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Toxicity

The document outlines the toxicity and withdrawal effects of various CNS stimulants and hallucinogens, including cocaine, amphetamines, caffeine, nicotine, phencyclidine, LSD, ecstasy, and marijuana. It details symptoms such as psychosis, hyperphagia, and severe depression during withdrawal, along with treatment options like benzodiazepines and antidepressants. Additionally, it highlights the mechanisms of action for each substance and their potential health risks.

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Joseph Rishmawi
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24 views2 pages

Toxicity

The document outlines the toxicity and withdrawal effects of various CNS stimulants and hallucinogens, including cocaine, amphetamines, caffeine, nicotine, phencyclidine, LSD, ecstasy, and marijuana. It details symptoms such as psychosis, hyperphagia, and severe depression during withdrawal, along with treatment options like benzodiazepines and antidepressants. Additionally, it highlights the mechanisms of action for each substance and their potential health risks.

Uploaded by

Joseph Rishmawi
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd
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CNS Stimulants

Toxicity Withdrawal
Sympathetic activation (Mydriasis Tachycardia) Hyperphagia, Hypersomnia
Cocaine Psychotic symptoms (Tactile Hallucinations,
Paranoia)
Severe depression
#1: Local anesthetic (Na channel blocker)
Coronary vasoconstriction & Stroke
#2: Inhibits NE reuptake
TTT: Benzodiazepines
Avoid BB for coronary vasospasm

Sympathetic activation (Mydriasis Tachycardia) Hyperphagia, Hypersomnia


Amphetamines Psychotic symptoms (Tactile Hallucinations,
Paranoia)
Severe depression
#1: Increase release of NE
Rarely causes seizures
#2: Decrease reuptake of NE
TTT: Benzodiazepines

Caffeine
Antagonist of adenosine receptors
Leads to release of dopamine/NE
Renal adenosine blockade → diuresis

Acts on nicotinic acetylcholine receptors Increased appetite


Nicotine CNS stimulant
Activates sympathetic nervous system
Weight gain
Depression
Smoking Cessation: Nicotine replacement,
Peak in first three days after cessation
Bupropion (antidepressant Blocks reuptake of
Subside in 3-4 weeks
NE and dopamine), Varenicline (partial
nicotinic receptor agonist)
Hallucinogens
Toxicity Withdrawal
Stimulant
Phencyclidine Psychosis, Violent behavior, Hallucinations
Nystagmus
Antagonist of NMDA receptor in CNS
Inhibits reuptake of dopamine, NE, 5HT Fatalities most commonly from trauma
Increases sympathetic activity Psychosis plus loss of pain/sensation -Patients
may dissociate
TTT:: Benzodiazepines
Haloperidol (anti-psychotic)
Psychosis, Hallucinations
LSD Paranoia
“Lysergic acid diethylamide” Flashbacks
Can sense things beyond usual reality
Binds serotonin 5-HT2A receptors
“Hearing" colors or "seeing" sounds
Not a stimulant
Depersonalization
TTT: Supportive
Euphoria Depression and anxiety
Ecstasy Bruxism (grinding teeth) Jaw soreness (from grinding teeth while high)
Methylenedioxy-methamphetamine (MDMA) Hyponatremia (Secretion ADH - Reports of
Amphetamine seizures and death)
Major effects on serotonin • Increased release Hepatotoxicity (RUQ pain - Increased AST/ALT)
of serotonin • Inhibition of serotonin reuptake Serotonin Syndrome
conjunctival injection
Marijuana Euphoria
Stimulates cannabinoid receptors in CNS Increased appetite
Dry mouth

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