Common SSx of Drug Intoxications

Drug Motor/Speech Impairment Emotional/Perceptual Manifestations CV Manifestations Other Manifestations

Alcohol Ataxia, incoordination, loquacity, Euphoria, impaired attention, irritability, mood changes, Flushed face Nystagmus
slurred speech sedation
Amphetamines Agitation, loquacity Decreased fatigue, euphoria, grandiosity, Hypertension or hypotension, Chills, mydriasis, nausea,
hypervigilance, paranoia tachycardia nystagmus ,sweating, vomiting
Barbiturates, Same as EtOH Same as EtOH Hypotension Nystagmus
Benzodiazepines Same as EtOH Same as EtOH Hypotension Nystagmus
Cocaine Same as Amphetamines Altered tactile sensations ("cocaine bugs"), decreased Same as amphetamines Same as amphetamines
fatigue, euphoria, ,grandiosity, hypervigilance, paranoia
Hallucinogens Dizziness, incoordination, tremor, Depersonalization, derealization, hallucinations, Tachycardia Blurred vision, mydriasis,
weakness illusions, synesthesia sweating
Marijuana Loquacity, rapid speech Euphoria, hallucinations (with high doses) jocularity, Hypertension, tachycardia Conjunctivitis, dry mouth,
sensory intensifications increased appetite, tightness in
chest
Opioids Motor slowness, slurred speech Apathy, euphoria, dysphoria, impaired attention, None miosis
sedation
Phencyclidine Agitation, ataxia, muscle rigidity, Anxiety, delusions, emotional lability, euphoria, Hypertension, tachycardia Hostility, miosis, nystagmus,
slurred speech hallucinations violent behavior

Emergency Tx of Drug Intoxications

Drug Pharmacologic Tx Non pharmacologic Tx
EtOH None Support vital functions
Amphetamines Lorazepam for agitation, haloperidol for psychosis Monitor/support cardiac fxn
Barbituaates None Support vital fxn
Benzodiazepines Flumazenil Support vital fxn
Cocaine Lorazepam for agitation or seizures Support vital fxn
Hallucinogens Lorazepam for agitation Reassurance/support vitals
Marijuana Lorazepam for agitation Reassurance/support vitals
Opioids Naloxone Support vital fxn
Phencyclidine Lorazepam for agitation, haloperidol for psychosis Minimize sensory input
 Common SSx of Drug Withdrawal
Drug CNS Manifestations MSK Manifestations CV Manifestations Other Manifestations
EtOH Altered perceptions, insomnia, irritability, Tremor Hypertension, Delirium tremens, nausea, sweating
seizures tachycardia
Amphetamines Depression, drowsiness, dysphagia, fatigue, None Bradycardia None
appetite, sleepiness
Barbiturates Anxiety, insomnia, irritability, seizures Muscle twitches Hypertension, None
tachycardia
Benzodiazepines Agitation, anxiety, dizziness, insomnia Muscle cramps, myoclonic Hypertension, None
contractions tachycardia
Cocaine Same as amphetamines None Bradycardia None
Marijuana Irritability, mild agitation, sleep disturbances None none Nausea, stomach cramps
Nicotine Anxiety, dysphoria, hostility, impatience, None HR appetite
irritability, restlessness
Opioids Anxiety, dysphoria, irritability, restlessness, Muscle aches Hypertension, Diarrhea, fever, mydriasis, piloerection ("cold
sleep disturbances tachycardia turkey"), sweating, vomiting, yawning