Recreational substances Flashcards
Amphetamine - symptoms
Sympathomimetic (agitation, sweating, tachycardia, hypertension, hyperthermia), other (hypoNa, seizures, rhabdomyolysis, ICH)
Amphetamine - management
Safe, low stim environment. CCM. Benzos if needed.
ECG, BGL, UEC, CK, troponin. IC imaging if concern for vascular dissection.
Cannabis - symptoms
Mild sedation, euphoria, disinhibition –> CNS depression. Anxiety, psychosis. Hypotension, tachycardia.
Cannabis - management
Supportive care until asymptomatic. Diazepam. IV fludis if postural hypotension.
GHB - symptoms
CNS/resp depression, bradycardia, myclonic jerks. Hypertension.
Precursor of GABA so affects multiple neurotransmitters - dopamine, serotonin.
GHB - management
monitoring in resus. Improves within 4-6 hrs.
Hallucinogens - symptoms
Anti-cholinergic: agitation, delirium, hallucinations, mydriasis, tachycardia, dry flushed skin
Hallucinogens - management
Supportive care. Treat delirium with titrated diazepam.
Anti psychotics may worsen symptoms.
Opiates - symptoms
- CNS & respiratory depression associated with miosis
- Dextropropoxyphene (Digesic) - seizures & arrhythmias
- Tramadol - seizures & serotonin syndrome
Opiates - management
- Monitor for CNS & respiratory depression
- Airway protection & ventilation ensures good outcome
- Naloxone infusion (note short half-life)
- Treat seizures with benzodiazepines and phenobarbitone
Inhalants/Volatile Substance Abuse - symptoms
Euphoria/disinhibition followed by CNS depression.
Encephalopathy/seizures, methaemoglobinaemia, cardiac arrhythmias
Inhalants/Volatile Substance Abuse - management
Behavioural disturbance - benzos
Avoid/limit adrenaline if go into cardiac arrest
Alcohol - symptoms
hypoglycaemia, hypothermia, coma (even with small amounts of ethanol)
hypotension, tachycardia
Alcohol - management
Monitor and give frequent CHO containing drinks.
Manage symptoms (hypoglycaemia, hypovolaemia, hypothermia)
Monitor if decreased GCS, respiratory depression
