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 5 | P a g e
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 6 | P a g e
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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- Spring '17
- Benzodiazepine, physical dependence, Clonidine, Cause Significant impairment