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People and Illness > Illicit Drugs and Toxidromes > Flashcards

Illicit Drugs and Toxidromes Flashcards

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1
Q

What are the most commonly use illicit drugs?

A

Cannabis
opiates
cocaine

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2
Q

How can drugs cause harm?

A 
Direct acute neurological effects
indirect acute effects
direct chronic neurological effects
complications of route of administration 
effects of co-morbodities
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3
Q

How can heroin be administered?

A

Oral
Smoked
IV

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4
Q

How can cannabis be administered?

A

oral

smoked

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5
Q

How can cocaine be administered?

A

nasal
smoked
IV

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6
Q

How can amphetamines be administered?

A

Oral
nasal
smoked
IV

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7
Q

How can LSD be administered?

A

Orally

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8
Q

How can Pencyclidine (PCP) be administered?

A

Orally
nasally
smoked

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9
Q

Which neurotransmitters does heroin act upon?

A

Dopamine and GABA

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10
Q

Which neurotransmitters does cannabis act upon?

A

GABA

5HT/Ach/THC

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11
Q

Which neurotransmitters do cocaine and amphetamines act upon?

A

dopamine

noradrenaline

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12
Q

Which neurotransmitters does LSD act upon?

A

5HT/Ach/THC/DA

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13
Q

Which neurotransmitters does PCP act upon?

A

Dopamine
5HT/Ach/TCH
GABA

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14
Q

How does alcohol cause euphoria?

A

Acting on dopamine and opioid receptors

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15
Q

How does alcohol cause anxiety and ataxia?

A

Increasing GABA

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16
Q

How does alcohol cause sedation and amnesia?

A

Increasing GABA

Decreasing NMDA

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17
Q

Stimulants enhance transmission at the monoamine synapses. What effects does this have?

A 
Increases behavioural and motor activity
Increases alertness
Disrupts sleep
Causes eurphoria
Increases confidence e
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18
Q

What are the side effects of stimulants?

A

Anxiety
Insomnia
Irritability

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19
Q

What effects do stimulants have as a result of their stimulation of adrenergic activity?

A

Tachycardia, hypertension, risk fo arrhythmia, sweats, hallucinations, agitation, dilated pupils, elevated temperature

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20
Q

What symptoms occur in serotonin syndrome?

A 
Altered mental status (agitation, confusion, seizures)
autonomic changes (hyperthermia, diaphoresis, diarrhoea, tachycardia)
neuromuscular effects (myoclonus, clonus, hyperreflexia, tremor)
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21
Q

Cocaine is a stimulant which has a rapid onset and penetrates the blood brain barrier. What is its half life?

A

30-90 minutes

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22
Q

What is the mechanism of action of cocaine?

A

Blocks reuptake of dopamine, noradrenaline and 5HT

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23
Q

Amphetamines are stimulants which have a rapid onset and penetrate the blood brain barrier. What are their half life?

A

up to 12 hours

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24
Q

What is the mechanism of action of amphetamines?

A

Enhance release of dopamine and noradrenaline from pre-synaptic terminals causing a dopaminergic pleasure effects and noradrenergic excess

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25
Q

What are the acute neurological problems associated with stimulants?

A

Anxiety, sleep deprivation, paranoia, aggression, paranoid psychosis, cognitive dysfunction

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26
Q

What are the chronic neurological problems associated with stimulants?

A 
Anxiety
sleep deprivation
paranoia
aggression
paranoid psychosis
cognitive dysfunction
27
Q

How can stimulants accelerate atherosclerosis?

A

Cause vasospasm by alpha adrenergic stimulation

platelet aggregation is increased

28
Q

What type of strokes cans stimulants cause?

A

Hemorrhagic strokes

29
Q

How does cocaine use affect the management of a stroke patient?

A

Likely require blood pressure lowering

May not be able to have thrombolysis

30
Q

Give examples of stimulants other than cocaine and amphetamines.

A

Ephedrine
Pesudoephridine
phenylpropanolamine
MDMA

31
Q

How do opiates give a sedative effect?

A

Acting on opiate mu receptors

32
Q

How do opiates give a dysphoric effect?

A

Acting on kappa receptors to reduce GABA release

33
Q

How does GHB cause dysphoria and sedation?

A

Dysphoria by stimulating dopamine release

Sedation by activating GABA receptor

34
Q

What is the toxidrome for opiate use?

