-
Symptoms of BAL 50mg/dl
- euphoria
- talkativeness
- relaxation
-
Symptoms of 100mg/dl BAL
- CNS depression
- impaired motor & sensory function
- impaired cognition
-
symptoms of >140mg/dl BAL
decreased blood flow to the brain
-
-
Legal BAL in MO
0.08% or 80 mg/dl
-
Ethanol toxicities of the liver
- Fatty Liver
- Alcoholic hepatitis
- Cirrhosis
-
Characteristics of cirrhosis
- non-reversible
- mallory bodies
-
Alcohol metabolism
- mostly takes place in the liver
- some in the brain
- free radicles are released creating oxidative stress
-
Ethanol effects on the cardiovascular system
- cardiomyopathy (both atrial and ventricular hypertrophy) and heart failure
- arrhythmias
- hypertension
-
There is a direct correlation to > 3 per day
hypertension
-
Alcohol can prevent
coronary heart disease
-
Common fetal alcohol syndrome abnormalities
- growth retardation
- microcephaly
- poor coordination
- abnormal facial development
- minor joint abnormalities
-
Incidence of FAS births in the US
0.2-1.5/1000 live births
-
Wernicke-Korsakoff syndrome
- vision changes, ataxia, impaired memory
- Thiamine (B1) deficiency
- indirect effect of alcohol
-
Nicotine LD50
0.5-1 mg/kg (40-60 mg)
-
Toxic effects of nicotine
- standalone carcinogenicity is unknown
- teratogenicity is little
- blood pressure increases because nicotine is a vasoconstrictor
-
dose of nicotine that causes N/V
2-5 mg
-
Common ADEs with opiates
- constipation
- dry mouth
- n/v
- sedation
-
Uncommon ADEs with Opiates
- bad dreams/hallucinations
- dysphoria/delirium
- pruritus/urticaria
- respiratory depression
- urinary retention
-
Drugs to treat n/v secondary to opiates
- prochlorperazine
- haloperidol
- metocloperamide
-
Drugs to treat pruritus/urticaria secondary to opiates
- fexofenadine
- diphenhydramine
- loratadine
- doxepin
-
Drugs to treat respiratory depression secondary to opiates
naloxone
-
Cocaine CNS Toxicity
- euphoria, anxiety, agitation, hyperactivity
- muscle rigidity
- paranoid psychosis
- weight loss
-
Cocaine cardiovascular toxicity
- HTN
- increased platelet aggregation
- coronary artery spasm => MI
- shock
- hyperthermia
- tachyarrhythmia, Vtach or Vfib
- Renal failure
-
Amphetamine CNS toxicity
- Addiction
- Psychosis
- memory loss
- aggression
- mood disturbance
- dental problems
- wt loss
-
Amphentamine abuse during pregnancy
- Premature delivery
- fetal growth retardation
- heart and brain abnormalities
- placental abruption
-
Amphetamine cardiovascular toxicity
- dysrhythmias
- HTN
- heart failure
- rhabdomyolysis
-
LSD effects
- most potent mood changing chemical
- dilated pupils
- increased body temp
- increased HR and BP
- Profuse sweating
- loss of appetite
- sleeplessness, dry mouth, tremors
-
Antidote for LSD
no specific antidote
-
Acute marijuana toxicity
- impairs short term memory, attention & judgement
- impaired coordination and balance
- increased HR
-
Persistent marijuana toxicity
impaired memory and learning skills
-
Long term toxicity with marijuana use
- addiction (lower than most drugs)
- increased risk of bronchitis, cough or emphysema
- increased risk for cancer of head, neck and lungs
-
Inhalants and aerosols
- volatile gases
- solvents
- aerosols
- anesthetic gases
-
Volatile gases
- butane
- propane
- aerosol propellants
-
Solvents
- model glue
- gasoline
- toluene
- acetone
- amul nitrite
- cleaning solvent
- printing fluids
-
Aerosols
- deodorants
- hair spray
- freon
-
-
Toxic effects of inhalants and aerosols
- loss of consciousness/convulsion
- cardiac arrhythmias
- death
-
CNS effects of aerosols & inhalants
ataxia and peripheral neuropathy
-
Cardiac effects of aerosols & inhalants
- MI
- more so with halogenated solvents
-
Nephrotoxicity with aerosols and inhalants
-
Hepatotoxicity with aerosols and inhalants
-
Hematological toxicity with aerosols and inhalants
- bone marrow suppression
- N2O or benzene
-
Hypertension and tachycardia are associated with
-
Hypotension associated with
sedative hypnotics
-
Hypothermia associated with
CNS depressants
-
pupil constriction associated with
opioids
-
Pupil dilation associated with
-
Nystagmus (involuntary eye movement) associated with
- sedatives
- phencyclidine
- ketamine
-
-
-
-
Nystagmus, dysarthria & ataxia
-
Twitching and muscular hyperactivity
cocaine
-
-
Coma
- opioids
- sedative hypnotics
-
Mecamylamine
- Nicotine antidote
- nAChR antagonist
-
Flumazenil
Benzodiazepine antidote
-
-
alcohol antidotes
- naltrexone
- acamprosate
- disulfiram
-
Rimonabant
- Marijauna antidote
- CB1 receptor antagonist
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