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Doses of CNS depressants are tapered. Medications Uses: Chlordiazepoxide (Librium) Phenobarbital (Luminal Sodium) Diazepam (Valium) Lorazepam (Ativan) Detoxification can be extended up to 2weeks or longer when the drug of addiction is long acting. Chlordiazepoxide (Librium), haloperidol (Haldol), and anti-hypertensive are usually effective.CNS Stimulants (Cocaine, Amphetamines) Wide variations in onset from a few hours to several days. Dysphoric mood, agitation, suicidal ideation, fatigue, insomnia, vivid dreams, extended sleep, hunger, and drug craving. Stabilize vital signs; control behavior. Chlordiazepoxide (Librium), haloperidol (Haldol), and antihypertensive are usually effective. Caffeine (stimulant) Hours to days Anxiety, fatigue, drowsiness, dysphoria, irritability, difficulty concentrating Opiates (heroin, morphine, codeine, meperidine, methadone) Onset within minutes, hrs. or days after use; symptoms last 7-10 days. Chills, sweating, dilated pupils, increased pulse & blood pressure, muscle aches, abdominal cramps, drug craving, rhinorrhea, yawning, drowsiness, and coma Methadoneis administered orally in decreasing doses over a period of about 10 days clonidine (Catapres)0.3 -1.2mg/day, Decreased by 50% / day For 3 days, then discontinued. Cannabinoids (marijuana, hashish) Mild physical dependence with chronic use of high doses Restlessness, irritability, insomnia, nausea, vomiting, and sweating. No treatment required. Nicotine (Cigarettes, cigars, pipe and chewing tobacco) Symptoms develop within 24hrs of tapering or not using drug Irritability, nicotine craving, decreased heart rate, headache, increased appetite, difficulty concentrating, and insomnia. Nicotine is substituted in the form of gum or a patch, which is tapered and eventually discontinued.
36 Substances of Abuse: CNS Depressants-Include alcohol, benzodiazepines, minor tranquilizers, barbiturates, chloral hydrate, meprobamate, and methaqualone -Effects of CNS depressants include the relaxation of muscles, sedation, and decreased anxiety -Characterized by slurred speech, ataxia, impaired judgment, agitation, and depression. -Combining these drugs with alcohol potentiates the effects of intoxication, respiratory depression •Short – acting drugs such as lorazepam (Ativan)* are used to treat withdrawal in the presence of impaired liver function. IV diazepam is usually administered to treat withdrawal delirium.CNS Stimulants -Include caffeine, cocaine, amphetamines, and methylphenidate (Ritalin). -Effects – alertness, euphoria, decreased appetite, and an enhanced sexual response. -Intoxication from CNS stimulants – anxiety, paranoia, confusion, irritability, grandiosity, rhinitis, insomnia, tactile hallucinations, increased or decreased heart rate, chest pain, cardiac arrhythmias, dilated pupils, and respiratory distress.