Drug withdrawal Flashcards
clinical presentation of opioid withdrawal
GI: n/v/diarrhea, cramping, increased bowel sounds
Cardiac: increase pulse, increased BP and dysphoric mood
PsychologicalZ: insomnia, yawning, dysphoric mood
other: myalgias, arthralgias, lacrimination, rhinorrhea, piloerection and mydiasis
management of opioid withdrawal
methadone or buprenorphine
nonopioid: clonidine, adjunctive medications (anti-emetics, antidiarrheals or benzos)
if pt is on chronic opioids but then can’t eat due to foodborne illness then that can cause
abrupt cessation of oral morphine and cause acute withdrawal
Tolerance to opioids is a
prerequisite to withdrawal and this happens after >3 weeks of regular use of opioids
when does opioid withdrawal start?
3 half lives after abrupt discontinuation or within 6 to 12 hrs in short acting morphine
24 to 48 hrs after lonacting
when do symptoms of opioid withdrawal hit their peak? how long does it persist up to?
peaks in 3 days and can persist up to 10 days
alcohol withdrawal
see hyperadrenergic response with alcohol drawal.
see tremors
seizures and delirium tremens occurs
48 to 96 hrs after last drink and can last up to a week in duration
supportive care for ETOH withdrawal
no.
need to give benzos as this can be life threatening
either do CIWA or fixed benzo or phenobarbitual taper
cocaine withdrawal
resemble a depressive episode and include excessive sleep, hunger, dysphoria and severe psychomotor retardation
vitals are normal
MDMA withdrawal
this is ecstasy or molly
withdrawal symptoms: difficulty in concentrating, fatigue, anxiety, depression, and loss of appetite.
Long term users may experience impairment in reasoning, learning and long term confusion with disorientation
opioid withdrawal
see nausea, vomiting, diarrhea, rhinorrhea, yawning, abdominal cramping, piloerection and dilated pupils (mydriasis)
synthetic marijuana withdrawal
spice or K2
see nausea, vomiting, diarrhea diaphoresis and nightmares
