Flashcards in Overdose/Withdrawal Deck (25):
Nonspecific: mood elevation, decreased anxiety, sedation, behavioral disinhibition, respiratory depression
Nonspecific: anxiety, tremor, seizures, insomnia
Emotional lability, slurred speech, ataxia coma, blackouts. Serum gamma-glutamyltransferase (GGT) - sensitive indicator of alcohol use.
Lab AST value 2x ALT value
Mild alcohol withdrawal: symptoms similar to other depressants.
Severe alcohol withdrawal: autonomic hyperactivity and DTs (5-15% mortality rate). Tx for DTs: benzos
Euphoria, respiratory and CNS depression, decreased gag reflex, pupillary constriction (pinpoint pupils), seizures (overdose).
Tx: naloxone, naltrexone
Sweating, dilated pupils, piloerection ("cold turkey"), fever, rhinorrhea, yawning, nausea, stomach cramps, diarrhea ("flu-like" symptoms).
Tx: long-term support, methadone, buprenorphine
Low safety margin, marked respiratory depression.
Tx: symptom management (assist respiration, increase BP)
Delirium, life-threatening cardiovascular collapse
Greater safety margin. Ataxia, minor respiratory depression.
Tx: supportive care; consider flumazenil (competitive benzodiazepine antagonist)
Sleep disturbance, depression, rebound anxiety, seizure (can be triggered by reversal with flumazenil)
Nonspecific: mood elevation, psychomotor agitation, insomnia, cardiac arrhythmias, tachycardia, anxiety.
Nonspecific: post-use "crash," including depression, lethargy, weight gain, HA.
Euphoria, grandiosity, pupillary dilation, prolonged wakefulness and attention, hypertension, tachycardia, anorexia, paranoia, fever.
Severe: cardiac arrest, seizure
Anhedonia, increased appetite, hypersomnolence, existential crisis
Impaired judgment, pupillary dilation, hallucinations (including tactile), paranoid ideations, angina, sudden cardiac death.
Hypersomnolence, malaise, severe psychological craving, depression/suicidality
Restlessness, increased diuresis, muscle twitching
Lack of concentration, HA
Irritability, anxiety, craving.
Tx: nicotine patch, gum, or lozenges; bupropion/varenicline
Belligerence, impulsiveness, fever, psychomotor agitation, analgesia, vertical and horizontal nystagmus, tachycardia, homicadlity, psychosis, delirium, seizures.
Tx: benzos, rapid-acting antipsychotic
Depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep
Perceptual distortion (visual, auditory), depersonalization, anxiety, paranoia, psychosis, possible flashbacks
Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, social withdrawal, increased appetite, dry mouth, conjunctival injection, hallucinations.
Prescription form: dronabinol: used as antiemetic and appetite stimulant (AIDS pts)