QUIZ 4 Flashcards
Symptoms of withdrawal usually begins 4 to 12
hours after cessation or marked reduction of
alcohol intake
Coarse hand tremors,
Sweating
3. Elevated pulse and blood pressure
4. Insomnia
5. Anxiety
6. Nausea and vomiting
Severe or untreated withdrawal may progress to
transient hallucinations, seizures
Delirium Tremens”
Alcohol withdrawal usually peaks on the
2nd day
and is over in about 5 days.
a life threatening
condition and detoxification needs to be
accomplished under medical supervision.
Alcohol withdrawa
Safe withdrawal is usually accomplished with the
administration of
benzodiazepine
benzodiazepine such as
Lorazepam (Ativan ) and Chlordiazepoxide
( Librium ) or Diazepam (Valium )
Withdrawal can be accomplished by fixed
schedule dosing known as
tapering
Total
score less than 8 indicate
mild withdrawal
8 to 15 means
moderate
greater
than 15 indicate
severe withdrawal
PHYSIOLOGIC EFFECTS OF LONG TERM
ALCOHOL USE
Cardiac Myopathy
Wernicke Encephalopathy
Korsakoff Psychosis
Acute
neurological condition characterized by clinical triad
of opthalmoparesis
Wernicke Encephalopathy
This is life threatening condition brought
about by thiamine deficienc
Wernicke Encephalopathy
is a late
complication of persistent Wernicke
encephalopathy
Korsakoff Psychosis
Korsakoff Psychosis ( is a late
complication of persistent Wernicke
encephalopathy, results in
memory deficit, confusion and behavioral changes
it occurs in 80%
of untreated Wernicke encephalopathy severe
alcoholism is the underlying condition
Pancreatitis
Esophagitis
Hepatitis
Cirrhosis
Leukopenia
Thrombocytopenia
Ascites
the most
frequently abused drugs in this category.
Benzodiazepines and Barbiturates
(benzo & barbi)
Symptoms of Intoxication:
- Slurred speech
- Lack of coordination
- Unsteady gait
- Labile mood
- Impaired attention or memory
- Stupor and coma
Benzodiazepines when taken alone orally in
overdose is not fatal but the person is
lethargic and
confused
TREATMENT
Gastric lavage & . Dialysis
contrast can be lethal when
taken in overdose
Barbiturates
Barbiturates by contrast can be lethal when
taken in overdose. They can cause:
. Coma
2. Respiratory arrest
3. Cardiac failure
4. Death
The withdrawal syndrome is characterized by
symptoms that are the opposite of the acute
effects of the drug
. Autonomic hyperactivity ( increased pulse, blood
pressure, respirations and temperature )
2. Hand tremor
3. Insomnia
4. Anxiety
5. Nausea
6. Psychomotor agitation
are drugs that stimulate or excite the central
nervous system and have limited clinical use
Stimulants
) this was popular in
the past, they were used by people who
wanted to lose weight quickly or stay awake
Amphetamines ( Uppers )
n illegal drug with virtually no clinical
use in medicine is highly addictive and a
popular recreational drug because of the
intense and immediate feeling of euphoria it
produces.
Cocaine
particularly dangerous.
It is highly addictive and causes psychotic
behavior.
Methamphetamine
intoxication from stimulants develops rapidly. Effects include :& Physiological effects include:
Effects include : High or euphoric feeling hyperactivity, Hypervigilance Talkativeness Anxiety Grandiosity Hallucinations stereotypic or repetitive behavior Anger Fighting Impaired judgment
Physiological effects include: Tachycardia Elevated blood pressure Dilated pupils Perspiration or chills Nausea Chest pain
Confusion
Cardiac dysrhytmias
Overdose in stimulants can result in
seizures and
coma. Deaths are rare.
an antipsychotic, controls hallucination and lower blood pressure and
relives nausea.
Chlopromazine
Marked dysphoria is the primary
symptom, accompanied by:
Fatigue Vivid unpleasant dreams Insomnia or hypersomnia Increased appetite
Psychomotor retardation or agitation
Marked withdrawal symptoms are referred to
as crashing
– is the hemp plant that is widely
cultivated for its fiber used to make rope and cloth
and for oil from its seed. I
Cannabis Sativa
The resin contain
more than 60 substances called
cannabinoids
refers to the upper leaves, flowering
tops and stems of the plant.
Marijuana
dried resinous exudate from leaves
of the female plant.
Hashish
Two cannabinoids approved for the use of
treating nausea and vomiting asoociated with
cancer chemotherapy:
. Dronabinol ( Marinol )
2. Nabilone ( Cesamet )
Cannabis begins to act
Peak usually occurs in
less than 1 minute after
inhalation
20 to 30 minutes and last
at least 2 to 3 hours.
