substance use Flashcards
skin abscess cause
meth, heroin
d/t IV and “skin popping” abuse
cardiac murmur cause
IV heroin
2/2 vegetations introduced through IVDU
septic emboli, septic arthritis, osteomyelitis, spinal epidural abscess causes
any IV drug, but predominantly heroin
2/2 IVDU
stroke cause
sympathomimetic agents, predominantly meth, cocaine, or IV heroin
2/2 cerebral vasoconstriction
cardiac dysrhythmias cause
cocain, meth/derivatives
methadone - QT prolongation
violent, paranoid behavior cause
sympathomimetics, especially meth/derivatives, cocaine, PCP, synthetic cannabinoids
excessive DA or 5-HT stimulation in CNS
s/s of opioid withdrawal
watering eyes, runny nose, yawning, muscle twitching, hyperactive BS, piloerection
opioid withdrawal mgmt
clonidine for s/s
buprenorphine (can precipitate withdrawal)
methadone
supportive tx
BDZ withdrawal s/s
anxiety, tension, excessive sweating, HA, muscular stiffness, palpitations, tremors, cravings, panic attacks
tx of BDZ withdrawal
seizure monitoring - carbamazepine
supportive tx
flumazenil - for BDZ induced sedation (can lower seizure threshold)
s/s of meth intox
adrenergic excess!!! (inc catecholamines - DA, 5-HT, NE)
diaphoretic, hypertensive, tachycardia, agitation/psychosis, hyperthermia, mydriasis (dilation)
seizures, choreiform movement
meth intox mgmt
agitation -> benzos, antipsychotics
airway mgmt
tachycardia/HTN ->metop (just tachycardia), labetolol (tachycardia/HTN), nitroprusside (HTN w/o tachycardia)
hyperthermia - no antipyretics
fluid resuscitation
cocaine use tx
high risk for suicide
CBT
modafininil, topiramate, bupropion, propranolol
contingency mgmt - voucher based reinforcement therapy
s/s of acute cocaine toxicity
stage 1 - HTN, hyperthermia, agitation
stage 2 - worsening HTN, tachypnea, worsened hyperthermia, increased DTRs
stage 3 - cardiac arrest, hypotension, resp depression/agonal breathing
acute cocaine toxicity tx
HTN - benzos
