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Mood elevation, decreased anxiety, sedation, behavioral disinhibition, respiratory depression.
Alcohol Intoxication signs
Emotional lability, slurred speech, ataxia, coma, blackouts. GGT is a sensitive indicator of alcohol USE. AST 2x ALT
Severe alcohol withdrawal
DTs- Life threatening alcohol withdrawal syndrome that PEAKS 2-5 days after last drink. Autonomic system hyperactivity (tachycardia, tremors, anxiety, seizures) --> psychotic symptoms (hallucinations, delusions) --> confusion. Treat with benzos
CNS depression, nausea, vomiting, constipation, pinpoint pupils, seizures (OD life threatening). Treat: naloxone, naltrexone
Sweating, dilated pupils, piloerection, fever, rhinorrhea, nausea, stomach cramps, diarrhea
LOW safety margin, marked respiratory DEPRESSION. Treat: symptoms management (assist respiration and increase BP)
Greater safety margin than barbiturates. Ataxia, minor respiratory depression. Treat with FLUMAZENIL (competitive GABA antagonist).
Mood elevation, psychomotor agitation, insomnia, cardiac arrhythmias, tachycardia, anxiety
Impaired judgment, pupillary dilation, prolgoned wakefulness and attention, delusions, hallucinations, fever
Impaired judgment, pupillary dilation, hallucinations (tactile), paranoid ideations, angina, sudden cardiac death. Treat: BDZ
irritability, anxiety, craving. Treat: nicotine patch, gum, lozenges OR bupriopion or varenicline (chantix)
Belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, homicidality, psychosis, delirium.
Depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep.
Marked anxiety or depression, delusions, visual hallucinations, FLASHBACKS, pupillary dilation
Euphoria, anxiety, paranoid delusions, perception of SLOWED time, impaired judgment, social withdrawal, increased appetite, dry mouth, conjuctival injection, hallucinations
Irritability, depression, insomnia, nausea, anorexia. Most symptoms peak in 48 hours, last 5-7 days. Detected in urine up to ONE MONTH after use.
Heroin addiction increases risks for...
Hepatitis, abscesses, overdose, hemorrhoids, AIDS, right-sided endocarditis.
Naloxone + Buprenorphine (partial agonist). Long acting with fewer withdrawal symptoms than methadone. Naloxone is NOT active when taken orally, so withdrawal ONLY if INJECTED.
Complications of alcoholism
Alcoholic cirrhosis, hepatitis, pancreatitis, peripheral neuropathy, testicular atrophy
Deficiency of B1(thiamine). Confusion, opthalmoplegia, ataxia (Korsakoff's encephalopathy). Can progress to irrversible memory loss, confabulation, personality change (Korsakoff's psychosis). Associated with PERIVENTRICULAR hemorrhage and necrosis of mammillary bodies. Treat: IV B1
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