Illicit Drugs - NECESSSARY FACTs Flashcards

1
Q

Cocaine Intoxication - WORST CONSEQUENCES

Other side effects?

A

Cardiac arrhythmia, Stroke, MI

Rhabdomyolysis from constricture of muscle vasculature

DEATH!!!

also see increased DTR, Hyper-mydriasis, sweating, tics etc

Grandiose euphoria and can look manic

Can also see Tactile Hallucinations - Formication = bugs crawling on skin!

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2
Q

Treatmend for cocaine intoxication?

A

For seizures - diazepam or phenytoin

MI - TREAT THE MI

AGitation and angina - BZD and occasionally Nitroglycerin

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3
Q

What’s Withdrawal from cocaine like? Life threatening or not?

A

Not life threatening but can last for several days

occasionaly increased risk of suicide

Psychological Depression!!! Cocaine blocks reuptake of catecholamine and so stop using and get refractory period where receptors upregulated but not releasing as much and so physiological depressoin

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4
Q

Stimulant intoxication?

A

Same as cocaine but more psychotic symptoms and effects take longer to start and last longer

Same thing with withdrawal

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5
Q

Hallucinogen intoxication - effects? and treatment

A

Effects - not life threatening except ppl do stupid shit on them

Tachycardia, sweating, mydriasis, anticholinergic effects, hyperthermia, Depersonalization and derealziation, Illusion, synaesthesia

Treatment - supportive, Benzo, anitpsychotic if bad hallucinations

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6
Q

What is Hallucinogen Persisting PErception disorder?

A

Flashbacks that occur after you stop using hallucinogen and can continue for months to years

triggered by stress, fatugie, anxiety, dark environments, drug use

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7
Q

PCP - Onset/Duration, Side Effects

A

Quick onset and can last for several hours to DAYS!!! But can Wax and wane from wild to sedated - like Delirium

CAN DIE FROM EFFECTS

Often people commit Serious Self-Injuryious acts w/o realizing it bc it is a semi-anesthetic

Effects:

  • **VERTICAL AND HORIZONTAL GAZE NYSTAGMUS!!! **

HTN, Tachycardia, decreased pain, ataxia, slurred speech, muscle rigidity, hyperthermia, euphoria

Dissociateive symptoms

Can cause Paralysis symptoms

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8
Q

Mechanism of Action of PCP? Treatment of Intoxication?

A

NMDA Glutamate Receptors!

Tx - supportive and quiet, safe environment

Agitation - can use BZD

No longer do acidification of urine

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9
Q

BZD Intoxication?

Treatment?

A

Like Alcohol intoxication - minimal respiratory effects when used alone but dangerous when used in combination

Treatment - supportive

Flumezanil - BZD receptor Antagonist but be careful bc can put into BZD withdrawal which is life threatening!

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10
Q

BZD Withdrawal - what’s it like?

A

Can be Fatal!!!

Same as for EtOH but onset later after last use and course is longer

Seziures can be common

Treatment is same as for alchohol

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11
Q

Opioid intoxiction - What it’s like? In infants? Treatment?

A

CAN BE FATAL FROM CENTRAL RESP DEPRESSION

see Miosis, drowsiness, constipation, itching, euphoira, psychomotor retardation

In Infants - see seizures

Treattment - Establish Oxygenation!!!

Naloxone - Mu Antagonist given IV, IM, or Rectal and can reverse respiratory depression

Caution w/ Methadone OD bc much longer so can RE-narcanize

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12
Q

Opidate Withdrawal - what’s it like? Is it life threatening?

Treatments?

A

Withdrawal seen w/in 6-24 hrs or several days longer and subacute symptoms can last for months

**NOT life-threatening Except in Noenates and Disabled!!! **

Symptoms - goosebumps, dilation, sweating, runny nose, N/V, Diarrhea, Tachycardia, HTN, MUSCLE TWITCHING

Seizures in Neonates

TREATMENT -

1) Clonidine - Alpha blocker bc LC gets inhibited w/ chronic opioid use and then stop suddenly and get bad sympathetic rebound effects so this helps dampen those
2) Methadone
3) Buprenorphine - Partial Mu Agonist

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13
Q

3 types of inhalants?

A

Volatile Organic Compounds - CNS depressants

Nitrites - Vasodilate and smooth muscle relaxation

Nitrous Oxide - CNS depressant and alters neuronal memnbranes and Da/Opiate system

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14
Q

Inhalant Withdrawal and Intoxication

A

Intoxication - short, nystagmus, unsteady gait, slurred speech, euphoria, collapse, light-heeaded

Only supportive Measures

DANGER - Nitrites and Vasodilation - Bottom Out BP

Inhalant Withdrawal - non-specific seen a few days after last use

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15
Q

STeroid Intoxication, Treatment, Withdrawal

A

Symptoms - Roid rage, HA, sweating, HTN, ab pain, increased appetite, aggression, insomnia

Treatment - Supportive, Psychosis can treat w/ neuroleptic if prolonged, Agitation treat w/ BZD

Withdrawal - non-specific and opposite effects of symptoms

DETOX w/ SLOW taper

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16
Q

Ketamine - what’s so weird about ketamine intoxication

A

Dissociative Anesthetic - In the K hole

Vertical Nystagmus!!!

Hallucinations and disocation but realtively cal