Substance Use Flashcards
Maintenance for opiate use
Methadone OR buprenorphine
Can be used for tobacco USE to help patients stop
Buproprion OR varenicline
GIVE IV _______________ for delirium tremens from alcohol withdrawal
IV lorazepam
More than _____________ on the CAGE is indicative that an alcohol use disorder is likely
1 yes
Disinhibition. Impaired judgment. Emotional lability. Slurred speech. Ataxia. Aggression. Blackouts (retrograde amnesia). Coma
Alcohol intoxication
Alcohol intoxication can lead to
Hypoglycemia
Tremor, tachycardia, hypertension, seizures, agitation, hallucinations, delirium tremens
Alcohol withdrawal
Have a low safety margin and cause respiratory depression
Barbiturates
Withdrawal can cause life-threatening cardiovascular collapse. Seizures and delerium
Barbiturates
Can have interactions with alcohol
Benzos
Amnesia, ataxia, somnolence, mild respiratory depression
Benzo intoxication
Withdrawal = rebound anxiety, seizures, tremors, insomnia, hypertension, tachycardia
Benzo withdrawal
Intoxication = restlessness, insomnia, anxiety
Nicotine intoxication
Withdrawal = irritability, headaches, cravings, weight gain, anxiety
Nicotine withdrawal
Intoxication - restlessness, insomnia, diuresis, muscle twitching, arrhythmias, psychomotor agitation
Caffeine intoxication
Withdrawal - headache, lethargy, depression, weight gain, irritability, cravings
Caffeine withdrawal
Euphoria, slowed sense of time, impaired judgment, “heightened senses”
Marijuana
Social withdrawal, increased appetite, dry mouth, diaphoresis (sweating), conjunctival injection (red eyes)
Marijuana
Hallucinations, anxiety, paranoia, tachycardia, hypertension, no motivation
Marijuana
MARKED anxiety or depression. PUPIL DILATION.
FLASHBACKS are long term consequence.
Delusions, visual hallucinations
LSD
Treat - give reassurance and low stimulation environment. Benzos for severe symptoms
LSD
Phencyclidine hydrochloride
PCP
Belligerence, psychosis, violence, impulsiveness, psychomotor agitation
PCP
Vertical and horizontal nystagmus
PCP
Fever, tachycardia, ataxia, seizures, delirium
PCP
Reassure.
IF SEVERE, give benzos or haloperidol
PCP
Recurrence of intoxication symptoms due to reabsorption in GI tract - sudden onset of severe, random violence
PCP
Intoxication - Euphoria leading to apathy. CNS depression, constipation, PUPIL CONSTRICTION, respiratory depression
Opioid intoxication
Naloxone/Naltrexone will reverse effects
Opioids
Long acting opioid
Methadone
Withdrawal - anxiety, insomnia, anorexia, diaphoresis (sweating), dilated pupils (blown pupils), fever, rhinorrhea (runny nose), piloerection (goose bumps), nausea, stomach cramps, diarrhea, yawning, myalgia. Extremely uncomfortable, but rarely life threatening
Opioid withdrawal
Intoxication - psychomotor agitation, impaired judgment, tachycardia, pupillary dilation (blown pupils), fever, diaphoresis (sweating), hypertension, paranoia, angina, arrhythmias, seizures, hallucinations, sudden death
Amphetamines/cocaine
Treat intoxication with sedatives and benzos for severe agitation
Amphetamines/cocaine
Post use “crash” with hypersomnolence, dysphoria (uneasy feeling), nightmares, depression, malaise, severe craving, suicidality
Amphetamine/cocaine withdrawal
Check vitals signs for this for alcohol withdrawal
Tachycardia and hypertension
Palmar erythema and spider angiomata indicate
Liver disease
Macrocytosis.
Increased AST and GGT
Alcohol use disorder
For alcohol withdrawal, start
Benzo taper (chlordiazepoxide, lorazepam).
Give multivitamins and folic acid.
Thiamine BEFORE GLUCOSE to prevent wernicke’s encephalopathy
Disulfiram, naltrexone, and acamprosate can be used in
Alcohol withdrawal
Acute and usually reversible ataxia. Confusion and ophthalmoplegia.
Wernicke’s encephalopathy
Chronic. Often irreversible. Anterograde amnesia with OR without confabulation
Korsakoff’s syndrome
