Street drug Flashcards
(42 cards)
Crack cocaine clinical manifestations
decreased gastric motility, euphoria, chest pain, shortness of breath, occasional vasculitis of skin
first line treatment option for alcohol use disorder
naltrexone, a mu opioid receptor antagonist
acamprosate - glutamate modulator
Benefit of using naltrexone
can start while patient is still drinking and helps to decrease ETOH cravings and reduce heavy drinking, and increased days of abstinence
what is considered heavy drinking by gender?
ETOH >5 drinks for men
>4 for women
In whom is naltrexone contraindicated?
Those on opioids, those with acute hepatitis flare up and acute liver failure
Can use acamprosate
When do we use bupropion?
smoking cessation and depression
not used in helping people quit drinking
When do we use benzos?
only for acute severe ETOH withdrawal. It has high risk for abuse and dependence and doesn’t help with treatment of ETOH use disorder
Who can use aldehyde dehydrogenase inhibitor disulfram?
highly motivated individuals; doesn’t reduce ETOH cravings.
Second line
Role of SSRI in ETOH use disorder
None, doesn’t help with quitting ETOH use.
MDMA is also known as
ecstasy or Molly; most common stimulant used in dance clubs or raves
what happens when pts ingest MDMA?
it releases serotonin, dopamine, and NE from presynaptic neruosn and prevents metabolism by inhibiting the monoaminse oxidase.
causes for euphoria and sense of profound insight, intimacy and well being but also can get agitation and combativeness
When do patients start to get affected by MDMA?
start within 30-60 minutes and last up to 8 hours.
adverse effects of MDMA or ecstasy?
see delirium, hyperthermia, autonomic instability, neuromuscular irritability and see end organ damage like rhabdomyolysis, acute renal failure, hepatic failure and ARDS and DIC.
Can see heat from exertion and MDMA induced hyperthermia can lead to excessive water intake and cause severe hyponatremia - which can cause confusion, agitation, and seizures (From MDMA and hyponatremia)
treatment for MDMA is
supportive care, benzosdiazepines (for hypertension, seizures, and agitation) and fluids for hyponatremia, and ice baths for hyperthermia
diphenhydramine overdose
anticholinergic overdose symptoms such as flushing (red as a beet) very dry skin without diaphoresis (dry as abone) and mydriasis (blind as a bat), and agitation (mad as a hatter) and fever (hot as a hare). Can see sedation as a antihistamine effect
PCP ingestion presentation
see bizarre or violent behavior
psychomotor agitation, hallucinations, incoordination
see nystagmus (horizontal or vertical)
psilocybin is also known as
shrooms or hallucinogen in mushrooms
psilocybin ingestion causes
serotonergic effects that are mild and rarely see seizures
risperidone overdose
Would see muscle stiffness and or oversedation. NMS can occur with antipsychotic overdose see AMS, severe hyperthermia >104C and generalized lead pipe rigidity rather than hyperreflexia.
tardive dyskinesia is
sterotyped movements (lip smacking, grimacing, tongue movements and eye blinking) and sometimnes with limbs torso and fingers and they cannot use the limbs involved. Caused from increased activation of dopamine D2 receptors seen with antipsychotic medications.
treatment of tardive dyskinesia?
no treatment
use the lowest dose of antipyschotics for the shortest amount of time
Seen more with haloperidol over atypical antipyschotics.
tachycardia, hypertension, hyperthermia and poor dentition are all presentation of
methamphetamine intoxication
“see meth mouth”
methamphetamine is a
white powder that is easily dissolved into water and acts as stimulant to release catecholamines and cause a sympathomimetic toxidrome.
Can be snorted, injected, ingested and smoked.
when do you start to see methamphetamine intoxication
within minutes of ingestion and can last to >24 hrs.
