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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 |
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what is 5 HT syndrome
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Hyperthermia
confusion, flushing, sweating hyper or hypotension muscular rigidity myoclonus hyperreflexia renal failure rhabdomyolysis |
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tx of opiate intoxication? overdose? dependence?
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intox: ABCs
OD: naloxone (IV) and ventilation...may cause withdrawal dependence: oral methadone once daily/ taper over months to years + psychotherapy |
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opiate withdrawal is life threatening? (t/f)
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false
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dysphoria
insomnia lacrimation/rhinorrhea weak + muscle aches sweats + piloerection n/v pupils? |
opiate withdrawal
pupils are dilated |
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tx of opiate withdrawal?
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moderate sx: clonidine and/or buprenoprhine
severe: detox with methadone taper over 7 days |
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respiratory depression
altered mental status miosis |
opiate intoxication
"rebels admire morphine" |
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_______ does not cause physical dependence or withdrawal
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hallucinogens (LSD, mesculine, muschroms)
and marijuana |
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causes conjunctival injection, dry mouth, euphoria, impaired coordination, mild tachy, increased app
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marijuana intoxication
"conjunctival injection is key" |
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signs of marijuana withdrawal
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no syndrome:
sx: irritable, insomnia, nausea, decr app |
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drug that inhibits adenylate cyclase
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thc
|
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drug that antagonizes adenosine leading to increased cAMP and increased DA activaiton
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caffeine
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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 |
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withdrawal of caffeine resolves within ______ time
sx? tx? |
1 week
sx: ha, n/v, drowsy, anxious, depressed tx: analgesics for ha; benzos for anxiety |
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cigarrette smoking during PG is associated iwt ______ and ______of the newborn
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low birth weight
persistant pulmonary htn |
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withdrawal causes intense craving, dysphoria, anxiety, increased appetite, irritability, insomnia
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nicotine
|
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2 drugs used in nicotine withdrawal
|
zyban (antidep to reduce cravings)
clonidine |
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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 |
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tx for too many barbiturates?
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alkalanize urine with NaHco3
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tx for too many benzos
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flumazanil
|
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se of flumazanil to watch out for?
why do we use it? |
seizures
used for benzo OD |
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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 |
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withdrawal from drugs that are ____ are considered life threatening
withdrawal from _______ are not |
sedatives (except for opiates)
stimulants and hallucinogens |
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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) |
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______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) |
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dependence on cocain should be treated how?
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psychotherapy
TCAs DA agonists (amantadine, bromocriptine) |
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abrupt abstinence from cocaine produces?
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dysphoric crash
vivid dreams psychomotor agitation/retardation hunger constricted pupils |
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ataxia
confusion ocular abnl (nystagmus, gaze palsies) tx? |
wernicke's enceph
give thiamine (B1) |
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impaired recent memory
anterograde amnesia +/- confabulation |
korsakoff sundrome (irreversible)
|
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most commonly used substance in the united states
|
etoh
|
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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) |
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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 |
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tx of etoh dependence
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AA
Antabuse (aversive tx) Psychotherapy + SSRIs Naltrexone (reduces cravings) |
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define etoh withdrawal syndrome
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earliest sx w/in 6-24hrs since last drink
insomnia, anxiety, irritability tachy, htn fever seizures, tremor hallucinations delirium |
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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 |
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tactile hallucinations are commonly seen in ______?
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etoh withdrawal and cocaine intox
|
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tx of etoh withdrawal
|
tapered benzodiazpeines
(chlordiazepoxide, lorazepam) thiamine, folic acid, mva mgso4 |