Drug Intoxications and Withdrawal Flashcards Preview

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Flashcards in Drug Intoxications and Withdrawal Deck (23)
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1

Alcohol Intoxication

- Emotional lability, slurred speech, ataxia, coma, blackouts
- Serum gamma-glutamyltransferase (GGT) = sensitive indicator of alcohol use
- AST >> ALT

2

Alcohol Withdrawal

- Mild: anxiety, tremor, seizures, insomnia
- Severe: autonomic hyperactivity, delirium tremens (5-15% mortality rate)

3

Delirium Tremens

- Peaks 2-4 d after last drink
- Autonomic hyperactivity --> tachy, tremors, anxiety, seizures
- Occurs in hospital (2-4 d post-surgery) in alcoholics
- Rx: benzodiazepines

4

Alcoholic Hallucinosis

- Visual hallucinations 12-48 hrs after last drink
- Rx: benzodiazepines (chlordiazepoxide, lorazepam, diazepam)

5

Opioid Intoxication (Heroin)

- Euphoria, RESPIRATORY AND CNS DEPRESSION, decreased gag reflex, pupillary constriction (pinpoint pupils), seizures
- Most common cause of drug OD death
- Rx: naloxone, naltrexone

6

Opioid Withdrawal (Heroin)

- Sweating, dilated pupils, piloerection, fever, rinorrhea, YAWNING, LACRIMATION nausea, stomach cramps, diarrhea ("flu-like sx")
- Rx: long-term support, methadone, buprenorphine

7

Barbiturate Intoxication

- Marked respiratory depression
- Rx: sx management (assist respiration, increased BP)
- Low safety margin

8

Barbiturate Withdrawal

- Delirium, life-threatening CV collapse

9

Benzodiazepine Intoxication

- Greater safety margin
- Ataxia, minor respiratory depression
- Rx: flumazenil (benzo R antagonist, but rarely used because it causes seizures)

10

Benzodiazepine Withdrawal

- Sleep disturbances, depression, rebound anxiety, seizure

11

Amphetamine Intoxication

- Euphoria, grandiosity, pupillary dilation, prolonged wakefulness & attention, HTN, TACHY, anorexia, paranoia, fever
- Severe --> cardiac arrest, seizures
- Rx: benzos for agitation and seizure
- Presents similarly to paranoid schizophrenia

12

Stimulant Withdrawal

Post-use "crash" --> depression, lethargy, increased appetite, sleep disturbance, vivid nightmares

13

Cocaine Intoxication

- Impaired judgement, pupillary dilation, hallucination (TACTILE), paranoid ideations, ANGINA, SUDDEN CARDIAC DEATH
- Rx: alpha blockers, benzos
- BETA BLOCKERS NOT RECOMMENDED

14

Caffeine Intoxication

- Restlessness, diuresis, muscle twitching

15

Caffeine Withdrawal

- HA, difficulty concentrating, flu-like sx

16

Nicotine Intoxication

Restlessness

17

Nicotine Withdrawal

- Irritability, anxiety, restlessness, difficulty concentrating
- Rx: nicotine patch, bupropion/varenicline

18

Phencyclidine Intoxication
(NMDA R antagonist)
"Angel Dust"

- Violence, impulsivity, psychomotor agitation, NYSTAGMUS, tachycardia, HTN, analgesia, psychosis, delirium, seizures, DISORIENTATION/DETACHMENT
- Trauma is most common complication
- Rx: Benzodiazepines, rapid-acting antipsychotic

19

Lysergic Acid Diethylamide Intoxication

- Perceptual distortion (VISUAL, auditory), depersonalization, anxiety, paranoia, psychosis, possible flashbacks

20

Marijuana Intoxication

- Euphoria, anxiety, paranoid delusions, PERCEPTION OF SLOWED TIME, impaired judgement, social withdrawal, INCREASED APPETITE, dry mouth, CONJUNCTIVAL INJECTION, hallucinations

21

Marijuana Withdrawal

- Irritability, anxiety, depression, insomnia, restlessness, decreased appetite
- Can detect in urine for 1 mo

22

MDMA (Ecstasy) Intoxication

- Hallucinogenic stimulant --> euphoria, disinhibition, hyperactivity
- Life-threatening effects: HTN, tachy, hyperthermia, hyponatremia, 5HT syndrome

23

MDMA (Ecstasy) Withdrawal

Depression, fatigue, change in appetite, difficulty concentrating, anxiety