Drug Overdose: Withdrawal Chart

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The document discusses signs, symptoms, and treatments for overdose and withdrawal from several classes of drugs including CNS depressants, stimulants, opiates, hallucinogens, and inhalants.

For opioid overdose the signs include pupil dilation, respiratory depression, coma, shock and convulsions. Withdrawal signs include yawning, insomnia, irritability, panic, diarrhea and muscle aches.

For opioid overdose treatment narcotic antagonists like naloxone are used to reverse CNS depression. For withdrawal, treatments discussed include methadone tapering, clonidine with naltrexone for detoxification, and buprenorphine substitution.

CNS

Overdose Withdrawal
Depressants
Drug Signs Treatment Signs Treatment
If awake:
1. Keep awake  Nausea and
2. Induce vomiting vomiting
 Cardiovascular 3. Use activated charcoal to absorb  Tachycardia
or respiratory drug  Diaphoresis Carefully titrated
depression or 4. Vital signs (VS) q 15 minutes
arrest (mostly  Anxiety or detoxification with
Alcohol with agitation similar drug
Coma:
Barbiturates barbiturates) 1. Clear airway, intubate IV fluids  Tremors
Benzodiazepines  Marked insomnia NOTE: Abrupt
 Coma 2. Perform gastric lavage
 Grand mal withdrawal can
 Shock 3. Take seizure precautions
seizures lead to death
 Convulsions 4. Administer hemodialysis or
 Death peritoneal dialysis if ordered  Delirium (after
5. Assess VS as ordered 5–15 years of
6. Assess for shock and cardiac heavy use)
arrest.

Stimulants Overdose Withdrawal


Drug Signs Treatment Signs Treatment
 Respiratory
 Fatigue
distress
Management for:  Depression
 Ataxia
1. Hyperpyrexia  Agitation  Antidepressants
 Hyperpyrexia
2. Convulsions  Apathy (desipramine)
Cocaine/crack  Convulsions
3. Respiratory distress  Anxiety  Dopamine
Amphetamines  Coma 4. Cardiovascular shock  Sleepiness agonist
 Stroke 5. Acidic urine (ammonium  Disorientation  Bromocriptine
 Myocardial chloride for amphetamine).  Lethargy
infarction
 Craving
 Death
Opiates Overdose Withdrawal
Drug Signs Treatment Signs Treatment
 Yawning, insomnia
 Irritability
 Pupil dilation due
 Rhinorrhea
to anoxia  Methadone tapering
 Panic
Heroin  Respiratory Narcotic antagonist  Clonidine-
 Diaphoresis
Meperidine depression arrest (Narcan) quickly naltrexone
 Cramps
Morphine  Coma reverses CNS detoxification
 Nausea and vomiting
Methadone  Shock depression  Buprenorphine
 Muscle aches
 Convulsions substitution
 Chills and fever
 Death
 Lacrimation
 Diarrhea

Hallucinogens Overdose Withdrawal


Drug Signs Treatment Signs Treatment
1. Reduce environmental stimuli
2. Have one person “talk down
 Psychosis patient”; reassure
No pattern of
LSD  Brain damage 3. Speak slowly and clearly
withdrawal
 Death 4. Administer diazepam or
chloral hydrate for anxiety as
ordered
1. Acidify urine to help excrete
 Possible drug (cranberry juice, ascorbic
hypertensive acid); in acute stage: ammonium
crisis chloride
No pattern of
PCP  Respiratory 2. Minimize stimuli
withdrawal
arrest 3. Do not attempt to talk down;
 Hyperthermia speak slowly in low voice
 Seizures 4. Administer diazepam or
Haldol as ordered
Inhalants Overdose Withdrawal
Drugs Signs Treatment Signs Treatment
 Intoxication
Volatile solvents such  Agitation
as butane, paint  Drowsiness
No pattern of
thinner, airplane glue,  Disinhibition Support affected systems
withdrawal
and nail polish  Staggering
remover  Light-headedness
 Death
Enhanced sexual Neurologic symptoms may No pattern of
Nitrites
pleasure respond to vitamin B12 and folate withdrawal
Anesthetics such as Giggling, laughter Chronic users may experience No pattern of
nitrous oxide Euphoria polyneuropathy and myelopathy withdrawal

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