Substances

Question 1

SSRI acute withdrawal

Answer 1

• fatigue
• dizziness
• GI distress
• flu like symptoms
• electric shock
• dysphoria (dissatisfaction with life)

Restart and taper

Question 2

SSRI early side effects

Answer 2

• sexual dysfunction
• diarrhea
• anxiety
• headache
• insomnia

Think stimulating (erection is PNS btw)

Question 3

Alcohol withdrawal

Answer 3

Within 1 day

• tremors
• nausea/vomiting
• irritability/anxiety

-Alcoholic hallucinosis
most commonly visual
-no autonomic signs
-usually resolves in 48 hrs

1-2 days
Generalized tonic clonic seizures

2-4 days 
Delirium Tremens
-hallucinations 
\+confusion, disorientation
\+ autonomic instability (tachycardia, arrhythmia, fever, HTN, diaphoresis, increased RR) 

most common cause of death in DT: respiratory failure and cardiac arrhythmias.

• same sxs as benzos withdrawal
  tx: benzodiazepine taper

Question 4

LOT drugs in liver failure

Answer 4

Lorazepam
Oxazepam
Temazepam

these do not need to be metabolized to active compounds by the liver.

Question 5

Cocaine intoxication

Answer 5

Normal: euphoria, nausea, dilated pupils, tachycardia, chills, diaphoresis

Dangerous: 
respiratory depression, 
arrhythmias, 
seizures, 
hyperthermia, 
hallucinations (tactile)

Deadly: Myocardial infarction, stroke, intracranial hemorrhage

Question 6

Amphetamine intoxication

Answer 6

Euphoria
Dilated pupils
Increased sex drive
Tachycardia
Diaphoresis
Bruxism
Chest pain 
Seizures 

Overdose:
-hyperthermia
Dehydration
Rhabdomyolsis
Renal Failure 

Chronic> tooth decay “meth mouth”

Question 7

PCP overdose

Answer 7

Seizures (tx benzodiazepines)
Delirium
Coma
Death maybe

no withdrawal sxs