Psych: Psychoactive & Illegal drugs, Intox/Wdl Flashcards
Depressants
General sx of Intoxication?
Sx of Withdrawal?
Alcohol, Opioids, Barbituates, Benzos
Intox: Mood elevation, decr anxiety, sedation, behavioral disinhibition, respiratory depression
Wdl: anxiety, tremors, seizures, insomnia
Alcohol: sx of intox?
Labs?
- ataxia, slurred speech, coma, blackouts
- serum gamma-glutamyltransferase is sensitive indicator of alcohol use.
Lab AST value is twice ALT value
Alcohol: sx of wdl?
Treatment if severe?
Mild: similar sx as other depressants
Severe: autonomic hyperactivity, DTs (5-15% mortality)
Tx = benzodiazepines (ex chlordiazepoxide)
Delirium Tremens?
Tx?
“Glutamate storm”
Life-threatening alcohol wdl. Peaks 2-5 days after last drink.
Symptoms (in chrono order):
- Autonomic hyperactivity (tachycardia, tremors, anxiety, seizures)
- Psychotic sx (hallucinations, delusions)
- Confusion
Tx = Benzos
Alcohol: what receptors are involved?
GABA-A agonist
Glutamate/NMDA blocker
incr ß endorphins
Opioids
sx of toxication?
Tx?
(morphine, heroin, methadone)
Euphoria, pinpoint pupils
Resp/CNS depression - coma
seizures if OD
Tx: Naloxone (acute), Naltrexone (rehab)
Opioids
Sx of withdrawal?
Tx?
cold turkey: sweating, dilated pupils, piloerection
flu-like: fever, rhinorrhea, yawning, nausea, cramps, diarrhea
Tx: methadone, buprenorphine
Barbituates: sx of tox?
Tx?
Resp depression
low safety margin
Tx: manage symptoms, assist with respiration, BP support)
Barbituates: sx of wdl?
Delirium
CV collapse (life-threatening)
Benzodiazepines: sx of tox?
(ex diazepam, lorazepam)
ataxia, slight resp depression
Tx: support, flumazenil (competitive benzo antagonist)
Benzodiazepines: sx of wdl?
sleep issues, depression, rebound anxiety, seizure
(can be triggered by flumazenil in attempt to reverse intoxication)
alcohol: what is it the causes the hangover sx?
buildup of acetaldehyde
ADH = enzyme that converts this to acetate –> acetyl CoA –> TCA
what blocks ADH/what is the effect?
Disulfuram blocks ADH leading to a buildup of acetaldehyde if someone drinks alcohol.
Leads to really bad hangover sx. “antabuse”
Besides disulfuride, what drug can block acetaldehyde dehydrogenase (ADH) and cause hangover-like sx?
metronidazole
used to treat Trichomonas, giardia, and bacterial vaginosis
Stimulants: general signs of intoxication?
mood elevation, psychomotor agitation, insomnia, arrhythmias, tachycardia, anxiety
Stimulants: general signs of withdrawal?
post-use crash:
depression, lethargy, weight gain, headache
s/s of what?
euphoria, grandiosity, pupillary dilation, prolonged wakefulness, HTN, tachycardia, anorexia, paranoia, fever
(severe: cardia arrest, seizure)
amphetamine use
s/s of what?
anhedonia, incr apetite, hypersomnolence, existential crisis
amphetamine withdrawal
s/s of what?
impaired judgement, pupillary dilatation, hallucinations, paranoia, angina, sudden cardiac death
cocaine use
hypersomnolence, malaise, severe craving, depression/suicidality
cocaine wdl
restlessness, incr diuresis, muscle twitching
caffeine use
no concentration, headache
caffeine wdl
restlessness
nicotine use
irritability, anxiety, craving
nicotine wdl
tx for cocaine use/od
benzodiazepines
tx for nicotine wdl
nicotine patch, gum, lozenges
bupropion/varenicline
violent behavior, impulsiveness, fever, nystagmus, delirium (+ more)
PCP (phencyclidine) use
depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep
PCP wdl
perceptual distortion, depersonalization, anxiety, paranoia, psychosis, flashbacks
LSD use
(lysergic acid diethylamide)
euphoria, anziety, paranoid delusions, perception of slowed time, incr appetite, social withdrawal, conjunctival injection
marijuana (cannabinoid) use
irritability, depression, insomnia, nausea, anorexia
marijuana (cannabinoid) wdl
