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51 Cards in this Set
- Front
- Back
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What can occur between the drugs of the same class?
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Cross tolerance
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What are the sedative drugs?
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Alcohol, benzodiazepines (valium, xanax, etc.), and the barbiturates.
"The downers" |
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What is important about the sedative drugs?
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Overdoses and withdrawal can be fatal.
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What are adverse effects of sedatives?
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slurred speech, ataxic gait, disinhibition, and impaired judgment.
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What are the normal symptoms of certain alcohol blood concentrations?
150, 200, 250, 400, 500 |
150--clumsy, belligerent
200--lethargic, labile mood 250--confusion, stupor 400--disorientation, coma 500--respiratory depression, death |
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What can occur in sedative withdrawal?
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tremors, increased BP and pulse, nausea, vomiting, diaphoresis, SEIZURES, and delirium tremens. DELIRIUM occurs only with alcohol.
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Which drugs are included in the benzodiazepines?
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diazepam (valium), chlordiazepoxide (librium), lorazepam (ativan), alprazolam (xanax), and clonazepam (klonopin).
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What is interesting about benzodiazepines?
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They are cross-tolerant with alcohol.
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How does one treat withdrawal from benzodiazepines?
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Replace with a longer acting BDZ at an equivalent dose and taper.
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Which drugs fall under the stimulants class?
Is withdrawal fatal? |
meth, amphetamines, cocaine, nicotine, and caffeine
No, not fatal. |
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What occurs in stimulant intoxication?
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heightened energy, increased confidence, paranoia, increased BP and pulse, and not able to sleep for days.
*Overdose by cocaine and meth can occur by cardiotoxicity and neurotoxicity |
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What occurs in stimulant withdrawal?
In cocaine/meth? Nicotine? Caffeine |
Cocaine and meth: increased sleep and appetite, anhedonia--does not feel pleasure.
Nicotine: craving, irritability, and decreased pulse. Caffeine: headache |
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What is special about withdrawal of nicotine?
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Decreased pulse--this is the only drug where pulse goes down during withdrawal.
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What are some characteristics of meth?
Symptoms Half life? Dosing? |
A long half life
More paranoia, hallucinations, and other psychoses Maintenance dosing Can be used IV, snorting, smoking, and oral. |
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What are some characteristics of cocaine?
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A shorter half life--20 to 40 minutes
Used in binges/runs "Speedball" when injected with heroin Can be used IV or smoked. |
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What are some characteristics of nicotine?
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Half life of 2 hours
Pediatric onset Most addictive of all drugs Most lethal drug in the U.S. A marker for other drug use--especially in women A mild stimulant, anti-depressant, and anxiolytic (stops anxiety). Also used in weight loss. |
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What is nicotine withdrawal like?
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craving, irritability, anxiety, difficulty concentrating, decreased heart rate, and increased appetite.
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Which drugs are included in the opiates class?
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Heroin, oxycodone, opium, hydrocodone, and morphine.
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What is important about the opiate overdose and withdrawal?
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Overdose can be fatal from respiratory depression.
Withdrawal is never fatal. |
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What occurs in opiate intoxication?
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decreased appetite, respiratory depression, constricted pupils, constipation, and amenorrhea.
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What is opiate withdrawal like?
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The opposite of the symptoms of intoxication, and symptoms similar to the flu.
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What is included in the class of hallucinogens?
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LSD, mescaline/pyote, psilocybin/mushrooms.
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What are acute intoxication effects from halluncinogens?
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Anxiety and hallucinations
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What are chronic intoxication effects from hallucinogens?
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Prolonged psychoses, flashbacks, and exacerbated psychiatric illnesses
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What is interesting about hallucuinogen withdrawal?
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There is no withdrawal!
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What are some characteristics of cannabis?
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Highly lipid soluble, stored in fatty tissue with slow release, the drug will give a postive screen for 4-6 weeks, and it is the most frequently used drug in the world.
