Substances Of Abuse

Martin, Grace
Dela Cruz, Kristelle
Tindongan, Ofelia

Amphetamine/
Metamphetamine
Aka - POORMANS COCAINE
- SHABU
Hypertension
Arrhythmias
Seizures
CNS stimulation & Sympathomimetic
Treatment
Seizures- Diazepam & Phenytoin
Psychosis/ Agitation- Chlorpromazine/Haloperidol,
Diazepam
Hypertensive crisis- -blockers, a-blocking agents
Arrhythmias: Propranolol, Lidocaine

Antidote:
- Gastrointestinal decontamination with
activated charcoal is an early
therapeutic option if the patient is seen
within 1-2 hours of a potentially lifethreatening ingestion of these agents.
- Whole bowel irrigation with
polyethylene glycol solution both in
patients who swallow prewrapped drugs.

Opioids
Natural: Opium, Morphine
Semi-synthetic: Heroin & Codeine
Synthetic: Methadone & Meperidine
Signs and Symptoms
Miosis
Comatose
Respiratory depression
Seizures (meperidine)

Treatment
Naloxone
Naltrexone- which blocks opioid receptors
and prevents the drug from having an effect
Nalorphine
Nalmefen
* Competitive opioid antagonist but may
precipitate withdrawal symptoms in an
addict patient

SEDATIVES

BENZODIAZEPINES
In addition with alcohol causes fatal
CNS depression
Signs & Symptoms:
- Drowsiness
- Ataxia
- Confusion
Treatment:
- Flumazenil- reverses benzodiazepine
effect in the CNS

BARBITURATES
Used for induction of anesthesia and for
seizures
Signs and Symptoms:
- Mild: Slurred speech, ataxia, altered mental
status
- Severe: Comatose with absence of deep
tendon reflexes, Cheyne-Strokes (Irregular)
respiration
Treatment:
- Forced alkaline diuresis
- Hemodialysis

CHLORAL HYDRATE
Aka (MICKEY FINN)
In vivo via alcohol dehydrogenase
Trichloroethanol
knock-out drops, similar to
barbiturate poisoning
Treatment: Supportive

HALLUCINOGENS

LSD
Lysergic acid diethylamide,
acid, an ergot derivative
Mechanism of Action: inhibits
serotoninergic firing sympathetic
stimulation and hallucinations
Treatment:
- Benzodiazepines for seizures

MORNING GLORY FAMILY

Argyreia nervosa (wood rose)
Ipomea violacea (morning glory)
- Related to LSD but more GI effects

MESCALINE
Peyote cactus (Lophophora williamsii)
buttons

ECSTASY
MDMA (methylenedioxymethamphetamine)
Smooth metamphetamine
It produces feelings of increased energy, euphoria,
emotional warmth and empathy toward others, and
distortions in sensory and time perception.
MOA:
serves as a false neurotransmitter release of
catecholamines & inhibition of MAO, also stimulates
and a receptors (similar to amphetamine)
Toxic Dose: 50-150 mg
Treatment:
- Labetalol
- Nitroprusside
- Nifedipine for HTP

PHENCYCLIDINE (PCP)
angel dust
Dissociative anesthetic
Signs & Symptoms:
- Coma
- Acute brain syndrome (disorientation,
psychosis, coma)
Treatment:
- Diazepam for seizures
- Nitroprusside for HPN

MARIJUANA
- Mary jane, Grass, Pot session, MJ, Bang
Hashish or hash oil
Cannabis sativa
Most commonly used illegal drug
Active Ingredient: tetrahydrocannabinol
(THC)
Signs & Sym:
- Euphoria
- daily cough and phlegm production
- more frequent acute chest illness
- lung infections

COCAINE
Erythroxylon coca
Crack
coke
Free base
- CNS and sympathetic stimulation
Treatment:
- benzodiazepines: seizure
- Labetalol: HPN
- Neuroleptics: pychosis

ETHANOL

Most widely abused recreational drug

Grain alcohol
Neutral spirit
Responsible for major medical and socioeconomic problems
Alcohol content:
- beer: 4-5 %
- wine: 10-14%
distilled spirits: (whiskey, vodka, rum, brandy) 3050%
Metabolites:
- Acetaldehyde
- Acetic acid

ETHANOL

Signs & Symptoms:

CNS depression
Acid-base Imbalance
Impaired thermal regulation
Hypoglycemia
Treatment:
Thiamine (prevention of WernickeKorsakoff syndrome)
- Disulfiram (used to stop alcohol
addiction)

NICOTINE
Active ingredient of tobacco for the
addictive effect
Lethal dose:
ADULTS: 40-60 mg
CHILD: 1.5-2mg/kg
Treatment:
- Activated Charcoal
- Gastric lavage
- Lobeline

NITROUS OXIDE
Laughing gas
May cause diffusional hypoxia
Hysterical laughing
Treatment: Oxygen