Psychiatry and Substance Use Flashcards
Alcohol intoxication
Talkative, sullen, slurred speech, moody, disinhibited, AMS
Cocaine/amphetamines intoxication
Pupillary dilation, chest pain, euphoria, hyper-vigilance, autonomic hyperactivity, angina (vasoconstriction) and perceptual disturbances
Cannabis intoxication
Conjunctival injection, impaired motor coordination and slowed movements
PCP (phencyclidine) intoxication
Nystagmus, belligerence, psychomotor agitation, violence, hypertension and seizure
Anabolic steroids intoxication
Irritability, aggression mania and psychosis with a history of weight-lifting/sports
Alcohol withdrawal
Tremors, hallucinations, seizures, and fluctuating consciousness/awareness
Cocaine/amphetamines withdrawal
Anxiety, tremulousness, headache and depression/suicidal ideation
Cannabis withdrawal
Irritability, anger, anxiety, sleep problems, restlessness, and appetite problems
Opiate withdrawal
Diarrhea, fever, chills, lacrimation, abdominal cramps, and muscle spasms
What are two pharmacologic agents that can be used to treat Neuroleptic Malignant Syndrome?
Dantrolene or Bromocriptine
What is one pharmacologic agent that can be used to reverse/treat serotonin syndrome?
Cyproheptadine
What is one specific indicator of dementia (major neurocognitive disorder) vs. normal aging?
Loss of ADLs in dementia (e.g. getting lost in familiar setting, loss of ability to dress self or eat)
What is the treatment of choice of adjustment disorder?
Psychotherapy
Which second generation antipsychotic has the greatest risk of extrapyramidal side effects?
Risperidone
What is akathisia?
- A known extrapyramidal side effect of anti-psychotics
- Restlessness (e.g. patient can’t sit still, pacing)
What are some treatments for akathisia?
- Benztropine
- Beta-blocker
What is acute distonia?
- A known extrapyramidal side effect of anti-psychotics
- Sudden, sustained contraction of the neck, mouth, tongue, and eye muscles
What are some of the characteristic movements of Parkinsonism?
- Gradual onset tremor, rigidity, bradykinesia
What are some treatments for acute distonia?
- Benztropine
- Diphenhydramine
What is tardive dyskinesia?
Gradual onset of dyskinesia generally after 6mo of treatment with an antipsychotic
- Abnormal involuntary movements of the face, mouth, trunk and extremities
How is tardive dyskinesia treated?
- Discontinue 1st gen antipsychotic and switch to 2nd gen
- Valbenazine
A patient presenting with talkativeness, gregariousness and disinhibition is likely intoxicated with what substance?
Alcohol
A patient presenting with pupillary dilation, chest pain, euphoria, hyper-vigilance, autonomic hyperactivity, and perceptual disturbances is likely intoxicated with what substance?
Cocaine/amphetamines
A patient presenting with conjunctival injection, impaired motor coordination and slowed movements is likely intoxicated with what substance?
Cannabis (including K2 and spice)
A patient presenting with nystagmus, belligerence, psychomotor agitation, violence, hypertension and seizure is likely intoxicated with what substance?
PCP (phencyclidine)
A patient presenting with irritability, aggression mania and psychosis with a history of weight-lifting/sports is likely intoxicated with what substance?
Anabolic steroids (“roid rage”)
A patient presenting with tremors, hallucinations, seizures, and fluctuating consciousness/awareness is likely withdrawing from what substance?
Alcohol
A patient presenting with anxiety, tremulousness, headache and depression is likely withdrawing from what substance?
Cocaine
A patient presenting with irritability, anger, anxiety, sleep problems, restlessness, and appetite problems is likely withdrawing from what substance?
Cannabis
A patient presenting with diarrhea, fever, chills, lacrimation, abdominal cramps, and muscle spasms is likely withdrawing from what substance?
Opiates (e.g. heroin)
