Substance Abuse Flashcards
How long does it take for alcohol withdrawal symtpoms to start showing?
anywhere from 4-12 hours
How long does alcohol withdrawals typically last?
5-7 days
What are some signs of alcohol withdrawals?
nausea/vomiting
tremors
restlessness
tachycardia
HTN
Fever
Tonic-clonic seizures
delirium
What should you do if you think someone if having withdrawals?
call the physician!
Institute protocols!
Describe delirium, when does it occur in the alcohol withdrawal process usually, and how long does it last? Is it an emergency?
It is an emergency!!
It usually occurs within 2-3 days of cessation of alcohol and usually lasts 2-3 days
It presents as disorientation, hallucinations, severe HTN, cardiac dysrhythmias, and possible death.
How do we treat detoxification of alcohol?
Benzodiazepines: Chloridiazepoxide (librium), diazepam (Valium), (scheduled doses as well as PRN doses)
These will decrease the intensity of symptoms, including seizures, have a sedation effect
What should the nurse consider when treating a patient with alcohol withdrawals (and when being treated with benzos)?
Institute seizure precautions
Monitor vitals (especially respiratory and blood pressure)
check neurological status frequently
Administer benzos as scheduled and as needed
What are some other medications that can be used for alcohol withdrawals? What are some nursing actions for using these medications?
carbamazepine (tegretol) - reduces seizures (antiseizure medication)
clonidine (catapress) - decreases ANS response (decreases BP and HR)
propanolol (Inderal) - decreases ANS response and cravings
Seizure precautions
Monitor vital signs and neuro status frequently
What is an abstinence medication used to help patients avoid alcohol after detox?
disulfirum (Atnabuse) - this medication must be taken every day as part of avoidance therapy for it to work.
What happens if someone drinks alcohol while taking disulfirum? What is the point of this?
A disulfirum or acetaldehyde rection occurs: n/v weakness sweating palpitations hypotension FEELS LIKE THEY ARE REALLY HUNGOVER
Eventually can progress to: respiratory suppression cardiovascular supression seizures death USUALLY DOESNT OCCUR BECAUSE DOSES ARE USUALLY REALLY LOW
The point of this is to make the patient feel so bad after drinking alcohol that they never want to drink it again.
What are the other two medications that can help with abstinence? how?
Naltrexone (vivtrol) - reduces pleasurable effects and suppresses craving
Acamprposate (Campral) - decreases unpleasant effects from abstinence
When does withdrawals from opioids tend to start occuring and how long do they last?
1 hour to several days
What are some symptoms of opioid withdrawal and how would they be characterized?
Insomnia flu-like rhinorrhea agitation sweating
NOT LIFE-THREATENING
What is the really hard part about opioid withdrawals?
the psychological dependence is the hardest thing to get over, it is the main thing that is addressed with treatment.
What are some medications that are used to treat opioid dependence and why?
Methadone (Dolophine) - tranfer of the dependence from opioids to methadone, after dependence is transferred the dose is slowly tapered off to promote detoxification.
clonidice (catapress) - decrease ANS response
buprenorphine (subutex) - decreases the feelings of craving and helps with maintaining adherence.
