Chemically Impaired
Terms
undefined, object
copy deck
- Barbiturates
- Central Nervous System Depressants
- Alcohol (ETOH)
- Central Nervous System Depressants
- Meprobamate
- Central Nervous System Depressants
- Glutethimide
- Central Nervous System Depressants
- Chloral hydrate
- Central Nervous System Depressants
- Benzodiazepines
- Central Nervous System Depressants
-
Central Nervous System Depressants:
Intoxication -
Physical:
Slurred speech
Incoordination
Unsteady gait
Drowsiness
Decreased blood pressure
Psychological-perceptual:
Disinhibition of sexual or aggressive drives
Impaired judgment
Impaired social or occupational function
Impaired attention or memory
Irritability -
Central Nervous System Depressants:
Overdose Effects -
Cardiovascular or respiratory depression or arrest (mostly with barbiturates)
Coma
Shock
Convulsions
Death -
Central Nervous System Depressants:
Overdose Possible Treatments -
If awake:
Induce vomiting.
Give activated charcoal.
Coma:
Perform gastric lavage with activated charcoal
Possibly perform hemodialysis or peritoneal dialysis.
Administer flumazenil (Romazicon) IV. -
Central Nervous System Depressants:
Withdrawal Effects -
Cessation of prolonged-heavy use:
Nausea and vomiting
Tachycardia
Diaphoresis
Anxiety or irritability
Tremors in hands, fingers, eyelids
Marked insomnia
Grand mal seizures
After 5-15 years of heavy use: Delirium -
Central Nervous System Depressants:
Withdrawal Possible Treatments -
Perform carefully titrated detoxification with similar drug.
Note: Abrupt withdrawaf can lead to death. - For a person going through alcohol withdrawal, when will seizures most likely occur?
- 7 to 48 hours after the cessation of alcohol.
- When will alcohol withdrawal delirium most likely to occur?
- 2 to 3 days after cessation or reduction of alcohol intake and last 2 to 3 days.
- S&S of alcohol withdrawal delirium
-
anxiety
insomnia
anorexia
delirium
Autonomic hyperactivity (e.g., tachycardia, diaphoresis, elevated blood pressure)
Severe disturbance in sensorium (e.g., disorientation, clouding of consciousness)
Perceptual disturbances (e.g., visual or tactile hallucinations)
Fluctuating levels of consciousness (e.g., ranging from hyperexcitability to lethargy)
Delusions (paranoid)
Agitated behaviors
Fever (100°F to 103°F). -
Cocaine
Crack -
Central Nervous System Stimulants
(short-acting) -
Amphetamines
Dextroamphetamine
Methamphetamine
Ice -
Central Nervous System Stimulants
(long-acting) - Cocaine, Crack Intoxication
-
Physical:
Tachycardia
Dilated pupils
Elevated blood pressure
Nausea and vomiting
Insomnia
Psychological-perceptual:
Assaultiveness
Grandiosity
Impaired judgment
Impaired social and occupational functioning
Euphoria - Amphetamines Intoxication
-
Increased energy
Severe effects:
State resembling paranoid schizophrenia
Paranoia with delusions
Psychosis
Visual, auditory, and tactile hallucinations
Severe to panic levels of anxiety
Potential for violence
Note: Paranoia and ideas of reference may persist for
months afterward. -
Central Nervous System Stimulants:
Overdose Effects -
Respiratory distress
Ataxia
Hyperpyrexia
Convulsions
Coma
Stroke
Myocardial infarction
Death -
Central Nervous System Stimulants:
Overdose Treatments -
Antipsychotics
Hyperpyrexia (ambient cooling)
Convulsions (diazepam)
Respiratory distress
Cardiovascular
shock
Acidification of urine(ammonium chloride for amphetamine) -
Central Nervous System Stimulants:
Withdrawal Effects -
Fatigue
Depression
Agitation
Apathy
Anxiety
