Alcoholism/Withdrawl/Toxicity

Denial main problem

• Support if there’s loss

• Confont them

• Use “I” not “You”

Dependency

• Abusers

• Confront

Co-Dependency

• Self Esteem issues

• Teach to set limits

• Enforce limits

• Say no

Manipulation

• Abuser gets significant other to do things/make decisions

• Dangerous and harmful (In dependancy it is not dangerous or harmful)

Wernicke (Korsakoff) Syndrome

• Wernicke → Encephalopathy

• Korsakoff → Psychosis

• Vitamin B1 Deficiency

Wernicke (Korsakoff) Syndrome (S&S)

• Amnesia

• Confabulation

• Redirect them

Antabuse & Revia (Disulfiram)

• Alcohol deterrent (Antabuse)

• Revia (Antidote)

• AVOID ALL ALCOHOL

Upper Medications

• Caffeine

• Cocaine

• PCP/LSD

• Methamphetamines

• Adderall

Downer

• Anything that’s not an upper

Upper S&S

• Goes up

• Euphoria

• Seizures

• Restlessness

• Irritability

• Hyperreflexia

• Tachycardia

• Increased Bowels (Borborygmi)

• Diarrhea

Down S&S

• Go down

• Lethargic

• Respiratory Despression/Arrest

• Constipated

Upper Priority

• Suctioning d/t seizures

Down Priority

• Intubate/Ventilation d/t respiratory distress

Upper OD

• Too much

Downer OD

• Too little

Upper WD

• Too little

Downer WD

• Too much

Newborn

• < 24hrs → Intoxication

• >= 24hrs → WD

Alcohol WD Syndrome

• 24 hours after drinking

• Non-life threatening

Delirium Tremens

• 72 hours after drinking

• Life-threatening

NCP Alcohol WD

• Reg diet

• Semiprivate rooms

• AAT

• No restraints

NCP Delirium Tremens

• NPO d/t seizures or clear fluids

• Private rooms

• Bed rest

• Restraints

Aminoglycosides

• Mean old mycin

• Tx for serious life-threatening infections

• End in mycin (Vancomycin, Cleomycin, etc.)

• Not thro (Azithromycin, Erythromycin, etc.)

SE of Aminoglycosides

• Ototoxic

• Nephrotoxic

Neomycin & Kanamycin

• Oral Mycins that sterilize bowels

• Neo Kan!

Trough

• Mx at lowest concentration

• Drawn at 30 mins before next dose

Peak

• Mx athighest concentration

TAP Levels

• Trough, Administer, Peak

• On narrow theraputic mxs only

SubL Peak

• 5-10 mins after dissolving

IV Peak

• 15-30 mins after finishing

IM Peak

• 30-60 mins