Expect relapse frailty patient education recognition

Expect relapse; frailty
 Patient Education
 Recognition
 Explain thoughts, feelings and behaviors as symptoms of the drug use
 Discuss sign/behavior specific to patient
 Prevention
 Teach the patient to be alter to thoughts, feelings and behaviors in self.
 Choose alternative behaviors that reduce such thoughts or feelings
 Psychopharmacology
 Benzodiazepine (Ativan, Valium, Librium)
 Reduces acute withdrawal effects
 Reduces acute withdrawl effects on the CNS from alcohol, sedatives, and some
stimulants.
 Clonidine (Catapres) (Alpha Adrenergic Antagonists)
 Reduces the alpha effects of withdrawal
 Heart rate and blood pressure
 Narcan (Naloxone)
 Reverses respiratory depression, caused by narcotic, opioid abuse
 Short Acting
 May need multiple doses
 Antabuse (Disulfiram) Aversion Therapy
 A bio-physical deterrent to alcohol use by causing an immediate adverse reaction
when alcohol is consumed in any form
 Blocks oxidation of alcohol
 Nausea, vomiting, severe abdominal pain, headaches
 Methadone: opioid agonist (Acts as a cross-tolerance to opioids)
 Prevent effects of severe opiate withdrawal
 Naltrexone: opioid antagonist (Opioid antagonist; blocks opioid receptors)
 Decreases craving for opiates and alcohol
 Suboxone (buprenorpine & naloxone) sublingual tablets
 Block the effects of opiates; suppresses symptoms of withdrawal; decrease cravings
 Has addictive effect; can be abused; withdrawal potential
 Vivitrol
 Once monthly administration
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 Reduces potential for relapse post-detoxification
 Decrease opiate cravings
 Ondansetron (Zofran), Bentyl, Lomotil
 Antiemetic
 Anticonvulsants (Phenobarbital)
 Manage seizure activity associated w/ drug/alcohol withdrawal
 Vitamins and Minerals
 Multivitamins, thiamine, folic Acid, Magnesium
 Reduce the effects of neuropathies and encephalopathies associated with long
term alcohol abuse.
 Antipsychotics (olanzapine) Zyprexa, (haloperidol) Haldol
 Reduce the effects of drug-induced psychosis
 NSAIDs
 Ultram (tramadol)
 Pain management for opiate withdrawal
Match the following drug to its use in the tx of chemical dependency.
1. Can prevent Wernicke’s encephalopathy (A)
2. Manages hypertensice effects of withdrawal
3. Drug of choice for safe withdrawal of alcohol (D)
4. Controls psychosis and agitation.
A. thiamine (vitamin B1)
B. risperidone (Risperdal)
C. clonidine (Catapres)
D. chlordiazepoxide HCL (Librium)
 Milieu Management
 Environment
 Frequent observation of patient where-abouts
 Maintain calm, subdued, restful environment
 Promote Group Therapies (AA, NA, AL-ANON, Children of Alcoholics)
 Can help the family members as well
 Reduces denial , prevents a sense of isolation
 Opportunity to evaluate one’s self in a safe environment
 Self -evaluation
 Grief Work
 Significant emotional issues of attachment and loss are associated with drug use
 Facilitate opportunities for patient to talk about problems, resentments, guilt, remorse
 Emotional support/catharsis
 Provide emotional support without being overly sympathetic
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 Give patient time to work
 Patience/persistence
 Assertion Training
 Direct patient to focus on strengths and abilities
 Practice behaviors that promote autonomy (role-play)
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