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Psychotherapy: 118b - Substance Intoxication and Withdrawal

Psychology20 CardsCreated about 1 month ago

This flashcard set outlines key symptoms of stimulant withdrawal, including depression, fatigue, irritability, and heightened suicide risk, as well as features of alcohol withdrawal within 24 hours, such as autonomic hyperactivity, hallucinations, and seizures—emphasizing that withdrawal stages may overlap in presentation.

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List some of the symptoms of stimulant withdrawal

  • Depression, dyspohria

    • High risk of suicidality

  • Appetite stimulation, cravings

  • Fatigue

  • Sedation, slowing

  • Irritability

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Key Terms

Term
Definition

List some of the symptoms of stimulant withdrawal

  • Depression, dyspohria

    • High risk of suicidality

  • Appetite stimulation, cravings

A patient is experiencing alcohol withdrawl 24 hours after their last drink

What symptoms might they be experiencing?

  • ANS hyperactivity

  • Seizures

  • Hallucinations

Key here is that the stage...

List some of the signs of opioid withdrawal

Every orifice is open and excreting things (kind of like cholinergic toxicity)

  • Vomiting, diarrhea

  • Sweating

Which receptors are acted on by cannabinoids?

What are the effects?

  • CB1

    • CNS effects: analgesia, psychoactive, GI

    • THC is a partial agonist

    • CBD is an antagonist<...

How should alcohol withdrawal seizures be managed?

Usually generalized tonic-clonic

  • Benzos or barbituates acutely

    • Phenytoin is less effective in alcohol withdrawal se...

List some of the findings of opioid intoxication

Which one is most consistently found?

  • Meiosis - very consistent finding w/opioid intoxication

  • Euphoria, mood changes

  • Respiratory d...

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Psychotherapy: 118b - Substance Intoxication and Withdrawal
TermDefinition

List some of the symptoms of stimulant withdrawal

  • Depression, dyspohria

    • High risk of suicidality

  • Appetite stimulation, cravings

  • Fatigue

  • Sedation, slowing

  • Irritability

A patient is experiencing alcohol withdrawl 24 hours after their last drink

What symptoms might they be experiencing?

  • ANS hyperactivity

  • Seizures

  • Hallucinations

Key here is that the stages of withdrawal overlap

List some of the signs of opioid withdrawal

Every orifice is open and excreting things (kind of like cholinergic toxicity)

  • Vomiting, diarrhea

  • Sweating

  • Tearing

  • Pupil dilation

  • Tremor, restlessness

  • Anxiety/irritability

  • Piloerection

Which receptors are acted on by cannabinoids?

What are the effects?

  • CB1

    • CNS effects: analgesia, psychoactive, GI

    • THC is a partial agonist

    • CBD is an antagonist

  • CB2

    • Immune tissue

How should alcohol withdrawal seizures be managed?

Usually generalized tonic-clonic

  • Benzos or barbituates acutely

    • Phenytoin is less effective in alcohol withdrawal seizures

List some of the findings of opioid intoxication

Which one is most consistently found?

  • Meiosis - very consistent finding w/opioid intoxication

  • Euphoria, mood changes

  • Respiratory depression

  • Constipation, dry mouth, flushing

  • Impaired reflexes

What is the difference between cannabis sativa adn cannabis indica?

  • Sativa = more THC

    • Energizing -> productive, creative

  • Indica = more CBD

    • Relaxing, anxiolytic

List 2 commonly used illicit stimulants


Cocaine

Methamphetamine

What are the risk factors for delirium tremens?

Risk factors:

  • Sustained alcohol use (chronic drinking)

  • Prior history of delirium tremens

  • Age 30+

  • Concurrent medical illness

  • Withdrawal begins while still intoxicated

Note: 95% of people who experience alcohol withdrawal DO NOT have delirium tremens

Which illicit substance is most likely to cause serotonin syndrome?

MDMA (aka molly, ecstacy)

What pathophysiologic changes occur with prolonged drinking?

  • Downregulation of GABAa receptors

    • Alcohol stimulates GABAa receptors;
      constant stimulation -> downregulation

  • Upregulation of NMDA receptors

    • Alcohol inhibits the NMDA receptor;
      constant block -> upregulation

In alcohol withdrawal, when does delirium tremens typically occur?

3-5 days after last drink

May be 7-8 days for heavy drinkiers

95% of people who experience alcohol withdrawal WILL NOT have delirium tremens

List some of the symptosm of MDMA intoxication

  • Euphoria

  • Sense of connectedness

  • Enhanced visual, tactile senses

  • Extroversion

  • Well-being

  • Negative effects

    • Nausea, bruxism, motor restlessness

    • Serotonin syndrome possible

What is cannabinoid hyperemisis syndrome?

When does it occur?

  • Recurrent nausea and vomiting

  • Dehydration

  • Relief with hot showers

Usually happens when stopping after years of daily use

How do synthetic cannabinoids differ from cannabis?

  • More potent

  • Longer acting

  • Structurally different from THC

    • Not detected on urine drug screen

Desribe the biology behind alcohol withdrawal

Not enough GABA signaling, excess glutamate signaling

NE and dopamine also play a role

  • Alcohol stimulates GABAa receptors and inhibits glutamate receptors

  • Withdrawal occurs when this is reversed, especially in chronic drinkers

    • Chronic alcohol GABAa activation -> downregulation

    • Chronic alcohol NMDA inhibition -> upregulation

List some of the syptoms of stimulant intoxication

  • Mania

  • Anxiety

  • Restlessness

  • High energy, low need for sleep

  • Increased sympathetic tone

  • Chest pain, arrhythmia

  • Seizure

Which neurotransmitters are affected by stimulants?

Dopamine, norepinephrine increase

List some of the signs of cannabis withdrawal

  • Anxiety, worry, restlessness

  • Irritability, anger, aggression

  • Sweating, fever, chills, tremor

  • Abdominal pain, headache

  • Insomnia

  • Decreased appetite

Describe some of the signs of Phencyclidine (PCP) intoxication

  • Dissociation

    • Depersonalization, derealization, psychosis

  • Aggression

  • Nystagmus - hallmark of PCP intoxication

  • Autonomic symtoms

  • Neuromuscular symptoms