Psychoactive drug intoxication and withdrawal

Question 1

Alcohol

Answer 1

Intoxication: emotional lability, slurred speech, ataxia, coma, blackouts
Withdrawal: symptoms similar to other depressants. Severe alcohol withdrawal can cause autonomic hyperactivity and DTs
Tx: benzodiazepines

Question 2

Opioids

Answer 2

Intoxication: euphoria, respiratory and CNS depression, decreased gag reflex, pupillary constriction, seizures
Withdrawal: sweating, dilated pupils, piloerection, fever, rhinorrhea, yawning, nausea
Tx: methadone, buprenorphine

Question 3

Barbiturates

Answer 3

Intoxication: Low safety margin, marked respiratory depression
Withdrawal: delirium, life-threatening cardiovascular collapse
Tx: manage symptoms

Question 4

Benzodiazepines

Answer 4

Intoxication: Greater safety margin. Ataxia, minor respiratory depression
Withdrawal: sleep disturbance, depression, rebound anxiety, seizure
Tx: flumazenil (benzo receptor antagonize)

Question 5

Amphetamines

Answer 5

Intoxication: euphoria, grandiosity, pupillary dilation, prolonged wakefulness and attention, hypertension, tachycardia, anorexia, paranoia, fever
Withdrawal: anhedonia, increased appetite, hypersomnolence, existential crisis

Question 6

Cocaine

Answer 6

Intoxication: impaired judgment, pupillary dilation, hallucinations, paranoid ideations, angina, sudden cardiac death
Withdrawal: hypersomnolence, malaise, severe psychological craving, depression/suicide
Tx: alpha-blockers, benzos

Question 7

Heroin

Answer 7

Tx: methadone, naloxone + buprenorphine, naltrexone