Synthetics
This synthetic opioid has increased in prevalence over the last 10 years, but can't harm you from skin contact or ambient inhalation (no matter how many police dash cam videos you watch). Major player in increased overdose deaths, just ask Michael Jackson.
Fentanyl
You would think this sort of misinformation is a benefit, keeping people away from fentanyl, but due to this misinformation rescuers are actually refusing to go near people exposed to fentanyl. Pure idiocy.
Depressed level of consciousness, respiratory suppression, and this pupillary change are hallmarks of opioid overdose
miotic pupils
Despite the extensive list of derivatives, phenylethylamine is the backbone for the "amphetamine-based" stimulants and act on these three neurotransmitters
Dopamine, serotonin, and norepinephrine
Chronic usage of marijuana can lead to this repetitive and nauseating syndrome that has the near-pathognomonic feature of relief through hot-water bathing
Cannabinoid Hyperemesis Syndrome
Both PCP and ketamine block this receptor, which causes profound psychotic presentations
NMDA Receptors
Why do people even use these drugs? Because of the dissociative effects, mild euphoria, and tactile sensory distortions at lower doses
Synthetic cathinones, known by this innocuous street name, can result in violent agitation, self-mutilation, tachycardia, and seizures with severe intoxication
Bath salts
Opioid withdrawal makes you feel like you're dying (flu-like symptoms, myalgias, diarrhea, piloerection, rigors, hyperthermia, etc) but is not fatal. BUT seizure threshold is lowered in this related syndrome in newborns.
Neonatal Abstinence Syndrome
(thought to be due to the significant neurophysiologic stress of withdrawal)
People with psychostimulant overdose present with these symptoms (name at least 4, both neurologic and non-neurologic)
Hyperactive encephalopathy, psychosis, cardiac arrhythmia, seizures, dilated pupils, hyperthermia, and rhabdo
True or false: both natural and synthetic cannabis use is associated with cerebrovascular complications in people > 50 yo?
True
This antiemetic is often combined with codeine syrup and artificial flavors to create concoctions that go by the slang names "purple drank, sizzrup, or lean."
Promethazine
The anticholinergic effect potentiates the opioid effect from the codeine
Synthetic marijuana is typically an herb that is sprayed in synthetic cannabinoids then smoked, and has a higher risk for precipitating this common neurological emergency not typically seen in organic cannabis
Seizures
Naloxone is the go-to reversal agent for opioid reversal, but this mechanistic caveat to administration often leads to patients returning to their overdose state after initial revival
Short duration of action
This street name of 3,4-MethyleneDioxyMethAmphetamine is a close analog of serotonin and has been associated with acute dystonic reactions, SIADH, seizures (with or without hyponatremia), and even anecdotal toxic leukoencephalopathy
MDMA, Molly, Ecstasy, X, or E
Marijuana is a listed risk factor for this syndrome, typically preceded by thunderclap headache and associated with ischemic and hemorrhagic stroke
Reversible Cerebral Vasoconstriction Syndrome (RCVS)
A patient presents with dilated pupils, tachycardia, encephalopathy, flushing, urinary retention, and respiratory depression. Reports from family state she was "sippin' on that lean" and had tried a new supplement called jimson weed. Name the acetylcholinesterase inhibitor that has CNS penetrance to reverse her anticholinergic toxicity
IV physostigmine
Synthetic cannabinoids can be cut with brodifacuom, a rodenticide that can cause this spontaneous neurological emergency
Intracranial hemorrhage
This specific condition (named after MRI changes/the area of the brain effected) can be seen in association to recurrent exposure to black tar heroin vapor, typically inhaled via a pipe after firing the from underneath a piece of aluminum foil
Toxic spongiform leukoencephalopathy
Will accept "chasing the dragon" as an answer if they describe white matter changes or simply "leukoencephalopathy"
While all psychostimulants lower seizure threshold, cocaine can undergo this phenomenon wherein recurrent seizures can continue to be provoked with any re-exposure to the drug, even in lowered dosages
Kindling
Potentiation of this centrally acting neurotransmitter is the mechanism for the powerful hallucinations in LSD, psilocybin and other hallucinations, leading to ongoing research in depression, anxiety, substance abuse disorders, and PTSD
Serotonin
Chronic toluene exposure from huffing can cause a clinical picture that appears comparable to dementia. On MRI imaging this will appear as a _____.
leukoencephalopathy (toxic)
T2 FLAIR hyperintensity in the cerebrum and posterior fossa, hypointensity in the bilateral thalami
A non-levodopa responsive parkinsonism is caused by this trace mineral that is frequently used as an additive in the preparation of injectable methcathinone
Manganese
Acute opioid intoxication can result in a lesser-reported gray-matter predominant insult named this, an acronym of the spectrum of gray matter areas that are effected
CHANTER Syndrome
(Cerebellar, Hippocampal, And Basal Nuclei Transient Edema with Restricted Diffusion Syndrome)
Levamisole, an antihelminthic compound, is used as a cutting agent in cocaine and can lead to this white matter disease in exposed patients
Inflammatory demyelinating leukoencephalopathy
This drug is actually the ground leaf of a tropical tree, is widely available in vape shops across the US, and is technically a hallucinogen but is more sought after for its weak opioid properties
Kratom
This is the name for the isolated hallucinations that occur in the first 12-24 hours of alcohol withdrawal
Alcoholic Hallucinosis
Resolves by day 2, often confused with DTs (48-72 hours after abstinence with tachycardia/agitation/hyperthermia/hallucinations/gen seizures)