SM_118b: Substance Intoxication and Withdrawal Flashcards
This is most consistent with ____
This is most consistent with opioid withdrawal
Beta-endorphin preferentially binds to the ____ opioid receptor
Beta-endorphin preferentially binds to the mu opioid receptor
Enkephalins preferentially bind to the ____ opioid receptor
Enkephalins preferentially bind to the delta opioid receptor
Dynoprhins prefentially bind to the ____ opioid receptor
Dynoprhins prefentially bind to the kappa opioid receptor
Opioid intoxication presents with ____, ____, ____, ____, ____, ____, and ____
Opioid intoxication presents with
- Respiratory depression
- Constipation, dry mouth
- Euphoria, mood changes
- Sedation
- Meiosis
- Flushing
- Impaired reflexes
____ include moprhine, codeine, thebaine, hydromorphone, hydrocodone, oxycodone, dihydrocodeine, and heroin
Opioids include moprhine, codeine, thebaine, hydromorphone, hydrocodone, oxycodone, dihydrocodeine, and heroin
Descibe symptoms of opioid withdrawal
Opioid withdrawal symptoms
- Pulse rate
- GI upset: vomiting, diarrhea
- Sweating
- Tremor
- Restlessness
- Yawning
- Mydriasis
- Anxiety / irritability
- Myalgias, arthralgias
- Piloerection
- Rhinorrhea, tearing
This is most consistent with ____
This is most consistent with stimulant intoxication
Methamphetamines and cocaine are ____
Methamphetamines and cocaine are stimulants
Stimulate intoxication presents with ____, ____, ____, ____, ____, ____, and ____
Stimulate intoxication presents with
- Euphoria, irritability, anger, tension
- Anxiety
- Psychomotor agitation: stereotypes, dyskinesia, restlessness
- Energy, less need for sleep
- Increased sympathetic ANS tone: tachycardia, HTN, mydriasis, and diaphoresis
- Chest pain, arrhytmias
- Seizures
Stimulant withdrawal presents with ____, ____, ____, ____, ____, ____, and ____
Stimulant withdrawal presents with
- Depression, dysphoria
- Appetite stimulation
- Fatigue
- Sedation, slowing
- Cravings
- Irritability
- Suicidality
This is most consistent with ____
This is most consistent with alcohol withdrawal
Prolonged drinking results in ____, ____, and ____
Prolonged drinking results in
- Down-regulation of GABAA receptors with prolonged stimulation
- Upregulation / alteration of NMDA receptors with inhibition
- Inhibition of catecholamines
Alcohol abstinence involves ____, ____, ____, an d____
Alcohol abstinence involves
- Decreased signaling and fewer GABAA receptors
- Increased glutamate transmission and signaling via altered receptors
- Increased catecholamine release
- Increased dopamine tranmission and plasma levels of homovallinic acid
Describe stages of alcohol withdrawal
Alcohol withdrawal stages
- Autonomic instability (minor withdrawal): in 6-48 hours
- Seizures in 12-48 hours
- Hallucinosis: 12-48 hours
- Delirium tremens: 3-5 days
____ stage of alcohol withdrawal occurs at 6-48 hours and involves insomnia / tremor / anxiety, GI upset / anorexia / headache, and diaphoresis / palpitations
Autonomic instability stage of alcohol withdrawal occurs at 6-48 hours and involves insomnia / tremor / anxiety, GI upset / anorexia / headache, and diaphoresis / palpitations
(increased adrenergic transmission)
Seizure stage of alcohol withdrawal occurs ____ after last drink and involves ____ seizures
(decreased GABAA transmission and increased NMDA transmission)
Seizure stage of alcohol withdrawal occurs 12-48 hours after last drink and involves GTC seizures
(phenytoin is less effective)
____ stage of alcohol withdrawal occurs at 12-24 hours after last drink until 48 hours and usually involves clear sensorium
Hallucinosis stage of alcohol withdrawal occurs at 12-24 hours after last drink until 48 hours and usually involves clear sensorium
(increased dopamine transmission)
____ stage of alcohol withdrawal involves perception change, disorientation, ANS changes, agitation, and diaphoresis and typically occurs ____ after last drink
Delirium tremens stage of alcohol withdrawal involves perception change, disorientation, ANS changes, agitation, and diaphoresis and typically occurs 3-5 days after last drink
(5% incidence, 5% mortality)
____ stage of alcohol withdrawl may involve mortality due to arrhythmiasn or complicating illness
Delirium tremens stage of alcohol withdrawl may involve mortality due to arrhythmiasn or complicating illness
____ and ____ are key for management of alcohol withdrawal
Early recognition and treatment are key for management of alcohol withdrawal
This is most consistent with ____
This is most consistent with hallucinogen intoxication
PCP has ____, ____, ____, and ____ effects
PCP has dissociation, perception, autonomic, and neuromuscular effects
PCP exerts dissociative properties by ____
PCP exerts dissociative properties by antagonizing the NMDA glutamate receptor
PCP, mescaline, psilocybin, and MDMA are ____
PCP, mescaline, psilocybin, and MDMA are hallucinogens
Hallucinations, light trails, micro/macropsia, and synesthesia are symptoms of ____ or ____ use
Hallucinations, light trails, micro/macropsia, and synesthesia are symptoms of psilocybin or mescaline use
____ affects the serotonergic systems and causes symptoms of euophoria, sense of connectedness, enhanced senses, extroversion, and well-being
MDMA affects the serotonergic systems and causes symptoms of euophoria, sense of connectedness, enhanced senses, extroversion, and well-being
Describe adverse effects of MDMA
MDMA adverse effects
- Side effects: nausea, bruxism, dry mouth, reduced appetite, headache, motor restlessness
- Serotonin syndrome: clonus, hyperthermia, HTN, delirium, rhabdomyolysis, seizures
- Long-term: aggression, poor impulse control, reduced serotonergic transmission
This is most consistent with ____
This is most consistent with cannabinoid withdrawal
Cannabinoids signal via the ____ and ____ receptors
Cannabinoids signal via the CB1 and CB2 receptors
- CB1 (CNS): analgesia, psychoactive, GI
- CB2: immune tissue
____ may cause a change in psychomotor behavior, impaired short-term memory, appetite stimulation, and analgesia
Cannabinoids may cause a change in psychomotor behavior, impaired short-term memory, appetite stimulation, and analgesia
____ is a synthetic cannabinoid that causes significant delays in gastric emptying and chemo-induced nausea and vomiting
Dronabinol is a synthetic cannabinoid that causes significant delays in gastric emptying and chemo-induced nausea and vomiting
Synthetic cannabinoids are often ____ in urine drug screens and are fragrant, longer-acting, and more potent
Synthetic cannabinoids are often undetected in urine drug screens and are fragrant, longer-acting, and more potent
Cannibinoid withdrawal presents with ____, ____, ____, and ____
Cannibinoid withdrawal presents with
- Significant depression / anxiety / irritability
- Fatigue
- Concentration deficits
- Nausea / vomiting
____ is recurrent episodes of nausea and profuse vomiting, involves dehydration, and may be relieved with hot showers (compulsive)
Cannabinoid hyperemesis syndrome is recurrent episodes of nausea and profuse vomiting, involves dehydration, and may be relieved with hot showers (compulsive)
