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29 Cards in this Set
- Front
- Back
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Alcohol - withdrawal Symptoms
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Start w/in 4-12hr of last intake of alcohol, peak 24-48 hr, then disappear
-Common symptoms: n/v, tremors, restlessness+inability to sleep, depressed mood or irritability, increased HR, BP, RR, and temp, and tonic-clinc seizures |
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Alcohol withdrawal delirium
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may occur 2-3 days after cessation, may last 2-3 days. Considered ER. Symptoms - severe disoritentation, psychotic symptoms, severe hypertension, cardiac dysrhythmias, delirium. May progress to death
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Opioids (including heroin, as well as prescription meds) Withdrawal Symptoms
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-Occur w/in hours to several days after cessation
-Common symptoms - agitation, insomonia, flu-like symptoms, rhinorrhea, yawning, sweating, diarrhea -Symptoms not life threatening, although suicidal ideation may occur |
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Nicotine Withdrawal Symptoms
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Adstinence syndrome as e/b irritability, nervousness, restlessness, insomonia, difficulty concentrating
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Medications to support withdrawal/abstinence from alcohol: DETOXIFICATION MEDS
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Bendodiazepines
Chlordiazepoxide (Librium) Diazepam (Valium) Lorazepam (Ativan) |
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Medications to support withdrawal/abstinence from alcohol: Benzodiazepines Intended Effects
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Maintenance of VS w/in normal limits
Decrease in risk of seizures Decrease in intensity of symptoms |
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Medications to support withdrawal/abstinence from alcohol: Benzodiazepines Nursing iNterventions
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-Admin around the clock or PRN
-Obtain baseline vitals -Monitor PT vitals and neurological status on an ongoing basis -Provide for seizure precautions (padded side rails, suction equiptment at bedside) |
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Medications to support withdrawal/abstinence from alcohol: What is used for decrease in seizures?
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Carbamazepine
*Also provide for seizure precations (padded side rails, suction equiptment at bedside) |
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Medications to support withdrawal/abstinence from alcohol:
What is used for depression of autonomic response (Decrease in HR, BP)? |
Clonodine and Propanolol!
Obtain pt BASELINE VITALS AND MONITOR REGULARLY |
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Medications to support withdrawal/abstinence from alcohol:
What med is used to decrease cravings? |
Propranolol
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Abstinence Maintenance - Following Detox!!
Disulfiram (Antabuse) --> Intended Effects |
Daily oral med that is a type of aversion (behavioral therapy)
-Used w/alcohol will cause acetaldehyde syndrome to occur (n/v. weakness, sweating, palpitations, and hypotension) |
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acetaldehyde syndrome
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Caused by using alcohol w/ disulfiram (antabuse) can progress to resp depression, cardiovascular suppression, seizure, and death
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Abstinence Maintenance - Following Detox!!
Disulfiram (Antabuse) --> Nursing INterventions |
-Inform of potential dangers of drinking w/med
-Avoid products taht contain alcohol (coughs yrups, aftershave lotion) -Encourage wear med alert bracelet -Ecourage 12-step program Advise PT that med effects - like potential for acetaldehyde syndrome with alcohol ingestion, persists for 2 weeks following d/c of disulfiram |
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Abstinence Maintenance - Following Detox!!
Naltrexone (ReVia) Intended effects |
Pure opioid antagonist that suppresses the craving and pleasurable effects of alcohol (also used for opioid withdrawal)
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Abstinence Maintenance - Following Detox!!
Naltrexone (ReVia) Nursing Interventions |
Assess PT hx and determine of PT is also dependent on opioids. Use of naltrexone will initial withdrawal syndrome
Advise PT to take med w/meals to decrease GI distress 0Suggest monthly IM injections for PTs who have diff adhering to med schedule |
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Abstinence Maintenance - Following Detox!!
Acamprosate (Campral) Intended Effects |
Decreases unpleasant effects resulting from abstinence (anxiety, restlessness)
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Abstinence Maintenance - Following Detox!!
Naltrexone (ReVia) Nursing Interventions |
Inform PT that diarrhea may result
aDVISE pt TO MAINTAIN ADEQUATE fluid intake and get rest Avoid use in pregnancy |
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Medications to support withdrawal/abstinence from Opioids:
Methadone (Dolophine) Substitution Intended effects |
Methadone sub is oral opioid agonist that replaces the opioid to which PT addicted
-Prevents abstinence syndrome from occuring and remove need for PT to obtain legal drugs -Used for withdrawal and long-term maintenance -Dependence will be transferred from illegal opioid to methadone |
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Medications to support withdrawal/abstinence from Opioids:
Methadone (Dolophine) Substitution Nursing Interventions |
Inform PT that methadone dose must be slowly tapered during detox
-Encourage PT to participate in 12 step program Inform PT that medication must be admin from an approve treatment center |
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Medications to support withdrawal/abstinence from Opioids: Clonodine (Catapres) Intended Effects
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Clonodine assists w/withdrawal symptoms r/t autonomic hyperactivity (diarrhea, n/v)
Does NOT reduce cravings |
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Medications to support withdrawal/abstinence from Opioids: Clonodine (Catapres)Nursing INterventions
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-Obtain baseline VS
-Advise PT to avoid activities that require mental alertness until symptoms of drowsiness subside -Encourage PT to chew on gum or hand candy and to sip on small amts of water or suck on ice chips for dry mouth |
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Medications to support withdrawal/abstinence from Opioids: Buprenorphine (Subutext) / Buprenorphien combined w/Naloxone = Suboxone Intended Effects
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Agonist-antagonist opioids used for both detox and maintenance
Decrease feelings of craving and ma be effective in maintain compliance |
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Medications to support withdrawal/abstinence from Opioids:
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Methadone Substitution (Dolophine)
Clonodine (Catapress) Subtex or Suboxone |
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Medications to support withdrawal/abstinence from Opioids: Buprenorphine (Subutext) / Buprenorphien combined w/Naloxone = Suboxone Nursing Interventions
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Must be admin by approved treatment center
Administer meds sublingually |
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Medications to support withdrawal/abstinence from nicotine
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Buprprion (Zyban)
Nicotine replacement therapy nocorette gum etc |
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Medications to support withdrawal/abstinence from nicotine: Buprprion (Zyban) Intended Effects
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To treat dry mouth - encourage PT to chew on gum or hard candy and to sip on small amts of water/suck on ice chips
dvise PT to avoid caffeine and other CNS stims to control insomonia |
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Medications to support withdrawal/abstinence from nicotine:
Nicotine replacement therapy iNTENDED EFFECTS |
REPLACEMENTS are pharmaceutical product substitutes for nicotine in cigarettes or chewing tobacco
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Medications to support withdrawal/abstinence from nicotine:
Nicotine replacement therapy NI |
-chewing gum not rec for longer than 6 months
Advise PT to: Chew gum slowly/intermittently over 30 min -Avoid eating/drinking 15 min prior to and while chewing gum -Apply nicotine patch to an area of clean, dry skin Avoid using other nicotine products w/patch -Avoid using while pregnant or breast feeding Remove patch prior to MRI scan |
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What meds used for long term management of abstinence from alcohol?
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Disulfiram (Antabuse)
Naltrexone (ReVia) Acamprosate (cAMPRAL) |
