Cox quiz SUDS - Opioid use withdrawal, Stimulants/Designer

Opioid types

heroin

oxycontin

oxycodone

fentanyl

Opioid effects

pain suppression

pinpoint pupils

vs: lowered HR, BP, Resp rate

Constipation

cough suppression

lax muscle tone

dry mouth

euphoria

Opioid Withdrawal sx

yawning

fever

msucle ache, pain

insomnia,

dysphoric mood

NVD

Lacrimation, rhinorrea

pupillary dialtion

sweating

pilorection

Opioids with shrot half lifes

morpine

heroin

hydromorphine

withdrawal in 8-12 hours, peak 2 days, last 7 days

Opioids with longer half lives

Methadone

withdrawal in 36-48 hrs

peak 4-6 days

can last up to 2 weeks

Opioid detox

supportive care- pain management(tylenol), diarrhea(antidiarrheal), N/V(zofran,compazine), congestion/rhinorrhea(benadryl), anxiety or insomnia(benadryl, trazodone, ativan)

Post detox meds

Naltrexone(ReVia) decreases cracingsO

Overdose meds for opioids

Naloxone or Narcan

Medication assested Tx: Opioid Replacement

Methadone Maintenance Therapy(MMT)

Buprenorphine+Naloxone = Suboxone

Method used to control cravings, prevent OD, and improve withdrawal

Must be in withdrawal for 12-24 hrs

Stimulant examples

cocaine, crack, speed, meth, amphetamines, caffeine, nicotine, methylphenidate, Ecstasy, MDMA

Stimulants physiological effects

releases NE, E, DA → may lead to tolerance and NT depletion if overused

VS: Inc HR, BP, Resp

Inc energy, reflexes

Dec appetite, thirst

Cardiac risk

Neuro risk with meth

Hypersensitivity

dilated pupils

Stimulant psychological effect

Everything fast: inc energy, alert, restlessness, anxiety, talking too much, over confident, supremacy feeling, euphoria, elevated mood, irritability/paranoia possibleS

Stimulant withdrawal

in 12-96 hours, mild in nature

sx: depression, irritability, anergia, anhedonia

risk for depression, SI, or related behavior

Meth/cocaine cardiac risk

Cardiac artery constriction leads to dmg to blood vessels and heart → arrythmias, Cardiac arrest, MI

Rlly bad for ppl with previous cardiac condition

Severe vasoconstriction → MI risk, vfib, sudden death

Meth effect on brain

Holes in brain - basically areas of brain have become deactivated from drug use

• more toxic than heroin or cocaine

Sig dmg to striatum

Affect DA nerve ending

Signals apoptosis of nerve cells in brain

Treatment of Meth, cocaine

Wellbutrin(Buproprion)

• anti depressant

Supportive care mainly - 12 step recovery, sleep, dental, nutrition, infections r/t route of use