Psychoactive Drug Intoxication And Withdrawal

Question 1

Name the Depressants (4)

Answer 1

Alcohol, Opioids, Barbiturates, Benzodiazapines

Question 2

General depressant intoxication

Answer 2

Mood elevation, decreased anxiety, sedation, behavioral disinhibition, respiratory depression

Question 3

General depressant withdrawal

Answer 3

Anxiety, tremor, seizures, insomnia

Question 4

Alcohol intoxication

Answer 4

Emotional lability, slurred speech, ataxia, coma, blackouts

Question 5

Serum indicator of alcohol use

Answer 5

Gamma-glutamyltransferase (GGT)

AST= x2 ALT

Question 6

Alcohol withdrawal

Answer 6

Mild: anxiety, tremors, seizures, insomnia
Severe: autonomic hyperactivity (tachycardia, hypertension), malaise, nausea, delirium tremens

Question 7

Complications of alcoholism

Answer 7

Alcoholic cirrhosis, hepatitis, pancreatitis, peripheral neuropathy, testicular atrophy

Question 8

Treatments for alcoholism

Answer 8

Disulfiram- condition to abstain
Acamprosate, Naltrexone
AA groups

Question 9

What is the triad of Wernicke-Korsakoff syndrome

Answer 9

Confusion, opthalmoplegia, ataxia

Question 10

Cause and treatment of Wernicke-Korsakoff syndrome

Answer 10

Vitamin B1 (thiamine) deficiency

Tx: IV vitamin B1

Question 11

Symptoms of Korsakoff syndrome

Answer 11

Irreversible memory loss, confabulation, personality change

Associated with periventricular hemorrhage and necrosis of mammillary bodies

Question 12

What is the timing of Delirium Tremens?

Answer 12

2-4 days after the last drink

Typically occurs in the hospital setting

Question 13

Symptoms and treatment of Delirium Tremens

Answer 13

Tachycardia, tremors, anxiety, seizures, agitation

Tx: Benzodiazapines

Question 14

What is alcoholic hallucinosis?

Answer 14

Visual hallucinations 12-48 hours after last drink

Tx: Benzodiazapines

Question 15

Name 3 clinical CNS stimulants

Answer 15

Methylphenidate, dextroamphetamine, methamphetamine

Question 16

Mechanism and clinical use of CNS stimulants

Answer 16

Increase NE and dopamine in synaptic cleft

ADHD, appetite control, narcolepsy

Question 17

Opioid intoxication

Answer 17

Euphoria, respiratory and CNS depression, miosis, seizures, decreased gag reflex

Question 18

Most common drug in overdose death

Answer 18

Opioids

Question 19

Treatment of opioid overdose

Answer 19

Naloxone, Naltrexone

Question 20

Opioid withdrawal

Answer 20

Anxious, hot, moist, yawning, mydriasis
Fever, sweating, piloerection
Rhinorrhea, nausea, diarrhea
Flu like symptoms

Question 21

Treatment of opioid withdrawal

Answer 21

Long term support

Methadone, Buprenorphine

Question 22

Barbiturate intoxication

Answer 22

Respiratory depression, low safety margin

Question 23

Treatment for barbiturate intoxication

Answer 23

Supportive management: Increase BP, assist respiration

Question 24

Barbiturate withdrawal

Answer 24

Delirium, cardiovascular collapse

Question 25

Benzodiazepine intoxication

Answer 25

Ataxia, minor respiratory depression, safer than barbiturates

Question 26

Treatment for benzodiazepine intoxication

Answer 26

Flumazenil- benzodiazepine receptor antagonist | Can precipitate seizures

Question 27

Benzodiazepine withdrawal

Answer 27

Sleep disturbance, depression, rebound anxiety, seizures

Question 28

Stimulants (4)

Answer 28

Amphetamines, Cocaine, Caffeine, Nicotine

Question 29

General stimulant intoxication

Answer 29

Mood elevation, psychomotor agitation, insomnia, cardiac arrhythmias, tachycardia, anxiety

Question 30

General stimulant withdrawal

Answer 30

Post use crash, depression, lethargy, increased appetite, sleep disturbances, vivid nightmares

Question 31

Amphetamine intoxication

Answer 31

Euphoria, grandiosity, mydriasis, alertness, HTN, tachycardia, anorexia, paranoia, fever Severe: cardiac arrest, seizures

Question 32

Treatment for amphetamine intoxication

Answer 32

benzodiazepines for agitation and seizures

Question 33

Cocaine intoxication

Answer 33

Mydriasis, impaired judgement, hallucinations (tactile), paranoia, angina, sudden cardiac death

Question 34

Treatment for cocaine intoxication

Answer 34

Alpha blockers, benzodiazepines NO beta blockers

Question 35

Caffeine intoxication

Answer 35

Restlessness, increased diuresis, muscle twitching

Question 36

Caffeine withdrawal

Answer 36

Headaches, difficulty concentrating, flu like symptoms

Question 37

Nicotine intoxication and withdrawal

Answer 37

Intoxication- restlessness Withdrawal- irritable, anxiety, restless, difficulty concentrating

Question 38

Treatment for nicotine use

Answer 38

Nicotine patch, gum, lozenges | Bupropion, Varenicline

Question 39

Heroin addiction complications

Answer 39

Hepatitis, HIV, abscesses, bacteremia, right heart endocarditis

Question 40

Treatment of Heroin addiction

Answer 40

Methadone- long acting opioid agonist- detox or long term maintenance Naloxone and Buprenorphine- antagonist and partial agonist Naltrexone- long acting antagonist- relapse prevention after detox is completed

Question 41

Mallory- Weiss Syndrome

Answer 41

Partial thickness tear at gastroesophageal junction Due to excessive/forceful vomiting Hematemesis Misdiagnosed as ruptured esophageal varices

Question 42

Hallucinogens (4)

Answer 42

Phencyclidine, Lysergic acid diethylamide (LSD), Marijuana, MDMA (ecstasy)

Question 43

Phencyclidine intoxication

Answer 43

Violence, impulsivity, psychomotor agitation, nystagmus, tachycardia, psychosis, delirium, seizures Usually complicated by trauma

Question 44

Phencyclidine intoxication treatment

Answer 44

Benzodiazepines, rapid acting anti-psychotic

Question 45

Lysergic acid diethylamide (LSD) intoxication

Answer 45

Visual/auditory perceptual distortion, depersonalization, anxiety, paranoia, psychosis, possible flashbacks

Question 46

Marijuana (cannabinoid) intoxication

Answer 46

Euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgement, social withdrawal, increased appetite, dry mouth, conjunctival injection, hallucinations

Question 47

Pharmaceutical form of marijuana

Answer 47

Dronabinol- tetrahydrocannabinol isomer Antiemetic, appetite stimulant For Chemotherapy side effects and AIDS patients

Question 48

Marijuana withdrawal

Answer 48

Irritable, anxiety, depression, insomnia, restless, decreased appetite Detectable in urine for up to a month

Question 49

MDMA (ecstasy) intoxication

Answer 49

Hallucinogenic stimulant Euphoria, disinhibition, hyperactivity HTN, tachycardia, hyperthermia, hyponatremia, serotonin syndrome

Question 50

MDMA withdrawal

Answer 50

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