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38 Cards in this Set

  • Front
  • Back
Meperidine is what type of drug?

distinguishing features: effect on eyes? effect when combined with MAOIs?
opiate (demerol)

dilates pupils while opiates typically constrict pupils

causes 5HT syndrome
what is 5 HT syndrome
Hyperthermia
confusion, flushing, sweating
hyper or hypotension
muscular rigidity
myoclonus
hyperreflexia
renal failure
rhabdomyolysis
tx of opiate intoxication? overdose? dependence?
intox: ABCs

OD: naloxone (IV) and ventilation...may cause withdrawal

dependence: oral methadone once daily/ taper over months to years + psychotherapy
opiate withdrawal is life threatening? (t/f)
false
dysphoria
insomnia
lacrimation/rhinorrhea
weak + muscle aches
sweats + piloerection
n/v


pupils?
opiate withdrawal

pupils are dilated
tx of opiate withdrawal?
moderate sx: clonidine and/or buprenoprhine

severe: detox with methadone taper over 7 days
respiratory depression
altered mental status
miosis
opiate intoxication

"rebels admire morphine"
_______ does not cause physical dependence or withdrawal
hallucinogens (LSD, mesculine, muschroms)

and

marijuana
causes conjunctival injection, dry mouth, euphoria, impaired coordination, mild tachy, increased app
marijuana intoxication

"conjunctival injection is key"
signs of marijuana withdrawal
no syndrome:

sx: irritable, insomnia, nausea, decr app
drug that inhibits adenylate cyclase
thc
drug that antagonizes adenosine leading to increased cAMP and increased DA activaiton
caffeine
if you consume >1g of caffeine in one day, excpect these sx ____

>10g/day, expect these sx:
1g: tinnitus, agitation, cardiac arrythmia

10g: death 2/2 siezures, resp fail
withdrawal of caffeine resolves within ______ time

sx?
tx?
1 week

sx: ha, n/v, drowsy, anxious, depressed

tx: analgesics for ha; benzos for anxiety
cigarrette smoking during PG is associated iwt ______ and ______of the newborn
low birth weight
persistant pulmonary htn
withdrawal causes intense craving, dysphoria, anxiety, increased appetite, irritability, insomnia
nicotine
2 drugs used in nicotine withdrawal
zyban (antidep to reduce cravings)

clonidine
how do barbiturates and benzos differ?

common complication of use?
sx that distinguishes intox from this from etoh?
barbiturates tx epilepsy and used as anesthetic -- increase duration of cl channel opening in order to potentiate GABA

benzos: increase freq of cl opening to potentiate GABA and used for anxiety d/o

resp depression (both are sedative-hypnotics) and hypotension

nystagmus
tx for too many barbiturates?
alkalanize urine with NaHco3
tx for too many benzos
flumazanil
se of flumazanil to watch out for?
why do we use it?
seizures

used for benzo OD
sx of sedative-hypnotic withdrawal

most severe complication during withdrawal? tx?
autonomic hyperactivity (tachy, sweating, insomnia, anxiety, tremor, n/v, delirium, hallucinations)

seizures

long acting benzy (chlorodiazepoxice or diazepam with dose taper)...to prevent seizures, give tegretol or valproic acid
withdrawal from drugs that are ____ are considered life threatening

withdrawal from _______ are not
sedatives (except for opiates)

stimulants and hallucinogens
CPK and AST are usually elevated when someone takes too much _____

other distinguishing signs?

NTs affected?
pcp

violence, rotatory nystagmus

dopaminergic system activating, decreases NMDA receptor activation (glutamate receptor)
______blocks DA reuptake causing a stimulant affect

intoxication with this drug can cause death 2/2 to:

pupils are ____
cocaine

cardiac arrythmia, seizure, respiratory depression -- MI, CVA 2/2 vasoconstriction

dilated (think fight or flight response)
intoxication with cocaine can be treated by:
mild: benzos
severe agitation/psychosis: haldol
sx support (htn, arryth)
dependence on cocain should be treated how?
psychotherapy
TCAs
DA agonists (amantadine, bromocriptine)
abrupt abstinence from cocaine produces?
dysphoric crash
vivid dreams
psychomotor agitation/retardation
hunger
constricted pupils
ataxia
confusion
ocular abnl (nystagmus, gaze palsies)

tx?
wernicke's enceph

give thiamine (B1)
impaired recent memory
anterograde amnesia
+/- confabulation
korsakoff sundrome (irreversible)
most commonly used substance in the united states
etoh
enzyme for each:

etoh to acetaldehyde

acetaldehyde to acetic acid

which is inhibited by antabuse?

which substance accumulates to cause flushing and nausea in asians?
etoh dehydrogenase

aldehyde deydrogenase (antabuse inhibits)

acetaldehyde (deficient in the enzyme aldehyde dehydrogenase)
in evaluating someone who might be drunk, get a ____ to r/o ____

tx of pt with altered mental status in the setting of acute etoh intoxication
CT
subdural hematoma or other brain injury

abcs, thiamine then glucose, naloxone
tx of etoh dependence
AA
Antabuse (aversive tx)
Psychotherapy + SSRIs
Naltrexone (reduces cravings)
define etoh withdrawal syndrome
earliest sx w/in 6-24hrs since last drink

insomnia, anxiety, irritability
tachy, htn
fever
seizures, tremor
hallucinations
delirium
when do DTs set in

how many die if left untreated?

sx of DT
w/in 72hrs since last drink

15-20%

sx: vfisual/tactile hallucinations, gross tremor, ans instability, psychomotor lability
tactile hallucinations are commonly seen in ______?
etoh withdrawal and cocaine intox
tx of etoh withdrawal
tapered benzodiazpeines
(chlordiazepoxide, lorazepam)

thiamine, folic acid, mva

mgso4