30 terms

Psychiatry-Signs and Symptoms of Substance Abuse

Depressant Intoxication
Mood elevation, decreased anxiety, sedation, behavioral disinhibition, respiratory depression.
Depressant Withdrawal
Anxiety, tremor, seizures, insomnia
Alcohol Intoxication signs
Emotional lability, slurred speech, ataxia, coma, blackouts. GGT is a sensitive indicator of alcohol USE. AST 2x ALT
Mild alcohol withdrawal
Anxiety, tremor, seizures, insomnia
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
Opioid Intoxication
CNS depression, nausea, vomiting, constipation, pinpoint pupils, seizures (OD life threatening). Treat: naloxone, naltrexone
Opioid Withdrawal
Sweating, dilated pupils, piloerection, fever, rhinorrhea, nausea, stomach cramps, diarrhea
Barbiturates Intoxication
LOW safety margin, marked respiratory DEPRESSION. Treat: symptoms management (assist respiration and increase BP)
Barbiturates withdrawal
Delirium, life-threatening CV collapse
Benzodiazepines Intoxication
Greater safety margin than barbiturates. Ataxia, minor respiratory depression. Treat with FLUMAZENIL (competitive GABA antagonist).
Stimulants intoxication
Mood elevation, psychomotor agitation, insomnia, cardiac arrhythmias, tachycardia, anxiety
Stimulants withdrawal
Post-use "crash," Depression, lethargy, weight gain, headache
Amphetamines intoxication
Impaired judgment, pupillary dilation, prolgoned wakefulness and attention, delusions, hallucinations, fever
Amphetamines withdrawal
Stomach cramps, hunger, hypersomnolence
Cocaine intoxication
Impaired judgment, pupillary dilation, hallucinations (tactile), paranoid ideations, angina, sudden cardiac death. Treat: BDZ
Cocaine withdrawal
Suicidality, hypersomnolence, malaise, severe psychological craving.
Caffeine intoxication
restlessness, increased diuresis, muscle twitching
Nicotine intoxication
Nicotine withdrawal
irritability, anxiety, craving. Treat: nicotine patch, gum, lozenges OR bupriopion or varenicline (chantix)
PCP intoxication
Belligerence, impulsiveness, fever, psychomotor agitation, vertical and horizontal nystagmus, tachycardia, homicidality, psychosis, delirium.
PCP withdrawal
Depression, anxiety, irritability, restlessness, anergia, disturbances of thought and sleep.
LSD intoxication
Marked anxiety or depression, delusions, visual hallucinations, FLASHBACKS, pupillary dilation
Marijuana intoxication
Euphoria, anxiety, paranoid delusions, perception of SLOWED time, impaired judgment, social withdrawal, increased appetite, dry mouth, conjuctival injection, hallucinations
Marijuana withdrawal
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.
Long acting oral opiate, used for heroin detoxification or long-term maintenance.
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
Wernicke-Korsakoff syndrome
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
Mallory-Weiss syndrome
Longitudinal lacerations at the GE junction caused by excessive vomiting. Presents with hematemesis. Associated with PAIN unlike esophageal varices.