Drug class |
Examples |
Intoxication |
Overdose |
Treatment |
Withdrawal |
|---|
Opioids |
Heroin |
Drowsy euphoria, analgesia, cough suppression, miosis. Often nausea, vomiting, sweating, pruritus, hypothermia, postural hypotension, constipation, decreased libido. “Rush” from parenteral route |
Coma, respiratory depression, pinpoint (but reactive) pupils |
Respiratory support, naloxone, close observation |
Irritability, lacrimation, rhinorrhea, sweating, yawning, mydriasis, myalgia, muscle spasms, piloerection, nausea, vomiting, abdominal cramps, fever, hot flashes, tachycardia, hypertension, orgasm. Often fatal in newborn |
Stimulants |
Cocaine, amphetamine, methamphetamine, methylphenidate, ephedrine, phenylpropanolamine |
Alert, euphoria, increased motor activity and physical endurance. “Rush” when taken parenterally or smoked (“crack,” “ice”) |
Headache, chest pain, tachycardia, hypertension, flushing, sweating, fever, excitement delirium, cardiac arrhythmia, seizures, stroke, myoglobinuria, shock, coma, death |
Sedation, correct acidosis, anticonvulsants, cooling, antihypertensives respiratory and blood pressure support, cardiac monitoring |
Fatigue, depression, increased hunger and sleep |
Sedatives |
Barbiturates, benzodiazepines, glutethimide, ethchlorvynol, methaqualone, zolpidem, gamma-hydroxybutyric acid (GHB) |
Similar to ethanol intoxication |
Similar to ethanol intoxication |
Supportive, flumazenil (benzodiazepine antagonist) |
Tremor, seizures, delirium tremens |
Cannabinoids |
Marijuana, hashish |
Relaxed, dreamy euphoria, jocularity, disinhibition, depersonalization, subjective slowing of time, conjunctival injection, tachycardia, postural hypotension |
Auditory or visual hallucinations, confusion, psychosis |
|
Craving |
Hallucinogens |
Psilocybin, psilocin, mescaline, lysergic acid diethylamide (LSD), 3,4-methylenedioxy methamphetamine (MDMA, “ecstasy”) |
Perceptual distortions or hallucinations (usually visual, elaborately formed), depersonalization, altered mood, dizziness, tremor, paresthesias. Acute panic, delayed “flashbacks” sometimes seen |
Hypertension, obtundation, seizures |
Calm environment, reassurance, sedation |
None |
Inhalants |
Nitrous oxide, trichloroethylene, toluene (from aerosols, spot removers, glues, lighter fluid, fire-extinguishing agents, bottled fuel gas, marker pens, paints, gasoline) |
Similar to ethanol intoxication |
Hallucinations, seizures, coma, death |
Respiratory and cardiac monitoring |
Craving |
Phencyclidine (“angel dust”) |
|
Euphoria or dysphoria, feeling of numbness |
Agitation, nystagmus, tachycardia, hypertension, fever, sweating, ataxia, paranoid or catatonic psychosis, hallucinations, myoclonus, myoglobinuria, seizures, coma, respiratory depression, death |
Calm environment, sedation, gastric suctioning, activated charcoal, forced diuresis, cooling, antihypertensives, anticonvulsants, monitoring of cardiorespiratory and renal function. Avoid neuroleptics |
None |
Anticholinergics |
Plant Datura stramonium, antiparkinsonian drugs, amitriptyline |
Decreased sweating, tachycardia, dry mouth, dilated unreactive pupils, delirium with hallucinations |
Myoclonus, seizures, coma, and death |
Intravenous physostigmine, gastric lavage, cooling, bladder catheterization, respiratory and cardiovascular monitoring, anticonvulsants. Neuroleptics contraindicated |
None |
|
