Psychoactive drug intoxication and withdrawal Flashcards
Depressants
Alcohol, opioids (morphine, heroin, methadone), barbiturates, benzodiazepines. Increase GABA activity.
Alcohol intoxication
Emotional lability, slurred speech, ataxia, coma, blackouts,. GGT is a sensitive indicator of alcohol use. AST > ALT.
Alcohol withdrawal
Severe: autonomic hyperactivity, and DTs. Treatment for DTs is benzodiazepines
Opioids intoxication
Euphoria, respiratory and CNS depression, decreased gag reflex, pupillary constriction (pinpoint pupils), seizures. Treatment is naloxone for acute and naltrexone for chronic management.
Opioids withdrawal
Sweating, dilated pupils, piloerection, fever, rhinorrhea, yawning, nausea, stomach cramps, diarrhea (flu-like symptoms). Treatment: methadone, buprenorphine.
Barbiturates intoxication
Low safety margin, marked respiratory depression. Treatment: assist respiration
Barbiturates withdrawal
Delirium, CV collapse
Benzodiazepines intoxication
Greater safety margin. Ataxia, minor respiratory depression. Treatment: flumazenil.
Benzodiazepines withdrawal
Sleep disturbance, depression, rebound anxiety, seizure.
Stimulants
Amphetamines, cocaine, Ceffeine, nicotine
Amphetamines intoxication
Euphoria, grandiosity, pupillary dilation, prolonged wakefullness and attention, hypertension, tachycardia, anorexia, paranoia, fever. Severe: cardiac arrest, seizure.
Amphetamines withdrawal
Anhedonia, increased appetite, hypersomnolence, existential crisis.
Cocaine intoxication
Impaired judgement, pupillary dilation, hallucinations, paranoid ideations, angian, sudden cardiac arrest. Treatment: alpha blockers, benzodiazepines, beta blockers not recommended.
Cocaine withdrawal
Hypersomnolence, malaise, severe psychological craving, depression.
Caffeine intoxication
Restlessness, increased diuresis, muscle twitching
Caffeine withdrawal
Lack of concentration, headache.
Nicotine intoxication
Restlessness
Nicotine withdrawal
Irritability, anxiety, craving. Treatment: nicotine patch, gum, or lozenges; bupropion, varenicline.
Hallucinogens
PCP, LSD, marijuana
PCP intoxication
Belligerence, impulsivity, fever, psychomotor agitation, analgesia, nystagmus, tachycardia, homicidality, psychosis, delirium, seizures. Treatment: benzodiazepines, rapid-acting antipsychotics.
PCP withdrawal
Depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep.
LSD intoxication
Perceptual distortion (visual and auditory), depersonalization, anxiety, paranoia, psychosis, possible flashbacks.
Marijuana intoxication
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, social withdrawal, increased appetite, dry mouth, conjuntival injection, hallucinations.
Marijuana withdrawal
Irritability, depression, insomnia, nausea, anorexia. Most symptoms peak in 48 hrs and last for about 5-7 days. Detectable in urine for up to a month.
