Substances of Abuse (Drugs, etc.)

Question 1

Methamphetamine

Answer 1

“Ice, Glass, Crystal”

1. Chronic Meth Abuse Sx:
   - Delusions
   - Tactile hallucinations (bugs under skin)
   - Aggressive behavior
   - Insomnia
   - Wt loss
   - Psychosis
   - Poor dentition + skin excoriation d/t skin picking
2. Other Meth Intoxication Sx:
   - Mood disturbances
   - Anxiety
   - Irritability
   - Confusion
   - Violent behavior
   - Sympathetic over-activity (High HR/BP, Hyperthermia, Sweating, Pupil Dilation)

Question 2

3,4-Methylenedioxy-methamphetamine

Answer 2

MDMA/Ecstasy/Molly = synthetic amphetamine w/hallucinogenic properties (seen during “raves”)
-Causes increase in synaptic NE, Dopamine, Serotonin

1. Intoxication Sx:
   - Euphoria
   - Increased sociability
   - Increased empathy
   - Increased sexual desire
   - HTN, tachycardia, hyperthermia, serotonin syndrome, hyponatremia, death
   - Risk of serotonin syndrome when combine MDMA w/SSRI or other serotonergic dru

Question 3

Phenicycline

Answer 3

PCP

1. PCP Intoxication Sx:
   - Behavior changes: Violent Aggression, Severe Agitation
   - Impulsivity
   - Impaired judgment
   - Acute psychotic sx: Paranoia, Hallucinations
   - Nystagmus
   - Amnesia, analgesia, HTN, tachycardia, ataxia, dysarthria, muscle rigidity, seizures, coma

Question 4

Bath Salts

Answer 4

Synthetic cathinones

Intoxication Sx:

• Severe agitation, combativeness
• Hyperthermia, but no high fevers

Question 5

Opioids/Heroin

Answer 5

Intoxication Sx:

• Slurred speech
• Pinpoint pupils
• Sedation/Drowsiness
• CNS Depression
• Constipation

Question 6

Cocaine

Answer 6

1. Cocaine Intoxication Sx:
   - Euphoria
   - Anxiety
   - Agitation
   - Psychosis
   - Delirium
   - Hypertension or Hypotension, Tachycardia or Bradycardia, Sweating, Nausea, Vomiting
   - Pupil dilation

Overdose Sx:

• Cardiac arrhythmia
• MI
• Seizures
• Stroke

Question 7

Lysergic acid diethylamide

Answer 7

LSD

1. LSD Intoxication Sx:
   - Euphoria
   - Subjective perceptual intensification (if. Brighter colors, heightened tastes, enhanced sensation)
   - Depersonalization
   - Illusions
   - Sweating, Tachycardia, Pupil Dilation, Palpitations, Tremors, Poor Coordination

Question 8

Alcohol

Answer 8

1. Alcohol Intoxication Sx:
   - Ataxia
   - Nystagmus
   - Aggression
   - Impaired judgment
2. Alcohol Withdrawal Sx:
   - Hallucinations
   - Tremor
   - Diaphoresis

Question 9

Benzos/Barbiturates

Answer 9

Intoxication Sx:

• Dysarthria
• Ataxia
• Sedation
• Decrease HR, Hypotension
• Anticonvulsants

Question 10

Inhalants:

Answer 10

CNS Depressants

Intoxication Sx (last 15-45 mins)

• Slurred speech
• Dizziness
• Transient euphoria
• Loss of consciousness

Question 11

Marijuana

Answer 11

Cannabis

Intoxication Sx:

• Euphoria
• Inappropriate laughter
• Lethargy
• Distorted sensory perceptions
• Conjunctival injection
• Increased appetite
• Tachycardia + hypertension = possible