Substances

Question 1

Marijuana and Hasish

Answer 1

Euphoria, dec reaction time, impaired memory, panic attacks

Question 2

Depressant Effects

Answer 2

(barbiturates, benzos, GHB or gamma hydroxy-butyrate, methaqualone, alcohol)

• Dec anxiety and inhibitions, resp depression, dec BP, sedation, drowsiness, etc

Question 3

Alcohol Withdrawal

Answer 3

• insomnia/anxiety/headache/GI upset –> hallucinations –> sz –> delirium tremens (tachy, hypertension, fever, agitation and disorientation)
• Treat Alcohol WIthdrawal w/ naltrexone, acamprosate, benzo, anticonvulsant, clonidine

Question 4

Dissociative Drugs

Answer 4

• Ketamine (NMDA antagonist) and PCP - tachy, HTN, memory loss, numbness, vomiting
• PCP can cause nystagmus and aggression

Question 5

Opioid Effects

Answer 5

(codeine, heroin, fentanyl, morphine, opium, oxy, hydrocodone)

• Pain relief, euphoria, miosis (pinpoint pupils), nausea constipation, resp depression, coma

Question 6

Opioid Withdrawal

Answer 6

muscle cramp, anxiety, nausea, vomiting, pilot reaction, sweating, rhinorrhea, lacrimation, diarrhea, inc BP and pulse (similar to flu)

Question 7

3 Opioid Addiction Meds

Answer 7

• Methadone - long acting synthetic opioid
• Naltrexone - long acting antagonist
• Buprenorphine - partial opioid agonist

Question 8

Hallucinogens

Answer 8

(LSD, mescaline, psilocybin)

• Altered perception, flashbacks, inc body temp, inc BP, tremor, paranoia

Question 9

Stimulant Effects

Answer 9

(amphetamine, cocaine, MDMA, methamphetamine, nicotine, methylphenidate AKA RItalin)

• Inc HR, inc BP, inc metabolism, inc mental alertness, arrhythmia, dec appetite, insomnia, tachypnea
• MDMA also has mild hallucinogenic effects
• Cocaine - can cause coronary vasospasm (esp if used in combo w/ alcohol –> cocaethylene) and dilated pupils

Question 10

Stimulant Withdrawal

Answer 10

Paranoia, depression, somnolence, anxiety rebound, diff concept, psychomotor retardation, inc appetite (all opposite); can give Ritalin or amantadine, propranolol, bupropion

Question 11

How long do certain drugs stay in system for toxicology screening?

Answer 11

• Alcohol - 3 to 10 hrs
• Amphetamines - 24 to 48 hrs
• Barbiturates and benzos - up to 6 wks
• Cocaine - 1 to 2 days
• Codeine/heroin/hydromorphone/morphine - 1 to 2 days
• PCP - 1 to 8 days

Question 12

MORPHINE - ABC Pneumonic

Answer 12

• M - miosis (pinpoint pupils)
• O - out of it (sedated)
• R - resp distress
• P - pneumonia / aspiration
• H - hypotension / hypothermia
• I - infrequency (constipation and dec urination)
• N - Nausea
• E - emesis / euphoria
• A - analgesic
• B - bradycardia
• C - coma