Psychiatry - Drugs
- Created by: LaurenSE
- Created on: 13-10-15 18:26
Opioids
USE: analgesia, euphoria
SIDE EFFECTS: nausea, vomiting, constipation, drowsiness, anorexia, lowered libido, apathy, slurred speech
DEPENDENCE: small pinpoint pupils, malaise, venepuncture marks,erectile dysfunction, tremor
WITHDRAWAL: intense craving, nausea, vomiting, muscle and joint aches and pains, lacrimation, rhinorrhoea, dilated pupils, sweating, pyrexia, restlessness, insomnia, tachycardia
TREATMENT: chlormethiazole/benzodiazepine during detox, methadone for heroin
Cannabinoids
USE: relaxation, euphoria, marked psychological dependence
SIDE EFFECTS: conjunctival injection, dry mouth, cough, tachycardia, increased appetite, suspiciousness, feeling of slowed time
SERIOUS SIDE EFFECTS: impaired judgement, persecutory hallucinations, depersonalisation, derealisation
Cocaine
USE: local anaesthetic, strong psychological dependence, euphoria
SIDE EFFECTS: tachycardia, dilated pupils, raised BP, sweating, nausea, vomiting, behavioural changes (grandiosity, agitation, impairment of judgement, social and occupational functioning)
HIGH DOSES: increased sexual interest, delusional disorder
WITHDRAWAL: dysphoric mood, craving for more cocaine, anxiety, irritability, fatigue, insomnia, paranoid and suicidal thoughts
TREATMENT: CBT, support groups, counselling
Amphetamines
USE: dexamfetamine use in treatment of narcolepsy and in hyperkinesis in children, physical and psychological dependene
SIDE EFFECTS: euphoria, excitement, increased confidence, increased energy and drive, reduced need for sleep, tachycardia, dilated pupils, hypertension
HIGH DOSES: sweating, nausea, vomiting, grandiosity, hypervigilance, agitation, impaired judgement, social and occupational functioning, illusions, hallucinations, delusional disorder, cardiac arrhythmias, paranoid psychosis
WITHDRAWAL: cravings, dysphoric mood, fatigue, insomnia, hypersomnia, agitation, excessive hunger, shaking, seizures, arrhythmias, suicidal ideation, psychosis
TREATMENT: symptom control, CBT, counselling, support groups
Benzodiazepines
USE: diazepam (valium), hypnotics, physical dependence occurs quickly, chronic use can cause amnesic syndrome
SIDE EFFECTS: slurred speech, incoordination, unsteady gait, impaired attention and memory, paradoxical increased aggression, disinhibition, mood lability, impaired judgement, social and occupational functioning
WITHDRAWAL: nausea, vomiting, malaise, weakness, tachycardia, sweating, anxiety, irritability, orthostatic hypotension, tremor, insomnia, grand mal fits, tinnitis, anorexia, hallucinations, delusions, agitation, delirium
TREATMENT: medically supervised detoxification, CBT, group therapy
Hallucinogens
DRUGS: LSD, DMT, magic mushrooms, PCP (phencyclidine), ketamine, MDMA
SIDE EFFECTS: dilated pupils, tachycardia, palpitations, sweating blurred vision, incoordination, tremor, perceptual abnormalities, hallucinations, depersonalisation, derealisation, illusions, synaesthesia
HIGH DOSES: anxiety, depression, suicidal ideation, ideas of reference, fear of going mad, paranoid thoughts, impaired judgement, social and occupational functioning
FLASHBACKS: re-experiencing perceptual changes that occurred whilst intoxicated, may occur for years, leads to distress, panic disorder, depression, suicide
LSD - lasts 6 hours, sense of detachment, visual distortions, misperceptions, harm comes from 'bad trips' causing behavioural toxicity and flashbacks
PCP - confusion, visual sensory distortions, aggression, sudden violence (opioid & aspartate receptors)
Mushrooms - not associated with dependence or withdrawal, harm comes from 'bad trips'
Ketamine - synaesthesia, ataxia, slurred speech, psychosis, amnesic syndrome
Ecstasy
USE: euphoria, stimulant
SIDE EFFECTS: increased sweating, nausea, vomiting, diminished potency, dehydration, hyperthermia, neurotoxic, hepatotoxic, chronic cognitive impairment,
OVERDOSE: extreme nausea, panic, anxiety, inability to sweat or urinate, loss of consciousness, arrhythmias, confusion, muscle cramps, death due to hyperthermia
WITHDRAWAL: fatigue/anorexia/depressed mood last for 24-48 hours, panic attacks, depersonalisation, derealisation, insomina
TREATMENT: symptom management
Solvents
USE: adhesives, petrol, butane gas, paint, paint thinner, cleaning agents
SIDE EFFECTS: euphoria, disinhibition, slurred speech, blurred vision, visual misperceptions
HIGH DOSES: local irritation, headache, cardiac arrhythmias, unconsciousness, aspiration, sudden death (direct toxicity or inhalation of gastric contents)
CHRONIC USE: liver and kidney damage, impaired memory and concentration, cognitive impairment, withdrawal similar to alcohol withdrawal
TREATMENT: CBT, group support, counselling
Alcohol
SIDE EFFECTS: boastfullness, embarrassing speech, offensiveness, reduced inhibition, labile mood, slurred speech, unsteady gait, nystagmus, erectile dysfunction, blackouts, increased risk of suicide, nausea, vomiting, gastritis, peptic ulcer, Mallory-Weiss tear
CHRONIC USE: loss of libido, loss of body hair, gynaecomastia, delusional jealousy, hepatic damage, pancreatitis, hypertension, arrhythmias, iron deficiency anaemia, vitamin K deficiency
KORSAKOV'S SYNDROME: chronic, thiamine deficiency, amnesic syndrome, impairment of recent and remote memory with preservation of immediate recall, confabulation
WERNICKE'S ENCEPHALOPATHY: acute, severe thiamine deficiency, acute confusion, gait ataxia, nystagmus, clouding of consciousness GIVE PABRINEX (thiamine)
DEPENDENCE TREATMENT: disulfiram (antabuse - ingestion of alcohol causes N&V)
WITHDRAWAL TREATMENT: thiamine, chlordiazepoxide (benzodiazepine), diazepam for withdrawal fits, phenothiazines for hallucinosis, zopiclone for insomnia, midazolem for seizures
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