Substance Abuse

Question 1

Barbiturates (benzodiazepines)

Answer 1

Abuse s/s: respiratory depression, decrease BP and pulse, coma, seizures, nystagmus

Withdrawal s/s: anxiety, insomnia, convulsions, delirium, tremors, increase temp

Maintain airway. Check LOC. Start IV. Give Na bicarbonate to promote excretion. Hemodialysis.

Question 2

Narcotics (morphine, heroin, codeine, dilaudid)

Opioids

Answer 2

Abuse: hyperpyrexia, respiratory depression, pinpoint pupils, seizures
Withdrawal: watery eyes, runny nose, decrease appetite, cramps, increase BP

Maintain airway. Control seizures. Have lidocaine and defib. Available. Give naloxone to reverse respiratory depression

Question 3

Stimulants (cocaine, amphetamines)

Answer 3

Abuse: tachycardia, increase BP, tachypnea, irritability, anxiety, euphoria, nasal septum perforation(cocaine), blurred vision, decrease weight, cravings
Withdrawal: apathy, long periods of sleep, depression, nightmares

Maintain airway. Start IV. Use cardiac monitoring.

Question 4

Alcohol

Answer 4

Intoxification: tremors, nystagmus, diminished reflexes, possible hypoglycemia, belligerence

Withdrawal: insomnia, anxiety, anorexic, hallucinations, delirium, ideas of reference, potential coma or death.