Intoxications and Withdrawals Flashcards
Alcohol Intoxication
Emotional lability, slurred speech, ataxia, inc serum GGT, AST > ALT (mito)
Alcohol Withdrawal
3-36 hrs - anxiety, tremor, insomnia
6-48 hrs - seizures
12-48 hrs - hallucinations (visual)
48-96 hrs - rapid onset confusion, autonomic hyperactivity, resp alkalosis (GIVE BENZOS)
Opioid Intoxication
Pinpoint pupils, resp and CNS depression
Sz if OD
Opioid Withdrawal
Pupil dilation, sweating, piloerection, fever, rhinorrhea, yawning, nausea, stomach cramps, diarrhea (FLU-LIKE)
Barbiturate v Benzos
Both depressants
Intoxication - worry about resp depression (barbiturates worse than benzos)
Withdrawal for benzos - rebound anxiety, depression, sleep problems
v. Withdrawal from barb - delirium and cardio collapse
Stimulant Intoxication
Mood elev, psychomotor agitation, insomnia, cardiac arrhythmia, tachy, anxiety
Amphetamines / cocaine - pupils dilated, paranoia, cardiac problems
Cocaine specifically can cause hallucinations
Amphetamines more euphoria, anorexia, HTN, prolonged attn
Nicotine / caffeine - restlass
Stimulant Withdrawal
Crash - depression, lethargy, inc appetite, sleep disturbance, vivid nightmares
Phencyclidine Intoxication
Violent, impulsive, nystagmus, tachy, analgesic, psychosis, delirium, sz
Often undergo trauma while high
LSD Intoxication
Perceptual distortion, depersonalization, psychosis, paranoia, flashbacks
MDMA (ecstasy) Intoxication
Euphoria, disinhibition, distorted sensory and time perception, teeth clenching
Life-threatening HTN, tachy, hyperthermia, hyponatremia, serotonin syndrome
Heroine Detox Meds (3)
Methadone - long acting oral opiate
Buprenorphine + naloxone - sublingual partial agonist plus naloxone to reduce abuse potential
Naltrexone - long acting opioid antagonist for relapse prevention
Serotonin Syndrome
3 A’s
hyperActivity (clonus, hypertonia, inc reflexes)
Autonomic stimulation (hyperthermia, diaphoresis)
Agitation
