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39 Cards in this Set
- Front
- Back
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Alcohol
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Intox: disinhibition, emotional lability, slurred speech, ataxia, coma, blackouts, serum GGT (sensitive indicator of alcohol use)
Withdrawal: tremor, tachy, HTN, malaise, nausea, seizures, delirium tremens (tx: benzos), agitation, hallucinations |
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Opioids
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Intoxication: CNS dep, n/v, constipation, pupillary constriction (pinpoint pupils), seizures (OD = life threatening) - tx: naloxone, naltrexone
Withdrawal: anxiety, insomnia, anorexia, sweating, dilated pupils, piloerection, fever, rhinorrhea, nausea, stomach cramps, diarrhea, yawning |
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Barbs
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Intox: low safety margin, resp dep
Withdrawal: anxiety, seizures, delirium, life-threatening CV collapse |
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Benzos
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Intox: greater safety margin than barbs, amnesia, ataxia, somnolescence, minor resp dep, additive EtOH effects; tx: flumanezil
Withdrawal: rebound anxiety, seizures, tremor, insomnia |
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Amphetamines
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Intox: psychomotor agitation, impaired judgment, pupillary dilation, HTN, tachy, euphoria, cardiac arrhythmias, delusions, hallucinations, fever
Withdrawal: post-use crash, depression, lethargy, headache, stomach cramps, hunger, hypersolmnolence |
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Cocaine
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Intox: euphoria, psychomotor agitation, impaired judgment, tachy, pupillary dilation, HTN, hallucination, paranoid ideations, angina, sudden death
Withdarwal: post-use crash, severe dep, suicidality, hypersolmnolence, fatigue, maliase, severe psychological craving |
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Caffeine
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Intox: restlessness, insomenia, increased diuresis, muscle twitch, CV arrhythmias
Withdrawal: headache, lethargy, depression, wt gain |
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Nicotine
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Intox: restlessness, insomnia, anxiety, arrhythmias
Withdrawal: irritability, headache, anxiety, wt gain craving |
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PCP
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Intox: belligerence, impulsiveness, fever, psychomotor agitation, vertical/horiztonal nystagmus, tachy, ataxia, homicidality, psychosis, delirium
Withdrawal: depression, anxiety, irritability, restlessness, anergia, disturbances of thought/sleep |
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LSD
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Intox: marked anxiety/dep, delusions, visual hallucinations, flashbacks, pupillary dilation
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Marijuana
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Intox: euphoria, anxiety, paranoid delusions, perception of slowed time, impared jugment, social withdrawal, inc appetite, dry mouth, hallucniatons
Withdrawal: irritabilty, depression, insomnia, nausea, anorexia, peak at 48h, last 5-7d, detected in urine for up to 1 mo. |
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Heroin addiction
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inc risk of hepatitis, abscess, OD, hemorrhoids, AIDS, R-sided endocarditis; track-marks
Tx: naloxone, naltrexone - competitively inhib opioids Methadone - long acting oral opiate; detox program and long term mgmt Suboxone - naltrexone + buprenophine - long acting w/ fewer withdrawal sxs than methadone |
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Methylphenidate
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inc presyn NE vesicular release
Use for ADHD |
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Alcohol withdrawal
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Benzos
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Anorexia/bulemia
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SSRIs
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Anxiety
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Buspirone
SSRI |
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ADHD
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Methylphenidate (ritalin)
Amphetamines MAO Inhibitors |
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Atypical depression
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SSRIs
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Bipolar disorder
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Mood stabilizers:
Lithium Valproic acid Carbamezapine Atypical antipsychotics |
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Depression
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SSRIs, NSRIs
TCAs |
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Depression w/ insomnia
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Mirtazapine
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OCD
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SSRIs
Clomipramine |
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Panic Disorder
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SSRIs
TCAs Benzos |
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PTSD
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SSRI
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Schizophrenia
Tourettes |
Antipsychotics
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Antispsychotics
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Haloperidol, Trifluoperazine, Fluphenazine, Thioridazine, Chlorpromazine (Haloperidol + Azines)
MOA: block D2 receptors Use in schizophrenia (for pos sx's), psychosis, acute mania, Tourettes Tox: EPS, endocrine s/e (hyperprolactinemia, galatctorrhea), dry mouth, constipation, hypoTN, sedation |
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Antipsychotics cont
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Neuroleptic malignant syndrome - rigidity, myoglobinuria, autonomic instability, hyperpyrexia (tx: dantrolene, bromocriptine)
Tardive dyskinesia -- oral facial movements from long term use |
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Atypical antipsychotics
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Clozapine, olanzapine, Risperidone, Aripiprazole, Quietapine, Ziprasidone
MOA: Block 5-HT2, alpha, H1, DA receptors Use in schizophrenia (+ and neg sx's); Olanzapine for OCD, anxiety, depression, mania, Tourettes Tox: fewer EPS and anticholin effects, Clozapine = agranulocytosis |
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Lithium
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Mood stabilizer for bipolar, blocks relapse and acute manic events; SIADH
Tox: tremor, hypothyroidism, polyuria (ADH antagonist), teratogenesis, narrow therapeutic window, nephrogenic diabetes insipidus |
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Buspirone
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MOA: stim 5HT1A receptors
Use in GAD, no sedation or addiction; does not interact with EtOH |
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TCAs
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Imipramine, Amitriptyline, Desipramine, Nortriptyline, Clomipramine, Doxepin, Amoxapine
MOA: block reuptake of NE & Serotonin Use for major depression, bedwetting, OCD S/E: sedation, alpha-blocking effects, atropine-like side effects (tachy, urinary retention), 3* TCAs have more anticholin effects than 2* TCAs * Desipramine = least-sedating Tox: Convulsions, coma, cardiotox, resp dep, hyperpyrexia, confusion and hallucination in elderly due to anticholin side effects; tx: NaHCO3 for cardiotox |
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SSRIs
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Fluoxetine, Paroxetine, Sertaline, Citalopram
Use for depression, OCD S/E less than TCAs, GI distress, sexual dysfunction Serotonin syndrome: hyperthermia, muscle rigidity, CV collapse, flushing, diarrhea |
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Bupropion
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Smoking cessation; inc NE & DA
Tox: stimulant (tachy, insomnia), headache, seizure in bulimics, no sexual side effects |
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Venlafaxine
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GAD; inhib serotonin & NE reuptake
Tox: inc BP, stimulant effects, sedation, nausea |
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Duloxetine
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inhib serotonin & NE reuptake (more effect on NE)
Use in diabetic peripheral neuropathy Same tox as Vanlafaxine |
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Mirtazapine
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A2 antagonist (inc release of NE & serotonin), potent 5HT2 ad 5HT3 antagonist
Tox: sedation, inc appetite, wt gain, dry mouth |
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Maprotiline
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Block NE reuptake
Tox: sedation, orthostatic hypoTN |
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Trazodone
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Inhib serotonin reuptake
Insomnia Tox: sedation, nauseau, priapism, postural hypoTN |
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MAOIs
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Phenelzine, tranylcypromine
Increase levels of amine NTs Use in atypical depression, anxiety, hypochondriasis Tox: HTN crisis w/ tyramine ingestion (cheese, wine) and B-agonists CNS stimulation, CI w/ SSRIs or meperidine (opioid) to prevent serotoin syndrome |
