What are symptoms of alcohol withdrawal? - ANSWER Nausea, vomiting, tremors, restlessness, insomnia, depressed mood or irritability, tonic-clonic
... [Show More] seizures, illusions.
What is alcohol withdrawal delirum and when can it occur? - ANSWER Alcohol withdrawal delirium is a medical emergency and may occur 2-3 days after cessation and last the same (2-3 days). S/s include severe disorientation, hallucinations, severe HTN, cardiac dysrhythmias, delirium.
What are symptoms of opioid withdrawal? - ANSWER Agitation, insomnia, flulike manifestations, rhinorrhea, yawning, sweating, diarrhea. Suicidal ideation may occur.
What are symptoms of tobacco (nicotine) withdrawal? - ANSWER Irritability, nervousness, restlessness, insomnia, difficulty concentrating
What kind of medications would be expected to be prescribed for a patient who is detoxing from alcohol? - ANSWER Chlordiazepoxide (Librium), Diazepam (Valium), Lorazepam (Ativan), Oxazepam (Serax)
What are the intended effects of the benzodiazepines for detoxification from alcohol? - ANSWER Maintenance of patient's v/s, decrease risk of seizures, decrease intensity of withdrawal s/s.
What are some of the adjunct medications for detoxification of alcohol? - ANSWER Carbamazepine (Tegretol), Clonidine (Catapres), Propanolol (Inderal)
What are each of the adjunct medications indicated for? - ANSWER Decrease seizures (Carbamazepine)
Decrease autonomic response (decrease BP, HR)- Clonidine and Propanolol
Decrease craving- Propanolol
What are overall nursing interventions and teaching points for patients who are experiencing detoxification? - ANSWER Pad the side rails and include suction equipment at bedside (seizure precautions). Monitor vital signs and continue monitoring on ongoing basis.
What kind of medications are indicated for abstinence maintenance of alcohol? - ANSWER Disulfiram (Antabuse), Naltrexone (Vivitrol), Acamprosate (Campral)
What is the intended effect of disulfiram (Antabuse)? - ANSWER After the patient ingests alcohol, acetaldehyde syndrome will occur and includes perfuse vomiting, nausea, weakness, sweating, palpitations, and hypotension. Can progress to respiratory depression, seizures, and death.
What teaching points need to be brought up with a patient who is beginning disulfiram (Antabuse)? - ANSWER Wear a med alert bracelet, avoid ALL products containing alcohol (cough syrups, aftershave lotion). Encourage participation in a 12 step program. Potential for acetaldehyde syndrome can occur for up to 2 weeks after disulfuram is discontinued.
Naltrexone (Vivitrol) What is the indicated effect? - ANSWER Pure opioid antagonist that supresses craving and pleasure of alcohol.
What can naltrexone (Vivitrol) also be utilized for? - ANSWER Opioid withdrawal.
Teaching points for naltrexone (Vivitrol)? - ANSWER Take with meals to supress GI distress. Monthly IM injections should be suggested for patients who have difficulty to adhering to the medication regimen.
Acamprosate (Campral) indication... - ANSWER Taken 3x daily to reduce alcohol craving.
Teaching points for acamprosate (Campral) - ANSWER Diarrhea may occur while taking the medication. Increase fluids. Do not take while pregnant.
What medications can be used to support withdrawal/abstinence from opioids? - ANSWER Methadone (Dolophine) substition, Clonidine (Catapres), Buprenorphine (Subutex) [Show Less]