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19 Cards in this Set
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patient has miosis increased BP, unsteady gait, slurred speech, is combatative and nodding off. Dx?
Tx? cause effects which structures? what to watch for in 2-3 days? abuse liability? |
intoxication sedative/hypnotic
Tx: Flumazenil GABAa channels; REM decreased can progress to grand mal seizure anterograde amnesia low abuse liability |
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patient has course tremor, is anxious, nausea and vomiting***,hyperflexic, hypotension and is sweating.Dx:
Tx: |
sedative/hypnotic withdrawal
long acting benzo (diazepam); taper off sedative |
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high doses of diazepam, lorazepam or barbiturates is used to treat?
muscle relaxation in cerebral palsy can be treated w/? |
status epillepticus
diazepam |
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Tx withdrawal of
Barbs? Benzos? Alcohol? |
barbs=barbs
benzos=barbs or benzos alcohol = all three |
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40 yo african american male physician w/ pneumonia presents w/ hyportension bradycardia, constipation, constricted pupils(tiny) and a flushed face,slurred speech, dental neglect and respiratory depression? Dx?
Tx? look for physical finding? |
opiate intox
methadone, naltrexone (block reinforcement) clonidine(flushing, miosis) buprenorphine SL (doc office) track marks |
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Pt has hypertension, tachycardia, hot and cold flashes***, goosebumps, nausea and vomiting, restless, decreased appetite.you see track marks.Dx?
what is the drug if miosis was not present? |
Dx= opiate withdrawal
meperidine does not cause miosis b/c acts on muscarinic not mu(resp depress) or Kappa(sedation) or delta (tolerence) |
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pt presents w/ marked weight loss, nausea vomiting, dental neglect, mydriasis"pie eyed", arrythmia, seizure earlier now dyskinesia and agitation sweating with chills, seeing bugs*** on skin Dx?
Tx? |
Dx? stimulant intox
Tx? none reqd but can give benzo= anxiety clozapine=psychosis SSRI's= depression |
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pt has frequent bloody noses, is dysphoric, profusely sweating, persecutory delusions and anxiety for past 48 hours, skinny and sullen. Dx?
Tx? |
stimulant withdrawal
clozapine, benzos |
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pt said he saw jesus and his garden hose turn into a serpent. he notes the radical changing of color in the ED lights.he is sweating, pupils dilated and has tremors and hypertension. Dx?
Tx? most concerning side effect? |
hallucinogen intox
Tx? no need. but benzos ok hyperpyrexia= coma |
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a very amorous teenage girl in ED has altered time perception, memory loss, mydriasis, sweating, is hyperpyrexic, and says "I can feel everyone breating"
Dx? action? |
MDMA ecstasy
release seratonin in cleft, block reuptake, stimulates dopaminergic path. |
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pt with agitation, belligerent, myoclonic jerks, confusion and vertical nystagmus*, and hyperacusis*
Dx? Tx? acts on ? |
PCP intox
Tx acidify urine; clozapine(psychosis) acts on NMDA receptors non-comp antagonist |
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long term PCP use causes permanent changes in/
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DA receptor in frontal cortex; hypofrontality
schizophrenia |
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benzo and barbiturate receptors?
caffeine? |
GABA a
adenosine agonist |
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think paranoia think?
LSD/mushroom/mescaline receptor? |
amphetamines/cocaine
5HT2 partial agonists |
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MDMA receptors?
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seratonin release/block r.u.
dopamine ag adrenergic (RI) |
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dependence needs 3 or more of ?
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tlerence
withdrawal increased dosing desire to quit but don't time spent important activities given up |
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hallmark of physical dependence?
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withdrawal symptoms in abscence of drug use.
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brain reward sites
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ventral tegmental area
medial forebrain nucleus accumbens |
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alcohol works on what receptors?
Nicotine targets? |
GAGA, NMDA, cannabinoid
cholinergic neurons in lat. tegmental this activates dopamine reward center |
