Townsend Chapter 14 Table 14-8 Summary of symptoms Associated With the Syndromes of Intoxication and Withdrawal

Alcohol withdrawal begins within ---------- from last drink

4-6 hours

Aggressive, impaired judgment, impaired attention, irritability, euphoria, depression, emotional lability, slurred speech, incoordination, unsteady gait, nystagmus, flushed face

Alcohol intoxication

Tremors, nausea/vomiting, malaise, weakness, tachycardia, sweating, elevated blood pressure, anxiety, depressed mood, irritability, hallucinations, headache, insomnia, seizures

Alcohol withdrawal

Fighting, grandiosity, hyper-vigilance, psychomotor agitation, impaired judgment, tachycardia, pupillary dilation, elevated blood pressure, perspiration or chills, nausea and vomiting

Amphetamine and related substances intoxication

Anxiety, depressed mood, irritability, craving for the substance, fatigue, insomnia or hypersomnia, psychomotor agitation, paranoid and suicidal ideation.

Amphetamine and related substances withdrawal

Withdrawal symptoms usually peak within 2-4 days, although depression and irritability may persist for months. Antidepressants may be used

Amphetamines and related substances

Is contained in coffee, tea, colas, cocoa, chocolate, some over-the-counter analgesics, "cold" preparations, and stimulants

Caffeine

Restlessness, nervousness, excitement, insomnia, flushed face, diuresis, gastrointestinal complaints, muscle twitching, rambling flow of thought and speech, cardiac arrhythmia, periods of inexhaustibility, psychomotor agitation

Caffeine intoxication

Headache

Caffeine withdrawal

Intoxication occurs immediately and lasts about 3 hours. Oral ingestion is more slowly absorbed and has longer-lasting effects

Cannabis

Euphoria, anxiety, suspiciousness, sensation of slowed time, impaired judgment, social withdrawal, tachycardia, conjunctival redness, increased appetite, hallucinations

Cannabis intoxication

Restlessness, irritability, insomnia, loss of appetite, depressed mood, tremors, fever, chills, headache, stomach pain

Cannabis withdrawal

Large doses of the drug can result in convulsions or death from cardiac arrhythmias or respiratory paralysis.

Cocaine

Euphoria, fighting, grandiosity, hyper vigilance, psychomotor agitation, impaired judgment, tachycardia, elevated blood pressure, pupillary dilation, perspiration or chills, nausea/vomiting, hallucinations, delirium

Cocaine intoxication

Depression, anxiety irritability, fatigue, insomnia or hypersomnia, psychomotor agitation, paranoid or suicidal ideation, apathy, social withdrawal

Cocaine withdrawal

Alcohol withdrawal may progress to ------------------ on the 2nd or 3rd day

Delirium tremens

Belligerence, assaultiveness, apathy, impaired judgment, dizziness, nystagmus, slurred speech, unsteady gait, lethargy, depressed reflexes, tremor, blurred vision, stupor or coma, euphoria, irritation around eyes, throat, and nose

Inhalant intoxication

Intoxication occurs within 5 minutes of inhalation. Symptoms last 60 - 90 minutes. Large doses can result in death from CNS depression or cardiac arrhythmia.

Inhalants

Symptoms of withdrawal begin within 24 hours of last drug use and decrease in intensity over days, weeks or sometimes longer.

Nicotine

Craving for the drug, irritability, anger, frustration, anxiety, difficulty concentrating, restlessness, decreased heart rate, increased appetite, weight gain, tremor, headaches insomnia

Nicotine withdrawal

Euphoria, lethargy, somnolence, apathy, dysphoria, impaired judgment, pupillary constriction, drowsiness, slurred speech, constipation, nausea, decreased respiratory rate and blood pressure

Opioid intoxication

Craving for the drug, nausea/vomiting, muscle aches, lacrimation or rhinorrhea, pupillary dilation, piloerection or sweating, diarrhea, yawning, fever, insomnia

Opioid withdrawal

Withdrawal symptoms appear within 6-8 hours after last dose, reach a peak in the 2nd or 3rd day, and subside in 5-10 days. Times are shorter for meperidine and longer with methadone.

Opioids

Delirium can occur within 24 hours after use, or may occur up to a week following recovery from an overdose of the drug

Phencyclidine

Belligerence, assaultiveness, impulsiveness, psychomotor agitation, impaired judgment, nystagmus, increased heart rate and blood pressure, diminished pain response, ataxia, dysarthria, muscle rigidity, seizures, hyperacusis, delirium

Phencyclidine an related substances intoxication

Withdrawal may progress to delirium, usually within 1 week of last use. Long-acting barbiturates or benzodiazepines may be used in withdrawal substitution therapy

Sedatives, hypnotics, and anxiolytics

Disinhibition of sexual or aggressive impulses, mood lability, impaired judgment, slurred speech, incoordination, unsteady gait, impairment in attention or memory disorientation, confusion

Sedatives, hypnotics, and anxiolytics intoxication

Nausea/vomiting, malaise, weakness, tachycardia sweating, anxiety, irritability, orthostatic hypotension, tremor, insomnia, seizures

Sedatives, hypnotics, and anxiolytics withdrawal