Week 11 Opioid/CNS depressant overdoses Flashcards
(24 cards)
what are the different types of CNS depressants?
opiates- morphine, heroin, codeine, tramadol and methadone
Sedative-hypnotic drugs - benzodiazapines and barbituites
GHB - gamma hydroxybutrate
alcohol
what are some of the clinical presentations of opioide overdoeses?
lower conciousness resp depression pinpoint pupils hyoptensive vomitting
in terms of synthetic opoid overdoses what symptoms might you see?
seizures
rarley resp depression but frequently tachycardia, agitation and serotonin syndrome
what are the clinical presentations of benzo ODs?
drowsie, confused, dizziness slurred speach nystagmus, blurred vision hypotension ataxia, weakness lack of cordination coma resp depression
what might be the clinical presentation of a large benzo OD?
hypothermia, bradycarida, hypotension
what are the clinical presentation of GHB overdoses?
resp and CNS depression
myoclonic jerkin, bradycardia, sweating, agitation, vomiting, delerium, cheyne-stoke breathing
what is a recreational dose of GHB?
30-40mg/kg
what is GHB recovery associated with?
agitation, delirium and vomiting
how does narcane work?
opiate antagonist - competes for same receptors
greater affinity
shorter half life- wear off
what should the other opiod parm of the opioide cpg be used for?
prescription - oxycodone, morphine, codien, fentynal, methadoe
latrogenic - secondary to analgesia
polypharmacy - opioid and meth
unknown - heroin nos suspected
what is the mecanisim of action for opioids?
agonists at opiod receptros (delta, kappa, mu) which modulates pain pathways in the body
what are the central effects of opiods?
analgesis CNS depression resp depression couch suppresion miosis - pupil constrction nausea/vom hypotension and bradycardia
what are the peripheral effects of opiods?
decreased gut motility- constipation
histamine relases
spasm of sphincter muscles
how do TCAs work?
preventing re-uptake of seritonin and nor-adrenaline. antagonists of seritonin, adrenaline, histamibe and acetylcholine
potent sodium and calcium channel blockers
what does the inhibition of nor-adrenaline/serotonin reuptake result in in an overdose?
delirium, seizures and coma
what are the anticholonergic effects of a TCA overdose?
hyperthermia, flushing, dry mucosa membranes
what does the blockage of sodium channels cause in a TCA overdose?
tachycardia, QRS widening, ventricular arythmias
what does the blockage of sodium channels cause in a TCA overdose?
tachycardia, QRS widening, ventricular arythmias
how long does it take for sevre toxicity to occur after TCA overdose?
1-2 hours
what is a toxic level of TCA injestion?
> 10mg / kg
what are the inital sings of TCA overdose?
mad as a hatter - delirium agitation
blind as a bat - mydriasia, blurred vision
hot as a hare- hyperthermia
dry as a bone - mucosa membranes and skin
red as a beet - flushed
what are the later sings and symptoms of TCA overdose?
sedation/coma seizures arythmias - SVT, VT, torsades de pointes hypotension bradycardia asystole, death
what is one of the most accurate tools for TCA overdose diagnosis?
ECG
prolonged PR interval
widening QURS >100ms
large r wave
what are the symptoms of opiod withdrawal?
agitation
nausea, vomiting, diarrhoea, lacrimation, diaphoresis, pain, tachycardia, hypertension
