Substance abuse Flashcards
What illicit drugs can cause psychosis similar to what is seen with schizophrenia?
Methamphetamine, PCP, LSD, mushrooms
What medical intervention is used for rapid relief of severe symptoms of hallucinogen intoxication (e.g. anxiety, fear, agitation)
A benzodiazepine
What adverse effects can be seen in meperidine (a synthetic opioid) intoxication in a chronic user?
Delirium or seizures (caused by the accumulation of normeperidine, a toxic metabolite with cerebral irritant properties)
At what BAL do symptoms of alcohol intoxication begin to appear in people with low tolerance?
20-30 mg/dL (0.02-0.03%)
How long does cocaine stay in the system?
2-4 days
How long does phencyclidine (PCP) stay in the system?
4-7 days
How long do barbiturates stay in the system?
Short-acting (e.g. pentobarbital): 24 hrs
Long-acting (e.g. phenobarbital): 3 weeks
How long do benzodiazepines stay in the system?
Short-acting (e.g. lorazepam): up to 5 days
Long-acting (e.g. diazepam): up to 30 days
How long do opioids stay in the system?
Urine drug tests remain positive for 1-3 days, but note that methadone and oxycodone will come up negative on a general screen (order a separate panel)
How long does marijuana stay in the system?
Single use: ~3 days
Heavy users: up to 4 weeks
What medication is useful for treating the autonomic instability (e.g. hypertension and sweating) seen with opioid withdrawal?
Clonidine
What medication is useful for treating the muscle ages, cravings, and insomnia associated with opioid withdrawal?
Methadone
What is the mechanism of action of amphetamines?
Increased release of dopamine and norepinephrine into the synaptic cleft
How is PCP intoxication managed?
Minimizing exposure to stimuli
What are adverse effects associated with inhalant abuse?
Hearing loss, peripheral neuritis, paresthesias, cerebellar signs, and motor impairments (neurologic symptoms). Muscle weakness can be caused by rhabdomyolysis, and patients may get irreversible hepatic and renal damage, cardiovascular symptoms and GI symptoms.
