Withdrawal
Abrupt cessation after chronic benzodiazepine use can produce this general state of CNS hyperexcitability.
What is withdrawal?
Cocaine produces its stimulant effects primarily by blocking reuptake of these three neurotransmitters.
What are Norepinephrine (NE), Dopamine (DA), Serotonin (5-HT)?
Benzodiazepines enhance the effect of this inhibitory neurotransmitter.
What is GABA?
This is the most common CNS effect of acute alcohol use.
What is CNS depression?
Cocaine causes this pupil finding.
What is mydriasis (dilated pupil)?
This severe withdrawal syndrome is characterized by confusion, agitation, hallucinations, fever, and autonomic instability
What is delirium tremens?
In a patient with suspected cocaine toxicity, this test is important when chest pain is present.
What is an ECG/EKG?
Older adults taking benzodiazepines are particularly susceptible to this adverse effect, increasing the risk of injury.
What are falls?
This laboratory test directly measures the concentration of alcohol in the blood.
What is blood ethanol concentration or blood alcohol content (BAC)?
Treatment of cocaine withdrawal is primarily this rather than a specific medication that reverses the withdrawal syndrome.
What is supportive care?
This potentially fatal complication of alcohol withdrawal typically occurs 12–48 hours after the last drink.
What are withdrawal seizures?
The risk of respiratory depression increases substantially when benzodiazepines are combined with this commonly abused CNS depressant.
What is alcohol?
Benzodiazepines increase the frequency of this ion channel's opening when GABA binds.
What are Cl- channels?
This withdrawal effect that has a high mortality rate, occurs 3-4 days post-cessation of alcohol
What is delirium tremens?
This medication should be avoided in treatment of cocaine intoxication, due to unopposed alpha-1 activation.
What are beta-blockers?
Depression and this psychiatric symptom can occur during cocaine withdrawal and require careful assessment.
What is suicidal ideation?
These neurologic findings are commonly seen with benzodiazepine intoxication.
What are ataxia, dysarthria, and impaired coordination?
This medication is a benzodiazepine receptor antagonist that can reverse benzodiazepine effects.
What is flumazenil?
This vitamin should be administered to patients with chronic alcohol use disorder to prevent neurologic complications.
What is thiamine (B1)?
This ECG abnormality can occur because cocaine blocks fast sodium channels in cardiac tissue.
What is QRS widening?
This condition can develop after repeated episodes of withdrawal and is characterized by progressively more severe withdrawal symptoms.
What is kindling?
Chronic use of cocaine can lead to this nasal complication due to vasoconstriction.
What is a perforated nasal septum?
These benzodiazepines are safe to use in patients with liver disease due to bypassing Phase I metabolism.
***remembered by the mnemonic "LOT"?
What are: Lorazepam, Oxazepam, and Temazepam?
A patient stops drinking after years of heavy alcohol use. Twelve hours later he develops tremors, anxiety, diaphoresis, tachycardia, and hypertension. This is the first-line pharmacologic treatment.
What are benzodiazepines?
A patient with cocaine toxicity has severe hypertension that persists despite sedation. This medication class can be used for additional blood-pressure control
What are vasodilators (such as nitroglycerin)?