Effect on the users: (cannabis)
Symptoms of Intoxication
Additional physiological effects:
Effect on the users: High feeling same to that on alcohol Lowered inhibitions Relaxation
Euphoria And increases appetite
Symptoms of Intoxication: Impaired motor coordination
Inappropriate laughter Impaired judgment Short term memory, and distortions of time
and perception. ○ Anxiety, dysphoria and social withdrawal may
occur in some users.
Additional physiological effects: Conjunctival injection ( bloodshot eyes ) Dry mouth
Hypotension
Tachycardia
Excessive use of cannabis may produce
delirium
are popular drugs of abuse because
they desensitize the user to both physiological and
psychological pain and induce a sense of euphoria
and well being.
Opioids
Opioid compounds include both potent
prescription analgesic such as:
Morphine Meperidine( Demerol ) Codeine Hydromorphone Oxycodone Methadone Oxymorphone Hydrocodone Propoxyphene
is a synthetic opioid
used in clinical setting for anesthesia.This also is
thought to be the cause for dramatic increase in
death from opioid deaths due to overdose
Fentanyl
Opioid intoxication develops soon after the initial
euphoric feeling.
Symptoms: Apathy Lethargy Listlessness Impaired judgment Psychomotor retardation or agitation
Constricted pupil Drowsiness Slurred speech
Impaired attention and memory
Severe intoxication and overdose can lead to: (opiod)
Coma Respiratory depression
Pupillary constriction
Unconsciousness Death
an opioid antagonist is the
drug of choice because it reverses all signs of opioid
toxicity.
Naloxone
Opioid withdrawal develops once drug intake
ceases or decreases markedly. Symptoms
( initially):
Anxiety Restlessness Aching back and legs Cravings for more opioids
Symptoms progresses to the following:
Nausea Vomiting Dysphoria ( a depressed low energy state
characterized by flattened emotions, lack of
interest in sex and physical immobility) Lacrimation
Rhinorrhea Sweating Diarrhea Yawning Fever Insomnia
Heroin produce withdrawal symptoms in
n 6 to 24
hrs; the symptoms peak in 2 to 3 days and gradually
subside in 5 to 7 days.
( opoid) Withdrawal Symptom such
s anxiety, insomnia, dysphoria, anhedonia and drug craving may persists
for weeks or months.
hallucinogen effects
Effects: Increased pulse, blood pressure, and
temperature Dilated pupils Hyperreflexia ( presence of hyperactive stretch
reflexes of the muscles)examples: finger
flexion reflexes; jaw jerks, clonus and
“irradiating” reflexes
are substances that distort the user’s
perception of reality and produce symptoms similar to psychosis, including hallucinations
HALLUCINOGEN
Example of hallucinogen:
Mescaline Psilocybin
Lysergic acid diethylamide Designer drug such as ecstasy
developed as anesthetic is
included because it acts similarly to hallucinogen.
Phencyclidine
hallucinogen
Symptoms of Intoxication( Marked by several
behavioral or psychological changes):
Symptoms of Intoxication( Marked by several
behavioral or psychological changes):
Anxiety
Depression
Paranoid ideation
Ideas of reference
Fear of losing one’s mind
Potentially dangerous behaviors such as
jumping out of a window in the belief than one
can fly.
Hallucinogen Physiological Symptoms:
Physiological Symptoms:
Sweating
Tachycardia
Palpitations
Blurred vision
Tremors and lack of coordination
Psychotic reaction is best managed by
external
stimuli isolation
Treatment of toxic reaction is supportive:
external
stimuli isolation, Physical restraints
HALLUCINOGEN
Toxicity symptoms:
Seizures Hypertension
Hyperthermia Respiratory depression
used and mechanical ventilation is used to
support respirations.
Cooling devices such as hyperthermia blankets
Are a diverse group of drugs that include
anesthetics, nitrates, and organic solvents, that are
inhaled for their effects.
INHALANTS
Common substances on this category are:
Aliphatic and aromatic hydrocarbons found
in gasoline, paint thinner, glue, and spray
paint. Less frequently used halogenated
hydrocarbons include cleaners, correction
fluid, spray can propellants, and
other compounds containing esters, ketones, and glycoles.
○ Inhalants can cause significant
brain damage, peripheral nervous system damage and liver
disease.
Intoxication symptoms: (INHALANTS)
Intoxication symptoms: Dizzeness Nystagmus ( rapid uncontrolled repetitive
movement of the eye) Lack of coordination
Slurred speech
Unsteady gait Tremor Muscle weakness Blurred vision
Stupor and coma can occur
(INHALANTS)
TREATMENT
Supporting cardiac and respiratory
functioning
People who abuse inhalants may suffer from
persistent dementia, or inhalant induced disorders
such as psychosis, anxiety or mood disorders
