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People and Illness > Illicit Drugs and Toxidromes > Flashcards

Illicit Drugs and Toxidromes Flashcards

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1
Q

What are the most commonly use illicit drugs?

A

Cannabis
opiates
cocaine

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2
Q

How can drugs cause harm?

A 
Direct acute neurological effects
indirect acute effects
direct chronic neurological effects
complications of route of administration 
effects of co-morbodities
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3
Q

How can heroin be administered?

A

Oral
Smoked
IV

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4
Q

How can cannabis be administered?

A

oral

smoked

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5
Q

How can cocaine be administered?

A

nasal
smoked
IV

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6
Q

How can amphetamines be administered?

A

Oral
nasal
smoked
IV

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7
Q

How can LSD be administered?

A

Orally

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8
Q

How can Pencyclidine (PCP) be administered?

A

Orally
nasally
smoked

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9
Q

Which neurotransmitters does heroin act upon?

A

Dopamine and GABA

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10
Q

Which neurotransmitters does cannabis act upon?

A

GABA

5HT/Ach/THC

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11
Q

Which neurotransmitters do cocaine and amphetamines act upon?

A

dopamine

noradrenaline

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12
Q

Which neurotransmitters does LSD act upon?

A

5HT/Ach/THC/DA

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13
Q

Which neurotransmitters does PCP act upon?

A

Dopamine
5HT/Ach/TCH
GABA

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14
Q

How does alcohol cause euphoria?

A

Acting on dopamine and opioid receptors

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15
Q

How does alcohol cause anxiety and ataxia?

A

Increasing GABA

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16
Q

How does alcohol cause sedation and amnesia?

A

Increasing GABA

Decreasing NMDA

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17
Q

Stimulants enhance transmission at the monoamine synapses. What effects does this have?

A 
Increases behavioural and motor activity
Increases alertness
Disrupts sleep
Causes eurphoria
Increases confidence e
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18
Q

What are the side effects of stimulants?

A

Anxiety
Insomnia
Irritability

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19
Q

What effects do stimulants have as a result of their stimulation of adrenergic activity?

A

Tachycardia, hypertension, risk fo arrhythmia, sweats, hallucinations, agitation, dilated pupils, elevated temperature

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20
Q

What symptoms occur in serotonin syndrome?

A 
Altered mental status (agitation, confusion, seizures)
autonomic changes (hyperthermia, diaphoresis, diarrhoea, tachycardia)
neuromuscular effects (myoclonus, clonus, hyperreflexia, tremor)
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21
Q

Cocaine is a stimulant which has a rapid onset and penetrates the blood brain barrier. What is its half life?

A

30-90 minutes

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22
Q

What is the mechanism of action of cocaine?

A

Blocks reuptake of dopamine, noradrenaline and 5HT

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23
Q

Amphetamines are stimulants which have a rapid onset and penetrate the blood brain barrier. What are their half life?

A

up to 12 hours

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24
Q

What is the mechanism of action of amphetamines?

A

Enhance release of dopamine and noradrenaline from pre-synaptic terminals causing a dopaminergic pleasure effects and noradrenergic excess

