Drugs of Abuse Flashcards
What mixture of cocaine and another common substance increases your risk of death? What does it make? What are three effects?
Ethanol
Makes Cocaethlyne
Potentiates effect and duration of cocaine
25x increased risk of cardiac death
What are two pathophysiologic mechanisms of meth mouth?
Xerostomia
Maxillary artery vasospasm
The average body packer has this many packets in their system?
Bonus: what is max seen
50-100
Max seen is 500
Packers will often know the exact number for delivery to be complete
Packs can contain 1-10 grams, and one package leak can be lethal
What is divine mint?
Hallucinogen - Salvia divinorum
Opioid receptor – euphoria
30 min to 2 hours
Supportive care
Which clinical exam finding correlates with psilocybin? What is a common complication? What should you be wary about with a known ingestion?
The degree of mydriasis Heat resistant Common complication is panic reaction Beware of other mushroom types Could also be a normal mushroom with PCP or LSD
What plant has both opioid and stimulant properties
Kratom
Native to SE asia – teas or eat leaves
Ataxia, euphoria
Can have co ingestions
What opioid contaminate can lead to naloxone-resistant overdoses?
Bonus: what % of opioid ingestions contained other drugs?
Etizolam (Benzo)
75% of the sample contained other drugs
What morphine derivative is 10x more potent and contains corrosive by products?
Krokodil
Desomorphine/codeine
Causes rash looks like the scale of a crocodile
Common in eastern Europe, Russia, Florida (classic)
What are three possible toxic exposures from being in a meth lab?
White phosphorus
Phosphine gas
Anhydrous ammonia
What are three mechanisms of cocaine related MI?
Increased O2 demand
Coronary artery vasospasm
Coronary artery thombus
What class of hallucinogens cause hypoNa and SS?
Entactogens
(amphetamines, mescaline/peyote, nutmeg)
Vomiting, hallucinations
SIADH
What drug mixed with K2 and Spice leads to bleeding?
Superwarfarin (rat posion)
What percentage of asymptomatic packers have a positive drug screen?
50-70%
External contamination/ micro perforation
Often taken opioid to slow bowel mobility during transport
Less likely to use substance than packer
What is a complication of edibles in peds? How long can it last?
CNS or respiratory depression
24-48 hours
What is spice/K2/ Mr Nice Guy?
Synthetic cannabinoid receptor antagonists
Sometimes put on leaves (think co-ingestion)
Two most common complications of levthimisole?
Agranulocytosis and ANCA positive vasculitis
10% of cocaine
7 features are reasons for admission with cocaine induced chest pain
Pre existing CAD/RFs Persistent pain/SOB CHF/cardiogenic shock Vasodilator required Elevated trop EKG changes Dysrhythmias
What synthetic cathinone can cause psychosis lasting days to weeks?
Bath salts
Synthetic amphetamine
What are the primary ocular effects of cannabis? Does it give you pupillary changes?
Conjunctival injection
Decreased IOP
Pupillary changes? No – think co-ingestions
What is a patient called who places drug in a body cavity to avoid police?
“Body stuffer”
What do you place on the belly for CHS?
Capsaicin cream
Name a smoked pant that leads to tachycardia, flushed skin and hallucinogens?
Jimson weed (pink flower)
Anticholinergic
Supportive care, observe 8 hours
What is the treatment and dose for an asymptomatic pediatric body packer? What if symptomatic?
WBI at 25ml/kg/hour
To clear effluent
Sympathomimetic – OR for removal
Opioid trial medical management
What is crank? What is the duration?
Crystal meth (methamphetamine) 15 hours
