Substance Use Flashcards
What are some physical exam findings in acute PCP intoxication?
1) Vital sign abnormalities (hypertension, tachycardia)
2) Ataxia
3) Nystagmus (PCP is the ONLY drug to cause vertical nystagmus, though other forms can be found)
4) Dysarthria
5) Muscle rigidity
6) DECREASED pain sensation
7) Seizures
Timeline of PCP intoxication
- Intoxication occurs in 1-2 hrs
- Peaks at 2-4 hrs
- Lasts 8-12 hrs
How do you manage PCP intoxication?
- Calm environment with minimal stimulation
- Diazepam or haloperidol for agitation
What are the two most studied genes implicated in substance use disorders?
The genes encoding for 1) alcohol dehydrogenase and 2) aldehyde dehydrogenase
What gene is associated with developing psychosis after cannabis use?
AKT1
What is a common lab abnormality in MDMA intoxication?
Hyponatremia (due to increased intake of water AND the secretion of ADH) –> typically less than 120
Why should patients on SSRIs or MAO-Is avoid using MDMA (molly, ecstasy)?
Increased risk of serotonin syndrome
What are signs of MDMA (methlylenedioxy-methylphenidate) intoxication?
- Mild hallucinogenic effects
- Increased TACTILE sensitivity
- Empathetic feelings
- Lowered inhibition
- Blurred vision
- Anxiety, agitation
- Chills, sweating
- Hypertension, tachycardia
- Teeth clenching
- Muscle cramping
- Sleep disturbance
What are the life-threatening effects of MDMA (methlylenedioxy-methylphenidate) intoxication?
Life threatening: hypertensive emergency, hepatotoxicity, serotonin syndrome, arrhythmia, seizures, coagulopthy
Why are children 6 and younger more susceptible to lead poisoning?
1) Incomplete blood brain barrier
2) Increased incidence of iron deficiency (leading to increased GI lead exposure)
3) Increased exposure to lead dust
