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What are symptoms of alcohol withdrawal? - ANSWER>>Nausea, vomiting, tremors,
restlessness, insomnia, depressed mood or irritability, tonic-clonic 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)
Intended effect of methadone (Dolophine) - ANSWER>>Oral opioid agonist that replaces the
opioid to which client addicted. Encourage participation in 12 step program. Inform that must
be administered at an approved treatment center.