Reading...
Play button
Play button
Use LEFT and RIGHT arrow keys to navigate between flashcards;
Use UP and DOWN arrow keys to flip the card;
H to show hint;
A reads text to speech;
60 Cards in this Set
- Front
- Back
|
What are the depressant psychoactive drugs?
|
- Alcohol
- Opioids (eg, morphine, heroin, methadone) - Barbiturates - Benzodiazepines |
|
|
What are the stimulant psychoactive drugs?
|
- Amphetamines
- Cocaine - Caffeine - Nicotine |
|
|
What are the hallucinogenic psychoactive drugs?
|
- PCP
- LSD - Marijuana (cannabinoid) |
|
|
Intoxication of depressant psychoactive drugs causes what non-specific changes?
|
- Mood elevation
- ↓ Anxiety - Sedation - Behavioral disinhibition - Respiratory depression |
|
|
Withdrawal of depressant psychoactive drugs causes what non-specific changes?
|
- Anxiety
- Tremor - Seizures - Insomnia |
|
|
Intoxication of alcohol causes what changes?
|
- Emotional lability
- Slurred speech - Ataxia - Coma - Blackouts |
|
|
What lab test is a sensitive indicator of alcohol use? What other lab tests?
|
- Serum γ-Glutamyltransferase (GGT) is a sensitive indicator of alcohol use
- AST value is twice ALT value |
|
|
Mild withdrawal of alcohol causes what changes?
|
Similar to other depressants:
- Anxiety - Tremor - Seizures - Insomnia |
|
|
Severe withdrawal of alcohol causes what changes?
|
- Autonomic hyperactivity
- Delirium tremors (5-15% mortality rate) |
|
|
How do you treat delirium tremors caused by withdrawal of alcohol?
|
Benzodiazepines
|
|
|
Intoxication of opioids (eg, morphine, heroin, methadone) causes what changes?
|
- Euphoria
- Respiratory and CNS depression - ↓ Gag reflex - Pupillary constriction (pinpoint pupils) - Seizures (overdose) |
|
|
How do you treat opioid intoxication?
|
- Naloxone
- Naltrexone |
|
|
Withdrawal of opioids (eg, morphine, heroin, methadone) causes what changes?
|
- Sweating
- Dilated pupils - Piloerection ("cold turkey") - Fever - Rhinorrhea - Yawning - Nausea - Stomach cramps - Diarrhea ("flu-like" symptoms) |
|
|
How do you treat withdrawal from opioids?
|
- Long-term support
- Methadone - Buprenorphine |
|
|
Intoxication of barbiturates causes what changes?
|
Low safety margin → marked respiratory depression
|
|
|
How do you treat barbiturate intoxication?
|
Symptom management (assist respiration, ↑ BP)
|
|
|
Withdrawal of barbiturates causes what changes?
|
- Delirium
- Life-threatening cardiovascular collapse |
|
|
Intoxication of benzodiazepines causes what changes?
|
- Ataxia
- Minor respiratory depression (greater safety margin) |
|
|
How do you treat benzodiazepine intoxication?
|
- Supportive care
- Consider flumazenil (competitive benzodiazepine antagonist) |
|
|
Withdrawal of benzodiazepines causes what changes?
|
- Sleep disturbance
- Depression - Rebound anxiety - Seizure (can be triggered by reversal w/ flumazenil) |
|
|
Intoxication of stimulant psychoactive drugs causes what non-specific changes?
|
- Mood elevation
- Psychomotor agitation - Insomnia - Cardiac arrhythmia - Tachycardia - Anxiety |
|
|
Withdrawal of stimulant psychoactive drugs causes what non-specific changes?
|
- Post-use "crash"
- Depression - Lethargy - Weight gain - Headache |
|
|
Intoxication of amphetamines causes what changes?
|
- Euphoria
- Grandiosity - Pupillary dilation - Prolonged wakefulness and attention - Hypertension and tachycardia - Anorexia - Paranoia - Fever Severe: cardiac arrest and seizure |
|
|
Withdrawal of amphetamines causes what changes?
|
- Anhedonia
- ↑ Appetite - Hypersomnolence - Existential crisis |
|
|
Intoxication of cocaine causes what changes?
|
- Impaired judgment
- Pupillary dilation - Hallucinations (including tactile) - Paranoid ideations - Angina - Sudden cardiac death |
|
|
How do you treat cocaine intoxication?
|
Benzodiazepines
|
|
|
Withdrawal of cocaine causes what changes?
|
- Hypersomnolence
- Malaise - Severe psychological craving - Depression / suicidality |
|
|
Intoxication of caffeine causes what changes?
|
- Restlessness
- ↑ Diuresis - Muscle twitching |
|
|
Withdrawal of caffeine causes what changes?
|
- Lack of concentration
- Headache |
|
|
Intoxication of nicotine causes what changes?
|
Restlessness
|
|
|
Withdrawal of nicotine causes what changes?
