copyright © 2002 by w. b. saunders company. all rights reserved. chapter 27 care of the chemically...
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Chapter 27
Care of the Chemically Impaired
Chapter 27
Care of the Chemically Impaired
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Assessment GuideAssessment Guide
History of Past Substance Abuse Use Treatment Blackouts, delirium, seizures Family History
Medical History Co-existing physical conditions Medications
History of Past Substance Abuse Use Treatment Blackouts, delirium, seizures Family History
Medical History Co-existing physical conditions Medications
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Psychiatric History Co-morbid problems Treatment Family violence History of suicide attempts Current suicidal thoughts
Psychosocial Issues Work record Effect of use on relationships Role relationships Legal problems Support system Coping style
Psychiatric History Co-morbid problems Treatment Family violence History of suicide attempts Current suicidal thoughts
Psychosocial Issues Work record Effect of use on relationships Role relationships Legal problems Support system Coping style
Assessment Guide, cont.Assessment Guide, cont.
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SlideSlide
Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Alcohol equivalentsAlcohol equivalents
27-427-4 (Fig. 27-3)(Fig. 27-3)
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Overdose Cardiovascular, respiratory depression Coma, shock, convulsions, death
Treatment Lavage/activated charcoal Vital signs Patent airway IV fluids
Withdrawal Abrupt withdrawal may lead to death Detox with similar drug
Overdose Cardiovascular, respiratory depression Coma, shock, convulsions, death
Treatment Lavage/activated charcoal Vital signs Patent airway IV fluids
Withdrawal Abrupt withdrawal may lead to death Detox with similar drug
CNS DepressantsCNS Depressants
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Overdose Assaultive, grandiose, paranoid Tachycardia, elevated BP, hyperpyrexia, convulsions Coma, death
Treatment Amtipsychotics prn Cooling (fever) Diazepam (seizures)
Withdrawal Antidepressants Dopamine agonist Bromocriptine
Overdose Assaultive, grandiose, paranoid Tachycardia, elevated BP, hyperpyrexia, convulsions Coma, death
Treatment Amtipsychotics prn Cooling (fever) Diazepam (seizures)
Withdrawal Antidepressants Dopamine agonist Bromocriptine
CNS StimulantsCNS Stimulants
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Overdose Respiratory depression Coma, death
Treatment
Narcotic antagonist
Withdrawal Methadone tapering Clonidine-naltrexone detox Buprenorphine substitution
Overdose Respiratory depression Coma, death
Treatment
Narcotic antagonist
Withdrawal Methadone tapering Clonidine-naltrexone detox Buprenorphine substitution
OpiatesOpiates
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Intoxication Paranoid ideas Anxiety Synesthesia Depersonalization Hallucinations
Treatment Low stimuli LSD - talk down PCP - do not talk down
- Valium or Haldol
- Ammonium chloride
Intoxication Paranoid ideas Anxiety Synesthesia Depersonalization Hallucinations
Treatment Low stimuli LSD - talk down PCP - do not talk down
- Valium or Haldol
- Ammonium chloride
HallucinogensHallucinogens
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Copyright © 2002 by W. B. Saunders Company. All rights reserved.
Benzodiazepines
- Tapering doses
Thiamine
- Prevents encephalopathy
Magnesium sulfate
- Reduces seizures
Anticonvulsants
- For seizure control
Folic Acid/Multivitamins
- Correct deficiencies
Benzodiazepines
- Tapering doses
Thiamine
- Prevents encephalopathy
Magnesium sulfate
- Reduces seizures
Anticonvulsants
- For seizure control
Folic Acid/Multivitamins
- Correct deficiencies
Alcohol Withdrawal Delirium TreatmentAlcohol Withdrawal Delirium Treatment
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