General sx of Intoxication?
Sx of Withdrawal?
Alcohol, Opioids, Barbituates, Benzos
Intox: Mood elevation, decr anxiety, sedation, behavioral disinhibition, respiratory depression
Wdl: anxiety, tremors, seizures, insomnia
Alcohol: sx of intox?
-ataxia, slurred speech, coma, blackouts
-serum gamma-glutamyltransferase is sensitive indicator of alcohol use.
Lab AST value is twice ALT value
Alcohol: sx of wdl?
Treatment if severe?
Mild: similar sx as other depressants
Severe: autonomic hyperactivity, DTs (5-15% mortality)
Tx = benzodiazepines (ex chlordiazepoxide)
Life-threatening alcohol wdl. Peaks 2-5 days after last drink.
Symptoms (in chrono order):
1. Autonomic hyperactivity (tachycardia, tremors, anxiety, seizures)
2. Psychotic sx (hallucinations, delusions)
Tx = Benzos
Alcohol: what receptors are involved?
incr ß endorphins
sx of toxication?
(morphine, heroin, methadone)
Euphoria, pinpoint pupils
Resp/CNS depression - coma
seizures if OD
Tx: Naloxone (acute), Naltrexone (rehab)
Sx of withdrawal?
cold turkey: sweating, dilated pupils, piloerection
flu-like: fever, rhinorrhea, yawning, nausea, cramps, diarrhea
Tx: methadone, buprenorphine
Barbituates: sx of tox?
low safety margin
Tx: manage symptoms, assist with respiration, BP support)
Barbituates: sx of wdl?
CV collapse (life-threatening)
Benzodiazepines: sx of tox?
(ex diazepam, lorazepam)
ataxia, slight resp depression
Tx: support, flumazenil (competitive benzo antagonist)
Benzodiazepines: sx of wdl?
sleep issues, depression, rebound anxiety, seizure
(can be triggered by flumazenil in attempt to reverse intoxication)
alcohol: what is it the causes the hangover sx?
buildup of acetaldehyde
ADH = enzyme that converts this to acetate --> acetyl CoA --> TCA
what blocks ADH/what is the effect?
Disulfuram blocks ADH leading to a buildup of acetaldehyde if someone drinks alcohol.
Leads to really bad hangover sx. "antabuse"
Besides disulfuride, what drug can block acetaldehyde dehydrogenase (ADH) and cause hangover-like sx?
used to treat Trichomonas, giardia, and bacterial vaginosis
Stimulants: general signs of intoxication?
mood elevation, psychomotor agitation, insomnia, arrhythmias, tachycardia, anxiety
Stimulants: general signs of withdrawal?
depression, lethargy, weight gain, headache
s/s of what?
euphoria, grandiosity, pupillary dilation, prolonged wakefulness, HTN, tachycardia, anorexia, paranoia, fever
(severe: cardia arrest, seizure)
s/s of what?
anhedonia, incr apetite, hypersomnolence, existential crisis
s/s of what?
impaired judgement, pupillary dilatation, hallucinations, paranoia, angina, sudden cardiac death
hypersomnolence, malaise, severe craving, depression/suicidality
restlessness, incr diuresis, muscle twitching
no concentration, headache
irritability, anxiety, craving
tx for cocaine use/od
tx for nicotine wdl
nicotine patch, gum, lozenges
violent behavior, impulsiveness, fever, nystagmus, delirium (+ more)
PCP (phencyclidine) use
depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep
perceptual distortion, depersonalization, anxiety, paranoia, psychosis, flashbacks
(lysergic acid diethylamide)
euphoria, anziety, paranoid delusions, perception of slowed time, incr appetite, social withdrawal, conjunctival injection
marijuana (cannabinoid) use
irritability, depression, insomnia, nausea, anorexia
marijuana (cannabinoid) wdl