addiction/ substance abuse

N421 Exam 3

intoxication of opioids

• slurred speech

• decreased respirations

• maladaptive behavior

• cardiac dysrhythmias

• decreased LOC overall CNS depression

interventions for opiods

Antidote: Naloxone

intoxication of alcohol

• slurred speech

• nystagmus

• memory impairment

• altered judgment

• decreased motor skills

• decreased LOC

chronic use of alcohol

• Cardiovascular damage

• liver damage

• cirrhosis

• erosive gastritis

• GI bleeding

• acute pancreatitis

• sexual dysfunction

interventions for alcohol use

Benzodiazepines - first-line treatment to reduce withdrawal symptoms and prevent seizures

Thiamine (Vit B1) - administer to prevent Wernicke’s encephalopathy

supportive care - IV fluids

Monitor viral signs

address co-occurring conditions

intoxications of sedative/hypnotics/anxiolytics

• increased drowsiness

• agitation

• slurred speech

• uncoordinated motor activity

• nystagmus

• disorientation

• N/V

• respiration depression and decreased LOC

interventions of Sedatives/hypnotics/anxiolytics

Antidote: flumazenil - only for benzos

intoxication of cannabis

• paranoia

• increased appetite

• dry mouth

• tachycardia

chronic use of cannabis

• increased risk of lung cancer

• problems with daily activities

interventions for cannabis

• supportive cares - calm environment, hydration and rest

• symptom management - benzos for anxiety, antiemetics for N/V

mild intoxication of cocaine

• dizziness

• irritability

• tremor

• blurred vision

chronic intoxication of cocaine

• hallucinations

• seizures

• extreme fever

• tachycardia

• HTN
  chest pain

• possible CV collapse

• death

intoxication of amphetamines

• impaired judgment

• psychomotor agitation

• hypervigilance

• extreme irritability

• acute CV effects

• possible death

intervention for uppers (cocaine /amphetamines)

Focus on managing symptoms and preventing complications

supportive care - Oxygen therapy, IV fluids, monitor vitals

cooling measures

antihypertensives

cardiac monitoring

intoxication of Inhalants

depends on substance

• dizziness

• nystagmus

• slurred speech

• drowsiness

• muscle weakness

• lightheadedness

• decreased LOC

interventions for inhalants

• oxygen therapy

• symptom management - benzos may be used cautiously

• monitoring - watch for arrhythmias

• long-term care - address with counseling, behavioral therapy and rehab

intoxication of Hallucinogens

• anxiety

• depression

• paranoia

• impaired judgment & social functioning

• pupil dilation

• tachycardia

• diaphoresis

• palpitations

• burred vision

• tremors/incoordination

• panic attacks

interventions for hallucinogens

No specific antidote for most hallucinogens

• supportive cares - calm environment, monitor vital signs

• manage agitation/psychosis

  • benzos

  • antipsychotics

• hydration - IV fluids

• Psychiatric evalutation

Intoxication of caffine

• tachycardia

• arrhythmias

• flushed face

• muscle twitching

• restlessness

• diuresis

• GI disturbances

• anxiety

• insomnia

Intervention for caffine

• IV FLUIDS!!!!!!

• beta blockers - to vasodilate

• stop using so much caffine

intoxication of tobacco

Highly toxic but acute tocivity is seen mainly in peds

• asthma

• SIDS

• acute resp issues

• Long-term effects

  • cardiovascular disease

  • snuff

interventions for tobacco

• Nicotine replacement therapy (NRT)

• mediations - bupropion (Zyban), varenicline (Chantix)

NRT (nicotine replacement therapy) examples

• provide controlled doses of nicotine to reduce withdraws

• nicotine patches, gum nasal sprays, inhalers