Master the board step 3

Master the Boards: USMLE Step 3
Substance
Signs and
Symptoms of
Intoxication
Treatment of
Intoxication
Signs and
Symptoms of
Withdrawal
Treatment of
Withdrawal
Hallucinogens
(e.g., LSD)
Ideas of reference,
hallucinations,
impaired judgment,
dissociative
symptoms,
pupil dilatation,
panic, tremors,
incoordination
Supportive
counseling
(talking down),
antipsychotics,
benzodiazepines
None
None
Inhalants
Belligerence, apathy,
assaultiveness,
impaired judgment,
blurred vision,
stupor, coma
Antipsychotics
if delirious or
agitated
None
None
Opiates
Apathy, dysphoria,
constricted pupils,
drowsiness, slurred
speech, impaired
memory, coma,
death
Naloxone
Fever, chills,
lacrimation,
runny node,
abdominal
cramps,
muscle spasms,
insomnia,
yawning
Clonidine, methadone
PCP
Panic reactions,
assaultiveness,
agitation,
nystagmus, HTN,
seizures, coma,
hyperacusis
Talking down,
benzodiazepines,
antipsychotics,
support respiratory
function
None
None
Barbiturates and
Benzodiazepines
Inappropriate sexual
or aggressive
behavior, impaired
memory or
concentration
Flumazenil
Autonomic
hyperactivity,
tremors,
insomnia,
seizures, anxiety
Substitute shortwith
long-acting
barbiturates
(chlordiazepoxide
or phenobarbitol)
Basic Science Correlate
Opiates bind to mu, kappa, and/or delta receptors.
526