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Psychiatry > Psychoactive drug intoxication & withdrawal > Flashcards

Psychoactive drug intoxication & withdrawal Flashcards

1
Q

What is Depressant intoxication like?

A
  • Nonspecific
  • Mood elevation
  • Dec anxiety
  • Sedation
  • Behavioral disinhibition
  • Resp depression
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2
Q

What does Depressant withdrawal look like?

A
  • Nonspecific
  • Anxiety
  • Tremor
  • Seizures
  • Insomnia
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3
Q

What does Alcohol intoxication look like?

A
  • Emotional lability
  • Slurred speech
  • Ataxia
  • Coma
  • Blackouts
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4
Q

What is Serum gamma-glutamyltransferase (GGT)?

A

Sensitive indicator of alchohol use

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5
Q

What labs indicate alcohol intoxication?

A

AST value is twice ALT value

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6
Q

What is Mild alcohol withdrawal like?

A

Sx similar to other depressants

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7
Q

What is severe alcohol withdrawal like?

A

Can cause autonomic hyperactivity & DTs

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8
Q

What is the tx for DTs?

A

Benzodiazepines

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9
Q

What is Opioid intoxication like?

A
  • Euphoria
  • Resp & CNS depression
  • Dec gag reflex
  • Pupillary constriction
  • Seizures (overdose)
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10
Q

What is the tx for opiod intoxication?

A

Naloxone & naltrexone

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11
Q

What are the sx of Opiod withdrawal?

A
  • Sweating
  • Dilated pupils
  • Piloerection
  • Fever
  • Rhinorrhea
  • Yawning
  • N/V
  • Stomach cramps
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12
Q

What is the tx for Opiod withdrawal?

A
  • LT support
  • Methadone
  • Buprenorphine
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13
Q

What is Barbiturates intoxication?

A
  • Low safety margin
  • Marked resp depression
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14
Q

What is the tx for Barbituate intoxication?

A

Sx management (assist rsp, inc BP)

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15
Q

What are the sx of Barbiturate withdrawal?

A

Delirium & life-threatening CV collapse

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16
Q

What are the characteristics of Benzodiazepine intoxication?

A
  • Greater safety margin
  • Ataxia
  • Minor resp depression
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17
Q

What is the tx for Benzodiazepine intoxication?

A

Flumazenil (competitive benzodiazepine antagonsit)

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18
Q

What are the sx of Benzodiazepine withdrawal?

A
  • Sleep disturbance
  • Depression
  • Rebound anxiety
  • Seizure (severe)
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19
Q

What are the sx of Stimulant intoxication?

A
  • Nonspecific
  • Mood elevation
  • Psychomotor agitation
  • Insomnia
  • Cardiac arrhythmias
  • Tachycardia
  • Anxiety
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20
Q

What are the sx of Stimulant withdrawal?

A
  • Nonspecific
  • “Post-use” crash
  • Depression
  • Lethargy
  • Wt gain
  • HA
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21
Q

What are the sx of Amphetamine intoxication?

A
  • Euphoria
  • Grandiosity
  • Pupillary dilation
  • Prolonged wakefulness & attention
  • HTN
  • Tachycardia
  • Anorexia
  • Paranoia
  • Fever
  • Severe: cardiac arrest, seizure
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22
Q

What are the sx of Ampheramine withdrawal?

A
  • Anhedonia
  • Inc appetite
  • Hypersomnolence
  • Existential crisis
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23
Q

What are the sx of Cocaine intoxication?

A
  • Impaired judgement
  • Pupillary dilation
  • Hallucinations
  • Paranoid ideations
  • Angina
  • Sudden cardiac death
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24
Q

What is the tx of cocaine intoxication?

A

Benzodiazepines

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25
Q

What are the sx of Cocaine withdrawal?

A
  • Hypersomnolence
  • Malaise
  • Severe Psychological craving
  • Depression/suicidality
26
Q

What are the sx of Caffeine intoxication?

A
  • Restlessness
  • Inc diuresis
  • Muscle twitching
27
Q

What are the sx of Caffeine withdrawal?

A

Lack of concentration & HA

28
Q

What are the sx of Nicotine intoxication?

A

Restlessness

29
Q

What are the sx of Nicotine withdrawal?

A
  • Irritability
  • Anxiety
  • Craving
30
Q

What is the tx for Nicotine withdrawal?

