for severe agitation.

Question 5

Intoxication: Assaultiveness, belligerence, psychosis, violence, impulsiveness, psychomotor agitation, fever, tachy, vertical/horizontal nystagmus, hypertension, impaired judgement, ataxia, seizures, delirum.1. Drug? 2. Rx?

Answer 5

1. PCP (Phencyclidine Hydrochloride) 2. Give Benzo or Haloperidol for severe symptoms. Acidification of urine and gastric lavage can help eliminate the drug.

Question 6

Intoxication: Marked anxiety or depression, delusions, visual hallucinations, flashbacks, pupillary dilation, impaired judgement, diaphoresis, tachy, hypertension, heightened sneses. 1. Drug? 2. Rx?

Answer 6

1. LSD 2. Supportive counseling, traditional antipsychotics for psychotic symptoms, benzos for anxiety.

Question 7

Intoxication: Euphoria, slowed sense of time, impaired judgement, social withdrawal, increase appetite, dry mouth, conjunctival injection, hallucinations, anxiety, paranoia, amotivational syndrome. 1. Drug?

Answer 7

Marijuanna

Question 8

Low safety marin, respiratory depression. 1. Drug? 2. Withdrawal?

Answer 8

1. Barbiturates 2. Anxiety, seizures, tremor, insomnia, hypertension, tachy, death.

Question 9

Intoxication: Restlessness, insomnia, diuresis, muscle twitching, arrhythmias, tachycardia, flushed face, psychomotor agitation. 1. Drug? 2. Withdrawal?

Answer 9

1. Caffeine 2. HA, lethargy, depression, weight gain, irritability, craving.

Question 10

Medication to help end heroin addiction?

Answer 10

Methadone.

Question 11

16 yr old with a long record of arrest found dead with paper bag over his head. For several months he had been experiencing HAs, tremors, muscle weakness, unsteady gaits and tingling sensations in his hands and feet. These symptoms suggest that he was addicted to which of the following substances? Dx?

Answer 11

An inhalant.

Question 12

Common side effect of MDMA?

Answer 12

Bruxism.

Question 13

Next step in management after you suspect NPH?

Answer 13

CT and LP.