|
- Irritability
- Anxiety - Craving |
|
|
How do you treat nicotine withdrawal?
|
- Nicotine patch, gum, or lozenges
- Bupropion / varenicline |
|
|
Intoxication of PCP causes what changes?
|
- Belligerence
- Impulsiveness - Fever - Psychomotor agitation - Analgesia - Vertical and horizontal nystagmus - Tachycardia - Homicidality - Psychosis - Delirium - Seizures |
|
|
How do you treat intoxication of PCP?
|
- Benzodiazepines
- Rapid-acting anti-psychotic |
|
|
Withdrawal of PCP causes what changes?
|
- Depression
- Anxiety - Irritability - Restlessness - Anergia - Disturbances of thought and sleep |
|
|
Intoxication of LSD causes what changes?
|
- Perceptual distortion (visual, auditory)
- Depersonalization - Anxiety - Paranoia - Psychosis - Possible flashbacks |
|
|
Intoxication of Marijuana causes what changes?
|
- Euphoria
- Anxiety - Paranoid delusions - Perception of slowed time - Impaired judgment - Social withdrawal - ↑ Appetite - Dry mouth - Conjunctival injection - Hallucinations |
|
|
What is the prescription form of Marijuana?
|
Dronabinol (tetrahydrocannabinol isomer)
|
|
|
What are the uses of Dronabinol (tetrahydrocannabinol isomer)?
|
- Anti-emetic (chemotherapy)
- Appetite stimulant (AIDS) |
|
|
Withdrawal of Marijuana causes what changes?
|
Most symptoms peak in 48 hours and last for 5-7 days:
- Irritability - Depression - Insomnia - Nausea - Anorexia |
|
|
For how long is marijuana detectable in the urine?
|
4-10 days
|
|
|
When do symptoms of marijuana withdrawal peak? How long do they last?
|
Peak in 48 hours, lasts 5-7 days
|
|
|
What are heroin addicts at increased risk for?
|
- Hepatitis
- Abscesses - Overdose - Hemorrhoids - AIDS - Right-sided endocarditis |
|
|
What should you look for in a patient you suspect of having a heroin addiction?
|
Track marks (needle sticks in veins)
|
|
|
What are the types of treatments for heroin addiction?
|
- Methadone
- Maloxone + Buprenorphine - Naltrexone |
|
|
What is methadone? Use?
|
- Long acting oral opiate
- Used for heroin detoxification or long-term maintenance |
|
|
What is naloxone + buprenorphine? Use?
|
- Partial agonist
- Used for treatment of heroin addiction - Long acting with fewer withdrawal symptoms than methadone - Naloxone is not active when taken orally, so withdrawal symptoms occur only if injected (lower abuse potential) |
|
|
What is naltrexone? Use?
|
- Long acting opioid antagonist
- Used for relapse prevention once detoxified |
|
|
What causes alcoholism? Signs?
|
Physiologic tolerance and dependence with symptoms of withdrawal (tremor, tachycardia, hypertension, malaise, nausea, DTs) when intake is interrupted
|
|
|
What are the complications of alcoholism?
|
- Alcoholic cirrhosis
- Hepatitis - Pancreatitis - Peripheral neuropathy - Testicular atrophy - Wernicke-Korsakoff Syndrome - Mallory-Weiss Syndrome |
|
|
How do you treat alcoholism?
|
- Disulfiram
- Naltrexone - Supportive care - Alcoholics Anonymous and other peer support groups |
|
|
What causes the triad of confusion, ophthalmoplegia, and ataxia?
|
Wernicke-Korsakoff Syndrome
- Wernicke Encephalopathy: caused by thiamine deficiency |
|
|
What can Wernicke Encephalopathy progress to?
|
Korsakoff Psychosis: irreversible memory loss, confabulation, personality change
|
|
|
What changes to the brain is Korsakoff Psychosis associated with?
|
Periventricular hemorrhage / necrosis of mammillary bodies
|
|
|
How do you treat Wernicke-Korsakoff syndrome?
|
IV Vitamin B1 (Thiamine)
|
|
|
What is the term for a longitudinal partial thickness tear at the gastroesophageal junction? Cause?
|
Mallory-Weiss Syndrome
- Caused by excessive vomiting |
|
|
What are the symptoms of Mallory-Weiss Syndrome?
|
- Hematemesis (d/t longitudinal partial thickness tear at gastroesophageal junction)
- Pain (vs esophageal varices) |
|
|
What is the life-threatening alcohol withdrawal syndrome? When does it peak?
|
Delirium Tremens (DTs):
- Peaks 2-5 days after last drink |
|
|
What are the symptoms in order of appearance of Delirium Tremens?
|
- Autonomic system hyperactivity (tachycardia, tremors, anxiety, seizures)
- Psychotic symptoms (hallucinations, delusions) - Confusion |
|
|
How do you treat Delirium Tremens?
|
Benzodiazepines
|