A
  • Nicotine patch, gum or lozenges
  • Bupropion/varenicline
31
Q

What are the sx of PCP intoxication?

A
  • Belligerence
  • Impulsiveness
  • Fever
  • Psychomotor agitation
  • Analgesia
  • Vertical & horizontal nystagmus
  • Tachycardia
  • Homicidality
  • Psychosis
  • Delirium
  • Seizures
32
Q

What is the tx for PCP intoxication?

A
  • Benzodiazepine
  • Rapid-acting antipsychotic
33
Q

What are the sx of PCP withdrawal?

A
  • Depression
  • Anxiety
  • Irritability
  • Restlessness
  • Anergia
  • Disturbances of though & sleep
34
Q

What are the sx of LSD intoxication?

A
  • Perceptual distortion (visual, auditory)
  • Depersonalization
  • Anxiety
  • Paranoia
  • Psychosis
  • Possible flashbacks
35
Q

What are the sx of Marijuana intoxication?

A
  • Euphoria
  • Anxiety
  • Paranoid delusions
  • Perception of slowed time
  • Impaired judgement
  • Social withdrawal
  • Inc appetite
  • Dry mouth
  • Conjuctival injection
  • Hallucinations
36
Q

What is Dronabinol (tetrahydrocannabinol isomer) used for?

A

Rx used as antiemetic (chemotherapy) & appetite stimulant (AIDs)

37
Q

What are the sx of Marijuana withdrawal?

A
  • Irritability
  • Depression
  • Insomnia
  • Nausea
  • Anorexia
38
Q

When do marijuana withdrawal sx peak?

A

48 hours & lasts for 5-7 days

39
Q

How long is marijuana detectable in the urine?

A

4-10 days

40
Q

What are Heroin uses at inc risk for?

A
  • Hepatitis
  • Abscess
  • Overdose
  • Hemorrhoids
  • AIDs
  • Right-sided endocarditis
41
Q

What should you look for in Heroin users?

A

Track marks (needle sticks in veins)

42
Q

What is Methadone?

A

Long-acting opiate

43
Q

What is Methadone used for?

A

Used for heroin detoxification or LT maintenance

44
Q

What is Naoloxone + Buprenorphine?

A

Partial agonist; long acting w/ fewer sx than methadone

45
Q
A
46
Q

When is Naloxone not active?

A

Not active when taken orally, so w/drawal sx occur only if injected (lower abuse potential)

47
Q

What is Alcoholism?

A

Physiologic tolerance & dependence w/ sx of w/drawal when intake is interrupted

48
Q

What are the complications of alcoholism?

A
  • Alcoholic cirrhosis
  • Hepatitis
  • Pancreatitis
  • Peripheral neuropathy
  • Testicular atrophy
49
Q

What is the tx for alcoholism?

A
  • Disulfiram
  • Supportive care
  • AA & peer support
50
Q

What is Disulfiram used for?

A

To condition pts to abstain from alcohol use

51
Q

What is Wernicke-Korsakoff synd caused by?

A

Thiamine (B1) deficiency

52
Q

What is the Triad of Wernicke encephalopathy?

A
  • Confusion
  • Ophthalmoplegia
  • Ataxia
53
Q

What are the sx of Korsakoff’s psychosis?

A
  • May progress to irreversible memorry loss
  • Confuabulation
  • Personality change
54
Q

What is Wernicke-Korsakoff synd assoc w/?

A

Periventricular hemorrhage/necrosis of mammillary bodies

55
Q

What is the tx for Wernicke-Korsakoff synd?

A

IV vitamin B1 (thiamine) 1st & then glucose

56
Q

What is Mallory-Weiss synd?

A

Longitudinal lacerations at the gastroesphageal junction caused by excessive vomiting

57
Q

What does Mallory-Weiss synd present w/?

A

Hematemesis

Assoc w/ pain

58
Q

What are Delirium tremens (DTs)?

A

Life-threatening alcohol w/drawal synd taht peaks 2-5 days after last drink

59
Q

What are the sx in order of appearance in Delirium tremens?

A
  • Autonomic system hyperactivity
  • Psychotic sx
  • Confusion
60
Q

What are the sx of autonomic system hyperactivity?

A
  • Tachycardia
  • Tremors
  • Anxiety
  • Seizures
61
Q

What are psychotic sx?

A

Hallucinations & delusions

62
Q

What is the tx for Delirium tremens?

A

Benzodiazepines

Psychiatry (6 decks)

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