Pharm Ch 12 Substance Abuse

Alcohol

Symptoms: - start within 4 to 12 hr of the last intake of alcohol, peak after 24-48 hrs, and subside within 5 to 7 days, unless alcohol withdrawal delirium occurs - Nausea, vomiting, tremors, restlessness, inability to sleep; depressed mood/irritability; increased HR/BP/RR/Temp; tonic-clonic seizures. illusions are also common - alcohol delirium may occur 2 to 3 days after cessation of alcohol, and may last 2 to 3 days, and is considered a medical emergency. Symptoms: severe disorientation, psychotic symptoms (hallucination), severe HTN, cardiac dysrhythmias that may progress to death

Antabuse

aka Disulfiram is a type of aversion (behavioral) therapy. If used concurrently with alcohol, acetaldehyde syndrome occur Effects include nausea, vomiting, weakness, sweating, palpitations, and hypotension Acetaldehyde syndrome can progress to respiratory depression, cardiovascular suppression, seizures, and death education: - inform clients of the potential dangers of drinking any alcohol - advise clients to avoid any products that contain alcohol (cough syrups, aftershave lotion) - encourage clients to wear a medi alert bracelet - encourage 12-step program - advise that medication effects (potential for acetaldehyde syndrome with alcohol ingestion) persist for 2 weeks following d/c of disulfiram

Librium

aka chlordiazepoxide Used during detoxification. Used to support withdrawal/abstinence from alcohol. - maintenance of the client's VS WNL - decrease in the risk of seizures - decrease in the intensity of symptoms Nursing: - Administer around the clock of PRN - Use librium only if the client is able to tolerate oral intake. otherwise, use IV route for diazepam and lorazepam. the client may continue with diazepam and lorazepam orally - obtain the client's baseline VS - monitoring VS and neuro status ongoing - provide for seizure precautions

Absinence syndrome

occurs when a client abruptly withdraws from a drug on which he is physically dependent. withdrawing from a substance that has the potential to cause addiction can cause an abstinence syndrome.

Opioids (and heroin and prescription)

occurs within 1 hr to several days of cessation of drug use Symptoms: agitation, insomnia, flu-like symptoms, rhinorrhea, yawning, sweating, diarrhea Symptoms are non- life threatening, although suicidal ideation may occur