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What occurs in cannabis intoxication?
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It has stimulant, hallucinogenic, and depressent properties.
Impaired learning, memory, judgment. Paranoia Increased heart rate. It is thought to be related to Scizophrenia. |
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What occurs from chronic cannabis use?
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Decreased pulmonary function, increased frequency of malignancy (in the head and neck), and short term memory deficits.
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What are characterisitics of ectasy?
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It is made up of meth and mescaline, to avoid state laws. It is a stimulant and a hallucinogen.
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What are characteristics of PCP (phencylidine and ketamine)?
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These are anesthetic agents. There is no loss of consciousness that occurs, flat facies, sightless staring, rigid posturing. The pts feel dissociated from their body sometimes.
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How long of a withdrawal is considered alcohol Stage 1?
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6-12 hours
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What are symtoms of alcohol Stage 1 withdrawal?
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Changes in BP, pulse, and temperature.
Tremors, hyperreflexia, diaphoresis, nausea, anxiety, irritability, insomnia, malaise, anorexia, and vomiting. |
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What is the treatment for alcohol Stage 1 withdrawal?
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Benzodiazapines, check electrolytes, glucose, and liver enzymes, obtain urine screen, thiamine, and fluids.
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How many hours since last drink is considered Stage II withdrawal?
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Within 24 hours
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What symptoms are present alcohol Stage II withdrawal?
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The usual, plus hallucinations but they remain oriented ("primative hallucinations")
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What is the treatment for Stage II withdrawal?
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The usual, but these pts must be hospitalized.
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How many hours since last drink is considered Stage III withdrawal?
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6-48 hours
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What symptoms are present in alcohol Stage III withdrawal?
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The usual, plus generalized seizures.
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How is Stage III withdrawal treated?
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The usual, plus a CT scan and EEG if this is the first seizure or there was an intervening head trauma.
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How long since a last drink is considered in Stage IV (Dilirium Tremens) withdrawal?
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2-10 days
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What symptoms are present in alcohol Stage IV withdrawal?
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Confusion, disorientation, hallucinations, 5-15% mortality if untreated, put pt in ICU, look for recurrent illnesses (GI, pacreatitis, etc.)
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What is the treatment for alcohol Stage IV withdrawal?
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The usual.
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When does nicotine withdrawal show up the most?
What does it consist of? |
It peaks at 1-2 days but persists for weeks.
Craving, irritability, anxiety, difficulty concentrating, decreased HR, restlessness, increased appetite, and insomnia. Never fatal. |
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What is the treatment for nicotine withdrawal?
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Use an equivalent dose nicotine replacement and taper over ~8 weeks.
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What is detoxification used for?
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Withdrawal, NOT for chemical dependency.
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What are pharmalogic treatments for alchohol addiction?
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Disulfaram (prevents acetlaldehyde metabolism, and aversive agent)
Neltrexone (an opiate blocker)--has the strongest evidence of success Acamprosate (decreases Glu neurotransmission.) |
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What is important about treating alcohol addiction with Anabuse?
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It must be taken with someone else watching everyday.
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What are pharmalogical treatments for nicotine?
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Nicotine replacements
Bupropion (blocks reuptake of dopamine, and blocks nicotinic acetylcholine recpetors) Do NOT give this drug if the pt gets seizures. Varenicline (partial agonist at nicotinic acetylcholine receptors)--assess pt's mood and suicidal thoughts throughout treatment with this drug! |
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What are pharmalogical treatments for opiate addiction?
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Methadone (full opiate agonist)
Buprenorphine (a partial opiate agonist). Works very well, pts become very compliant and clear-headed. ) |
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What is the treatment for cocaine addiction?
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Disulfarium (inhibits dopamine by catabolizing enzymes that increase dopamine conc.) Few drugs are good for cocaine--still an area of research.
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Why is benzodiazapine commonly contraindicated?
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Because it is a mood altering drug.
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