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36 Cards in this Set
- Front
- Back
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How long does cocaine stay in your system and how can it be detected?
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2-4 days
Urine drug screen |
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How long do amphetamines stay in your system and how can it be detected?
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1-3 days
Urine drug screen |
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How long does PCP stay in your system and how can it be detected?
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3-8 days
Urine drug screen CPK and AST are often elevated |
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How long do barbituates stay in your system and how can it be detected?
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Short acting (pentobarbital) = 24 hours
Long acting (phenobarbital) = 3 weeks |
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How long do benzos stay in your system and how can it be detected?
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Short acting (lorazepam) = 3 days
Long acting (diazepam) = 30 days |
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How long do opioids stay in your system and how can it be detected?
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2-3 days depending on the opioid
**methadone and oxycodone will come up negative on a general screen (order separate panel) |
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How long does marijuana stay in your system and how can it be detected?
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Heavy users = 4 weeks
Single use = 3 days Urine detection |
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How does alcohol affected the brain receptors?
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Activates GABA and serotonin receptors
inhibits glutamate receptors and voltage-gated Ca channels CNS depressant |
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Alcohol withdrawal symptoms
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Irritability
Tremor Insomnia Diaphoresis HTN Tachycardia Fever Disorientation Tonic-colonic seizures DTs Hallucinations |
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Symptoms of DTs
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Delirium, hallucinations, gross tremor, autonomic instability, fluctuating levels of psychomotor instability
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Treatment of choice for DTs
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Benzodiazepines:
Chlordiazepam (Librium) Diazepam (Valium) Lorazepam OR anticonvulsants = phenytoin (Dilantin) |
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MOA of Disulfram
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Inhibits aldehyde dehydrogenase in the liver and causes flushing, headache, nausea/vomiting, palpitations, SOB
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Naltrexone MOA
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Opioid receptor blocker
Decreases cravings or "high" of alcohol Will precipitate opioid withdrawal in patients with physical opioid dependence |
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Acamprosate MOA
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Structurally similar to GABA, thought to inhibit glutaminergic system
Should be started postdetox for relapse prevention in patients who have stopped drinking Can be used in patients with liver disease Contraindicated in severe renal disease |
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Topiramate MOA
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Anticonvulsant that potentials GABA and inhibits glutamate receptors
Reduces cravings for alcohol |
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How does cocaine affect the brain?
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It blocks dopamine reuptake = stimulant affect
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Signs of cocaine intoxication
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Euphoria, increase or decreased BP, tachy or bradycardia, nausea, dilated pupils, weight loss, psychomotor agitation or depression, chills, sweating
Respiratory depression, seizures, arrhythmias, paranoia, hallucinations (especially tactile) Vasoconstriction = MI or stroke |
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Symptoms of amphetamine abuse
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Dilated pupils
Increase libido Perspiration Respiratory depression Chest pain |
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What is the difference between the MOA of classic amphetamines and substituted amphetamines?
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Classic = blocks reuptake and facilitates release of DA and NE
Substituted (MDMA, MDEA) = release DA, NE and serotonin from nerve endings; associated with stimulant and hallucination effects; serotonin syndrome can occur if taken with SSRIs |
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Signs of amphetamine OD
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Hyperthermia
Dehydration Rhabdomyolysis leading to renal failure |
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How does PCP (phencyclidine) affect the brain?
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Antagonizes NMDA glutamate receptors and activates DA neurons
Dissociative, hallucinogenic drug |
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Ketamine signs
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Tachycardia
Tachypnea Hallucinations Amnesia |
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Signs of PCP intoxication
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Agitation, depersonalization, hallucinations, synesthesia, impaired judgement, memory impairment, assaultiveness, nystagmus, ataxia, HTN, tachycardia, ,uncle rigidity, coma, death
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PCP OD symptoms
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Seizures
Coma Death |
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What symptom is pathological for PCP intoxication?
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Rotary nystagmus
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Tactile and visual hallucinations are found with intoxication of which substances?
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Cocaine
PCP |
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Affects of benzos on the brain
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Affect GABA By increasing frequency of chloride channel openings
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Affects of barbiturates on the brain
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Affect GABA by increasing duration of chloride channel opening
At high doses, they act as direct GABA agonists = lower ,arguing of safety than benzos |
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What is the tx of choice for benzo OD?
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Flumazenil = very short acting benzo antagonist
Can cause seizures |
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Examples OD opioids
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Heroin
Oxycodone Vicodin (hydrocodone/acetaminophen) Percocet (oxycodone/acetaminophen) Codeine Dextramethorphan (in cough syrup) Morphine Methadone Meperidine (Demerol) |
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Signs of opioid intoxication
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Nausea, vomiting, sedation, decreased pain perception
Constipation, slurred speech Pupil constriction Respiratory depression Seizures **meperidine and MAOIs can cause serotonin syndrome |
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Which symptom seen in meperidine is the exception to opioid intoxication symptoms?
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Demerol (meperidine) produces miosis (dilates pupils instead of constricting them)
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Classic OD symptoms of opioids
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Respiratory depression
Altered mental status Miosis |
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Tx for severe opioid withdrawal
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Clonidine
NSAIDS Buprenorphine Methadone |
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Withdrawal symptoms of opioids
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Anxiety
Insomnia Anorexia Fever Rhino rhea Piloerection |
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Intoxication symptoms of hallucinogens
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Perceptual changes
Labile affect Dilated pupils Tachycardia Hypertension Hyperthermia Tremors In coordination Sweating Palpitations |
