withdraw Flashcards
How do opioids work?
attach to specific proteins in brain, spinal cord, and GI tract
blocks the transmission of pain
physiological effects of opioids
enhanced feeling of emotional wellbeing
addiction
memory deficits
hallucinations
delusions
paranoia
worsening of mental health
increase in symptoms of mental health
drowsiness, sedation, depressed respirations, constipation
to prevent orthostatic hypotension related to dehydration
get up slow
sit on edge of bed and dangle
drink 8-10 glasses of water each day
report any dizziness
if you vomit do not flush it let the nurse see it in order to dose meds
DT symptoms
increased activity
delusions
coarse tremors
hallucinations (auditory, visual, tactile)
gross confusion and disorientation
autonomic hyperactivity
agitation
paranoia
danger of misdiagnosis as psychiatric disorder
Treatment of DT’s
prevent them!
monitor closely
listen and respond to patient
treat complications
give thiamine and other nutrients
life support/sustaining measures as indicated
labs
hydrate
vs
treat seizures: phenytoin, or phenobarbital, diazepam
clonidine in high BP
haloperidol PRN
alcohol acamprosate (camprol)
most effective if patient has abstained from use for awhile (ETOH)
use after recent detoxification in NOT successful
structurally similar to GABA
SE: diarrhea and GI upset
category C
take with meals
alcohol antebuse (disulfiram)
alcohol antagonist
disrupts alcohol to acetate metabolism
disulfiram-ethanol reaction
due to ingesting alcohol while on disulfiram
symptoms: diaphoresis, flushing, vomiting, headache, tachycardia, and hypotension
probably excreted in breast milk not approved for use in pregnancy
*paint thinner, face toners, perfume, red wine reduction sauce can all cause vomiting
when can you begin using disulfiram
only after BAC is 0 and 12 hours since last ETOH intake
NEVER administer until ETOH free for 12 hours
hallucinogenics
Lysergic Acid (LSD)
Phencyclidine (PCP)
Psilocybin (mushroom)
acute side effects of hallucinogenic
increased HR, BP, temp, body chills, impaired vision/hearing, confusion, panic attacks, slurred/impaired speech
long term side effects of hallucinogenic
mental illness, hallucination, severe depression, flash backs, suicide
LSD
fugus that grows on rye or other grains
crystal form
odorless, colorless, bitter taste
known as acid
sold on streets in small tablets (microdots)
added to absorbent paper with cartoons called looney tunes
causes serious disconnect from reality
LSD experience called Trip- lasts 12 hours; a bad trip is referred to as a living hell
stimulants
cocaine
methamphetamine
ecstasy
methylphenidate
bath salts
cocaine
speeds up brain and body
acute effects of cocaine
increased RR, BP, Temp
increased alertness, chest pain, respiratory failure, nausea, abdominal pain, panic attacks, headaches
long term effects of cocaine
lung damage
nasal ulcers
personality changes
violent/aggressive behavior
paranoia
hallucinations
methamphetamine
stimulant
speeds up brain, nervous system and body
acute effects of meth
increased RR, BP, temp
more alert/awake
restlessness
insomnia
decreased appetite (poor nutrition)
long term effects of meth
brain/heart damage
labile mood
violent/aggressive behavior
hallucinations
paranoia
weight loss
METH MOUTH
methylohenidate
stimulant
increasing in abuse especially on college campuses
tachycardia, HTN
addictive
causes dangerously high body temps
Ritalin
bath salts
stimulant
synthetic powder
includes mephedrone, MDPV, and methylone from the Khat plant
ingredients are illegal to posses
snort it, shoot it, mix with food and drink
FLAKKA
risk of stroke, heart attack, and sudden death, risk of OD
delirium; death by suicide
depression, anxiety and intense cravings
treatment of illicit drug intoxication of stimulants
no specific med
runs its course and stop using
treatment of drug intoxication of hallucinogens/ PCP
benzos
antipsychotics - haldol/risperidol
treatment of drug intoxication of inhalants/solvents
phenobarbital- anti-convulsant
symptomatic and supportive care for drug intoxication
hydration
safety
nutrition
assess for infection
orientation
therapeutic interaction
medication management of stimulants
minor tranquilizers
major tranquilizers
anticonvulsants
antidepressants
medication management of hallucinogens and cannabinols
benzos
antipsychotics
medication management of depressants
phenobarbital (luminal)
long-acting benzodiazepines
