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Flashcards in Amphetamine intoxication Deck (15)
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1

Behavioural changes in stimulant intoxication

Euphoria/affective bluncting
Changes in social
Hypervigilant
Interpersonal sensitivty
Anxiety
Tension/anger
Stereotyped
Impaired judgement

2

Signs and symptoms of stimulant intoxications

Tachy/brady
Pupillary dilitation
+BP, -ve BP
Perspiration
NV
Weight loss
Psychomotor agitation/retardations
Muscle weakness, respiratory depression, chest pain, cardiac arrythmias
Confusion, seizures, dyskinesis, dystonias, coma

3

Mechanism of action

Takes place in VMAT= +dopamine release

4

Effects during pregnancy

Bleeding
Miscarriage
IUGR

Irritable, overactive->withdrawal

Poor breast feeding

5

Imaging of brain in chronic use

Bleeding
Ischemia
Infarction
Impaired blood flow

6

Long term effects

Cardiovascular risks: hypertension, arrythmias, MI, HF
Violence/aggression, psychosis, depression
Brain damage

7

Withdrawal

Crash
Withdrawal
Extinction

1. Sleep
2. Mood
3. Concentration
4. Appetite

8

What is the crash phase: onset, lasts how long, features

12-24 hours after first dose
Last 2-4 days
Fatigue, reduced craving, +sleep

9

What is the withdrawal phase: onset, duration, features

7-10 days, subsiding over 2-4 weeks
+Cravings, disturbed sleep, irritability, poor concentration, fluctuating moods ad disturbed thoughts
Extreme hunger

10

What is the extinction phase: onset, features

Involves weeks-months
Resumption of normal
Fluctuating moods/cravings
Altered irritability, agitation, fatigue, anhedonia.

11

Differential diagnosis

Amphetamine-induced
Cocaine intoxication
Hallucinogen intoxication
PCP

12

Management

Monitor and repeated assessment
No specific pharmacotherapy
Supportive, recovery is time dependant
Antipsychotics may be required if severe psychosis

13

Investigations

Urine toxicology
ECG-> MI, SVT, right heart strain associated with pulmonary HTN
Sodium->low, particularly in ecstasy
CK->elevated if suspect amphetamine induced rhabdomyolysis

Blood toxicology if need forensic confirmations
Echocardiogram

14

Patient instructions

Avoid further doses
Enrol in drug treatment program

15

What is meth mouth

Poor dentition due to lowered salivation and sugar cravings