Toxicology

Alcohol

• alcohol intoxication
  • emotional lability, slurred speech, ataxia, coma, blackouts

• ---

  alcohol withdrawal
  • headache, N/V, dry mouth, tremors, anxiety, seizures, hallucinations
  • Treatment:
    • benzos
      
    • disulfiram (long-term)

Amphetamine

• amphetamine intoxication
  • tachycardia, hypertension, pressured speech, flight of ideas, dilated pupils

• ---

  amphetamine withdrawal
  • depression, disturbed sleep, restlessness, disorientation

Benzodiazepines

• benzodiazepines intoxication
  • drowsiness, slowed respirations, slurred speech, slowed comprehension
  • Treatment:
    • flumazenil

• ---

  benzodiazepines withdrawal
  • seizures, anxiety, restlessness, HTN, psychosis

Cocaine

• cocaine intoxication
  • impaired judgment, pupillary dilation, hallucinations (including tactile), paranoid ideations, hyperthermia, sweating, angina, sudden cardiac death
  • Treatment:
    • supportive care or benzos, alpha then beta-blockade

• ---

  cocaine withdrawal
  • depression, anhedonia, insomnia, lethargy, mental slowing

Ecstasy

• ecstasy (MDMA) intoxication
  • euphoria, decreased interpersonal boundaries, tachycardia, hypertension, hyperthermia, muscle spasms, bruxism, nystagmus

• ---

  ecstasy (MDMA) withdrawal
  • depression, anxiety, paranoia, dehydration

Hallucinogen

• hallucinogen intoxication
  • psychosis, paranoia, anxiety, tachycardia, HTN, dry mouth, N/V

Inhalants

• Inhalants intoxication
  • euphoria, slurred speech, ataxia, diplopia, lacrimation, rhinorrhea, arrhythmia

• ---

  inhalant withdrawal
  • headaches, sleepiness, depression

Marijuana

• marijuana intoxication
  • euphoria, anxiety, paranoid delusions, perception of slowed time, impaired judgment, increased appetite, dry mouth, conjunctival injection, hallucinations

• ---

  marijuana withdrawal
  • anxiety, nervousness

Opioid

• opioid intoxication
  • constricted pupils, respiratory depression, bradycardia, constipation, nausea/vomiting
  • Treatment:
    • naloxone
      
    • methadone (long-term)

• ---

  opioid withdrawal
  • flu-like symptoms, muscle cramps, dilated pupils, lacrimation, sweating, N/V, diarrhea, hot flashes, yawning, piloerection, irritability

PCP

• PCP intoxication
  • aggressive psychosis, vertical/horizontal nystagmus, impossible strength, blunted senses
  • Treatment:
    • benzos, haloperidol

• ---

  PCP withdrawal
  • severe random violence