Sleepiness
Disortentation
Lethargy
Craving -
Central Nervous System Stimulants:
Possible Withdrawal treatments -
Antidepressants (desipramine)
Dopamine agonist
Bromocriptine - Opium (paregoric)
- Opiates
- Codeine
- Opiates
- Fentanyl(Sublimaze)
- Opiates
- Hydromorphone (Dilaudid)
- Opiates
- Methadone (Dolophine)
- Opiates
- Morphine
- Opiates
- Meperidine (Demerol)
- Opiates
- Heroin
- Opiates
- Opiates Intoxication
-
Physical:
Constricted pupils
Decreased respiration
Drowsiness
Decreased blood pressure
Slurred speech
Psychomotor retardation
Psychological-perceptual:
Initial euphoria followed by dysphoria and impairment of attention, judgment, and memory. - Opiates Overdose Effects
-
Possible dilation of pupils due to anoxia
Respiratory depression or arrest
Coma
Shock
Convulsions
Death - Opiates Possible Overdose Treatments
-
Narcotic antagonist
naloxone (Narcan) - Opiates Withdrawal Effects
-
Yawning
Insomnia
Irritability
Runny nose(rhinorrhea)
Panic
Diaphoresis
Cramps
Nausea and vomiting
Muscle aches ("bone
pain*)
Chills
Fever
Lacrimation
Diarrhea - Opiates: Possible Withdrawal Treatments
-
Methadone tapering
Clonidine-naltrexone detoxification
Buprenorphine substitution - Lysergic acid diethylamide (LSD)
- Hallucinogens
- Psilocybin
- Hallucinogens
- Mescaline (peyote)
- Hallucinogens
-
Phencyclidine
piperidine (PCP) - Hallucinogens
-
Hallucinogens:
LSD, Mescaline (peyote), Psilocybin intoxication -
Pupil dilation
Tachycardia
Diaphoresis
Palpitations
Tremors
Incoordination
Elevated temperature, pulse, respiration. - Hallucinogens: PCP intoxication
-
Vertical or horizontal nystagmus
Increased blood pressure, pulse, and temperature
Ataxia
Muscle rigidity
Seizures
Blank stare
Chronic jerking
Agitated, repetitive movements
Belligerence, assaultiveness, impulsiveness
Impaired judgment, impaired social and occupational functioning -
Hallucinogens:
Psychological-Perceptual Effects -
Fear of going crazy
Paranoid ideas
Marked anxiety, depression
Synesthesia (e.g., colors are heard; sounds are seen)
Depersonalization Hallucinations, although
sensorium is clear Grandiosity (e.g., thinking one can fly)
Severe effects: Hallucinations, paranoia
Bizarre behavior (e.g., barking like a dog, grimacing, repetitive chanting speech)
Regressive behavior
Violent bizarre behaviors
Very labile behaviors -
Hallucinogens:
LSD, Mescaline (peyote), Psilocybin Overdose effects -
Psychosis
Brain damage
Death -
Hallucinogens:
PCP Overdose effects -
Psychosis
Possible hypertensive crisis or cardiovascular accident
Respiratory arrest
Hyperthermia
Seizures -
Hallucinogens: LSD, Mescaline (peyote), Psilocybin
Possible treatment for overdose -
Keep client in room with low
stimuli—minimal light, sound,
activity.
Have one person stay with client; reassure client, "talk down"
client.
Speak slowly and clearly in low voice.
Give diazepam or chloralhydrate for extreme anxiety or tension. -
Hallucinogens: PCP
Possible overdose treatments -
If alert:
Caution: Gastric lavage can lead to laryngeal spasms or aspiration.
Acidify urine (cranberry juice, ascorbic acid); in acute stage, ammonium chloride acidifies urine to help excrete drug from body—may continue for 10-14 days.
Put in room with minimal stimuli.
Do not attempt to talk down! Speak slowly, clearly, and in a low voice.
Administer diazepam.
Haloperidol may be used for severe behavioral disturbance (not a phenothiazine). Institute medical intervention for:
Hyperthermia
High blood pressure
Respiratory distress
Hypertension