A 
pinpoint pupils
respiratory depression
bradycardia
hypotension
hypothermia
pulmonary oedema
seizures
35
Q

What is the toxidrome for sedative use?

A 
Ataxia
Blurred vision
coma
confusion
delirium
sedation
36
Q

What are the possible consequences /complications of injection?

A 
Embolic infarction
infective endocarditis
abscesses
discitis
meningitis
HIV
37
Q

What are the acute neurological problems which can occur with sedative use?

A

Coma
Compressive nerve palsies
Anoxic brain injury

38
Q

What is the toxidrome for cholinergics?

A 
Defecation
urination
miosis
bronchoconstriction
bradycardia
emesis
lacrimation
salivation
39
Q

MDMA is a hallucinogen. It blocks the reuptake of which neurotransmitters?

A

5HT and NA

40
Q

What are the neurological effects of hallucinogens?

A

toxic psychosis
dangerous behaviour
wernick’s type syndrome
stroke

41
Q

What are the acute effects of organic solvents such as toluene, hexane and benzene?

A

Lightheadedness

Hallucinations

42
Q

What are the effects of organic solvents such as toluene, hexane and benzene with prolonged use?

A 
Cognitive impairment
diplopia
ataxia
nystagmus
coma
43
Q

What is the active component of marijuana?

A

THC

44
Q

What are the effects of THC?

A

Psychosis
altered neural connectivity
cognitive effects

45
Q

Legal highs contain substances which produce similar psychoactive effects to traditional drugs. Give example of stimulant legal highs?

A

Cathinones
benzofurans
piperazines

46
Q

Legal highs contain substances which produce similar psychoactive effects to traditional drugs. Give example of sedativelegal highs?

A

benzodiazepine analogues

47
Q

Legal highs contain substances which produce similar psychoactive effects to traditional drugs. Give example of hallucinogen legal highs?

A

alpha-methyltryptamine

48
Q

Legal highs contain substances which produce similar psychoactive effects to traditional drugs. Give example of dissociative legal highs?

A

methoxetamine

49
Q

Delirium tremens results from withdrawal from alcohol. T/F?

A

True

50
Q

What behaviours characterise alcohol dependence?

A 
compulsion
control
tolerance
withdrawal
persistence
neglect
repertoire narrows
reinstatement
51
Q

What psychological problems are associated with acute intoxication with alcohol?

A 
Insomnia
depression
anxiety
amnesia
attempted suicide
suicide
52
Q

What are the effects of a blood alcohol content of 0.02 to 0.03%?

A

Mood elevation

Muscle relaxation

53
Q

What are the effects of a blood alcohol content of 0.05 to 0.06%?

A

Relaxation
Increased reaction time
Decreased fine muscle coordination

54
Q

What are the effects of a blood alcohol content of 0.08 to 0.09%?

A

Euphoria

Impaired balance, speech, vision, hearing, muscle coordination

55
Q

What are the effects of a blood alcohol content of 0.14 to 0.15%?

A

Gross impairment of physical and mental control

56
Q

What are the effects of a blood alcohol content of 0.20 to 0.30%?

A

Severely intoxicated, very little control of mind or body

57
Q

What are the effects of a blood alcohol content of 0.40 to 0.50%?

A

Unconscious

Death from respiratory depression

58
Q

Delirium tremens is a rapid onset of confusion caused. by withdrawal from alcohol. What is the mortality rate of delirium tremens?

A

5-15%

59
Q

Delirium tremens is a rapid onset of confusion caused. by withdrawal from alcohol. How can this cause death?

A

Respiratory failure

Cardiac arrhythmia

60
Q

Which patients with delirium. tremens are most at risk of death?

A

Extreme fever
Fluid or electrolyte imbalance
Intercurrent illness (occult trauma, pneumonia, hepatitis, pancreatitis, alcoholic ketoacidosis, Wernicke. Korsakoff syndrome)

61
Q

What are the psychiatric associations with cannabis use?

A

Cannabis dependence
Psychosis
Amotivational syndrome

62
Q

There is a specific and prolonged abstinence syndrome after only a short period of regular use of benzodiazepines in some individuals. T/F?

A

True

63
Q

Half of patients with opiod dependency will have a comorbid problem with benzodiazepines. T/F?

A

True

64
Q

What long term psychiatric problems. are associated with opioid use?

A 
Depression
Suicide
Personality disorders
PTSD
Polydrug dependency

People and Illness (18 decks)

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