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25
What are the acute neurological problems associated with stimulants?
Anxiety, sleep deprivation, paranoia, aggression, paranoid psychosis, cognitive dysfunction
26
What are the chronic neurological problems associated with stimulants?
``` Anxiety sleep deprivation paranoia aggression paranoid psychosis cognitive dysfunction ```
27
How can stimulants accelerate atherosclerosis?
Cause vasospasm by alpha adrenergic stimulation | platelet aggregation is increased
28
What type of strokes cans stimulants cause?
Hemorrhagic strokes
29
How does cocaine use affect the management of a stroke patient?
Likely require blood pressure lowering | May not be able to have thrombolysis
30
Give examples of stimulants other than cocaine and amphetamines.
Ephedrine Pesudoephridine phenylpropanolamine MDMA
31
How do opiates give a sedative effect?
Acting on opiate mu receptors
32
How do opiates give a dysphoric effect?
Acting on kappa receptors to reduce GABA release
33
How does GHB cause dysphoria and sedation?
Dysphoria by stimulating dopamine release | Sedation by activating GABA receptor
34
What is the toxidrome for opiate use?
``` pinpoint pupils respiratory depression bradycardia hypotension hypothermia pulmonary oedema seizures ```
35
What is the toxidrome for sedative use?
``` Ataxia Blurred vision coma confusion delirium sedation ```
36
What are the possible consequences /complications of injection?
``` Embolic infarction infective endocarditis abscesses discitis meningitis HIV ```
37
What are the acute neurological problems which can occur with sedative use?
Coma Compressive nerve palsies Anoxic brain injury
38
What is the toxidrome for cholinergics?
``` Defecation urination miosis bronchoconstriction bradycardia emesis lacrimation salivation ```
39
MDMA is a hallucinogen. It blocks the reuptake of which neurotransmitters?
5HT and NA
40
What are the neurological effects of hallucinogens?
toxic psychosis dangerous behaviour wernick's type syndrome stroke
41
What are the acute effects of organic solvents such as toluene, hexane and benzene?
Lightheadedness | Hallucinations
42
What are the effects of organic solvents such as toluene, hexane and benzene with prolonged use?
``` Cognitive impairment diplopia ataxia nystagmus coma ```
43
What is the active component of marijuana?
THC
44
What are the effects of THC?
Psychosis altered neural connectivity cognitive effects
45
Legal highs contain substances which produce similar psychoactive effects to traditional drugs. Give example of stimulant legal highs?
Cathinones benzofurans piperazines
46
Legal highs contain substances which produce similar psychoactive effects to traditional drugs. Give example of sedativelegal highs?
benzodiazepine analogues
47
Legal highs contain substances which produce similar psychoactive effects to traditional drugs. Give example of hallucinogen legal highs?
alpha-methyltryptamine
48
Legal highs contain substances which produce similar psychoactive effects to traditional drugs. Give example of dissociative legal highs?
methoxetamine
49
Delirium tremens results from withdrawal from alcohol. T/F?
True
50
What behaviours characterise alcohol dependence?
``` compulsion control tolerance withdrawal persistence neglect repertoire narrows reinstatement ```
51
What psychological problems are associated with acute intoxication with alcohol?
``` Insomnia depression anxiety amnesia attempted suicide suicide ```
52
What are the effects of a blood alcohol content of 0.02 to 0.03%?
Mood elevation | Muscle relaxation
53
What are the effects of a blood alcohol content of 0.05 to 0.06%?
Relaxation Increased reaction time Decreased fine muscle coordination
54
What are the effects of a blood alcohol content of 0.08 to 0.09%?
Euphoria | Impaired balance, speech, vision, hearing, muscle coordination
55
What are the effects of a blood alcohol content of 0.14 to 0.15%?
Gross impairment of physical and mental control
56
What are the effects of a blood alcohol content of 0.20 to 0.30%?
Severely intoxicated, very little control of mind or body
57
What are the effects of a blood alcohol content of 0.40 to 0.50%?
Unconscious | Death from respiratory depression
58
Delirium tremens is a rapid onset of confusion caused. by withdrawal from alcohol. What is the mortality rate of delirium tremens?
5-15%
59
Delirium tremens is a rapid onset of confusion caused. by withdrawal from alcohol. How can this cause death?
Respiratory failure | Cardiac arrhythmia
60
Which patients with delirium. tremens are most at risk of death?
Extreme fever Fluid or electrolyte imbalance Intercurrent illness (occult trauma, pneumonia, hepatitis, pancreatitis, alcoholic ketoacidosis, Wernicke. Korsakoff syndrome)
61
What are the psychiatric associations with cannabis use?
Cannabis dependence Psychosis Amotivational syndrome
62
There is a specific and prolonged abstinence syndrome after only a short period of regular use of benzodiazepines in some individuals. T/F?
True
63
Half of patients with opiod dependency will have a comorbid problem with benzodiazepines. T/F?
True
64
What long term psychiatric problems. are associated with opioid use?
``` Depression Suicide Personality disorders PTSD Polydrug dependency ```

People and Illness (18 decks)

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