Intox and withdrawal

Question 1

Examples of depressants

Answer 1

alcohol
opioids
barbituates
BNZs

Question 2

alcohol intoxication

Answer 2

emotional lability
slurred speech
ataxia
coma
blackouts

Question 3

General depressant intoxication presentation

Answer 3

mood elevation, decreased anxiety, sedation, behavioral disinhibition, respiratory depression

Question 4

general depressant withdrawal presentation

Answer 4

anxiety, tremor, seizures, insomnia

Question 5

alcohol withdrawal

Answer 5

autonomic hyperactivity, DT

Question 6

opioid intoxication

Answer 6

euphoria

respiratory and CNS depression, decreased gag reflex, pupillary constriction, seizures

Question 7

opioid withdrawal

Answer 7

sweating, dilated pupils, piloerection, fever, rhinorrhea, yawning, nausea, stomach cramps, diarrhea

Question 8

barbituate intoxication

Answer 8

marked respiratory depression

*low safety margin

Question 9

barbituate withdrawal

Answer 9

delirium, CV collapse (life threatening)

Question 10

BNZ intoxication

Answer 10

ataxia, minor respiratory depression

Question 11

BNZ withdrawal

Answer 11

sleep disturbance, depression, rebound anxiety, seizure

Question 12

Tx for alcohol withdrawal

Answer 12

if DT: BNZ

Question 13

Tx for opioid intix

Answer 13

naloxone, naltrexone

Question 14

Tx for opioid withdrawal

Answer 14

long-term support, methadone, buprenorphine

Question 15

Tx for barbituates intox

Answer 15

symptom management

Question 16

treatment for BNZ intox

Answer 16

supportive care

flumazenil

Question 17

tx for BNZ withdrawal

Answer 17

flumazenil

Question 18

Name some stimulants

Answer 18

amphetamines, cocaine, caffeine, nicotine

Question 19

general stimulant intoxication presentation

Answer 19

mood elevation, psychomotor agitation, insomnia, cardiac arrhythmias, tachycardia, anxiety

Question 20

general stimulant withdrawal presentation

Answer 20

post-use “crash” –> depression, lethargy, weight gain, headache

Question 21

amphetamine intox

Answer 21

euphoria, grandiosity, pupillary dilation, prolonged wakefulness and attention, HTN, tachycardia, anorexia, paranoia, fever
Severe: cardiac arrest, seizure

Question 22

amphetamine withdrawal

Answer 22

anhedonia, increased appetite, hyper somnolence, existential crisis

Question 23

cocaine intox

Answer 23

impaired judgement, pupillary dilation, hallucinations, paranoid ideations, angina, sudden cardiac death

Question 24

Tx of cocaine intox

Answer 24

BNZ

Question 25

cocaine withdrawal

Answer 25

hypersomnolence, malaise, severe psychological craving, depression/suicidality

Question 26

caffeine intox:

Answer 26

restlessness, increased diuresis, muscle twitching

Question 27

caffeine withdrawal

Answer 27

lack of conc., headache

Question 28

nicotine intox

Answer 28

restlessness

Question 29

nicotine withdrawal

Answer 29

irritability, anxiety, craving

Question 30

What is the cause of delirium tremens? When does it occur?

Answer 30

life-threatening alcohol withdrawal that peaks 2-5 days after last drink

Question 31

What are the symptoms of delirium tremens?

Answer 31

1st: autonomic system hyperactivity (tachycardia, tremors, anxiety, seizures)
2nd: psychotic symptoms (hallucinations, delusions)
3rd: confusion