Illicit Drugs Toxidromes Flashcards
(45 cards)
list some effects of alcohol
- Wernicke-Korsakoff syndrome
- Peripheral neuropathy
- Cerebellar degeneration
- Myopathy
- Cognitive decline
- Seizures
- Withdrawal effects
- Injury / intracranial haemorrhage
which transmitter gives euphoria/pleasure drinking alcohol
Dopamine, Opioids
which transmitter gives anxiolysis/ataxia
Increased GABA
which transmitter gives sedation/amnesia
increased GABA + decreased NMDA
triad of serotonin syndrome
- Altered mental status – Agitation / confusion / seizures
- Autonomic changes - Hyperthermia, diaphoresis, diarrhoea, tachycardia, hypertension, salivation
- Neuromuscular effects - Myoclonus, clonus, hyperreflexia, tremor, rigidity
when are Hallucinations common
serotonergic activation
stimulants cause stimulation of adrenergic activity. what are the symptoms of this
- Tachycardia
- Hypertension
- Risk of arrhythmia
- Sweaty
- Hallucination
- Agitation
- Dilated pupils
- Elevated temperature
which receptor causes you to feel euphoria/pleasure
Dopamine, Opioids
which receptor causes you to feel sedation/amnesia
increased GABA + decreased NMDA
which receptor causes you to feel anxiolysis/ataxia
increased GABA
how do stimulants cause stroke
Mostly haemorrhagic
Soon after use – within 3 hours
More common if underlying pre-disposition
full name for MDMA
3,4 methylenedioxymethamphetamine
how does MDMA work
Blocks 5-HT, NE reuptake
symptoms of MDMA
Thermoregulatory problems, hallucinations, CV complications
what is mephedrone
4-methylmethcathinone (4-MMC) or 4-methylephedrone
bath salts, M-cat, plant food, drone
methadone is a substitute for what
4-methoxy
what is the structure of mephedrone
A substituted cathinone = Phenethylamine core with an alkyl group attached to the alpha carbon and a ketone group to the beta carbon
- Enhance transmission at the catecholaminergic /dopaminergic / serotonergic synapses
- Increase behavioural and motor activity I
- ncrease alertness / disruption of sleep
- Euphoria
- Confidence Central and peripheral sympathomimetic effects
- Side effects of anxiety, insomnia and irritability
The stimulants
how does cocaine work
- Rapid BBB penetration – high brain concentrations
- Half-life in plasma = 30-90 minutes (longer PD action)
- Blocks DA, NE & 5-HT re-uptake
- Exerts inhibitory effect on postsynaptic dopamine receptors
- Blocks the presynaptic transporter protein for DA
- Dopaminergic pleasure effect
- Noradrenergic excess (readiness)
how do Amphetamines
- Enhance release of DA &
- NE from pre-synaptic terminals
- Dopaminergic pleasure effect
- Noradrenergic excess (readiness)
- Detectable for 48 hours in urine
list a few additional stimulants
- Ephedrine Pseudoephridrine
- Phenylpropanolamine
- Ephedra alkaloids
- Methylphenidate (Ritalin) MDMA
- Reports of all things described in previous slides with these drugs
how do Stimulants cause vasospasm / sticky blood
Mediated by alpha-adrenergic stimulation
Platelet aggregation is increased
Evidence for accelerated atherosclerosis
symptoms of opaites
- Pinpoint pupils
- Respiratory depression
- Bradycardia
- Hypotension
- Hypothermia
- Pulmonary edema
- Seizures
symptoms of sedatives and hypotonic
- Ataxia
- Blurred vision
- Coma
- Confusion
- Delirium
- Sedation
- Pupils likely to be normal
- Causes include anticonvulsants, benzodiazepines, GHB, ethanol.
