SM_118b: Substance Intoxication and Withdrawal Flashcards by Nathan Shlobin

This is most consistent with ____

This is most consistent with opioid withdrawal

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Beta-endorphin preferentially binds to the ____ opioid receptor

Beta-endorphin preferentially binds to the mu opioid receptor

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Enkephalins preferentially bind to the ____ opioid receptor

Enkephalins preferentially bind to the delta opioid receptor

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Dynoprhins prefentially bind to the ____ opioid receptor

Dynoprhins prefentially bind to the kappa opioid receptor

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Opioid intoxication presents with ____, ____, ____, ____, ____, ____, and ____

Opioid intoxication presents with

Respiratory depression
Constipation, dry mouth
Euphoria, mood changes
Sedation
Meiosis
Flushing
Impaired reflexes

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____ include moprhine, codeine, thebaine, hydromorphone, hydrocodone, oxycodone, dihydrocodeine, and heroin

Opioids include moprhine, codeine, thebaine, hydromorphone, hydrocodone, oxycodone, dihydrocodeine, and heroin

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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

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This is most consistent with ____

This is most consistent with stimulant intoxication

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Methamphetamines and cocaine are ____

Methamphetamines and cocaine are stimulants

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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

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Stimulant withdrawal presents with ____, ____, ____, ____, ____, ____, and ____

Stimulant withdrawal presents with

Depression, dysphoria
Appetite stimulation
Fatigue
Sedation, slowing
Cravings
Irritability
Suicidality

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This is most consistent with ____

This is most consistent with alcohol withdrawal

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Prolonged drinking results in ____, ____, and ____

Prolonged drinking results in

Down-regulation of GABA_A receptors with prolonged stimulation
Upregulation / alteration of NMDA receptors with inhibition
Inhibition of catecholamines

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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

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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

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____ 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 GABA_A 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)