Abstinence syndrome withdrawal

Acute abstinence syndrome (withdrawal) - In chronic pain patients in whom opioid analgesics are abruptly discontinued, anticipate a severe abstinence syndrome. This may be similar to the abstinence syndrome noted in patients who withdraw from heroin. Severity is related to the degree of dependence, the abruptness of withdrawal, and the drug used. Generally, withdrawal symptoms develop at the time the next dose would ordinarily be given. 

Because of the chronicity of illness, persons with GAD and panic disorder are at high risk of developing benzodiazepine dependence. Benzodiazepine dependence is a physiologic phenomenon demonstrated by the appearance of apredictable abstinence syndrome (withdrawal symptoms) on abrupt discontinuation of therapy. Withdrawal symptoms may result because of the sudden dissociation of a benzodiazepine from its receptor site. After abrupt discontinuation, an acute decrease in GABA neurotransmission results, producing a less inhibited CNS. 

The abstinence syndrome (synonym, withdrawal symptom) is observed after withdrawal of a dtug to which a person is addicted. For example, the abstinence syndrome after alcohol withdrawal is characterized by tremor, nausea, tachycardia, sweating and sometimes hallucinations. 

When a patient does not have a painful terminal illness, drug dependence must be avoided. Signs of drug dependence include occurrence of withdrawal symptoms (acute abstinence syndrome) when tiie narcotic is discontinued, requests for tiie narcotic at frequent intervals around tiie clock, personality changes if the narcotic is not given immediately, and constant complaints of pain and failure of tiie narcotic to relieve pain. Although these behaviors can have other causes, the nurse should consider drug dependence and discuss the problem with tiie primary health care provider. Specific symptoms of tiie abstinence syndrome are listed in Display 19-3. 

Ethanol also reduces the activity of the noradrenergic system in the locus coeruleus, and alterations in norepinephrine activity may account for some aspects of intoxication and the abstinence syndrome. The 0.2 antagonist clon-idine and the P-receptor antagonist propranolol reduce some symptoms of alcohol withdrawal (Bailly et al. 1992 Carlsson and Fasth 1976 Dobrydnjov et al. 2004 Kahkonen 2003 Petty et al. 1997 Wong et al. 2003). 

A protracted abstinence syndrome may follow the acute opioid withdrawal syndrome and last for many weeks (Martin et al. 1973). In one study ofher-oin addicts detoxified with methadone, withdrawal distress peaked at day 20,... 

Caffeinism A dependence on caffeine characterised by an abstinence syndrome on withdrawal. 

The abstinence syndrome, evoked in animals by the withdrawal of nicotine, appears to be similar to that seen following opiate withdrawal (Malin et al. 1992). Furthermore, Malin and co-workers have reported that the abstinence syndrome can be provoked by the administration of the opiate antagonist, naxolone, to nicotine-treated rats (Malin et al. 1993). These results suggest that the abstinence syndrome... 

The question remains, are the nicotine withdrawal phenomena in the rodent models sufficiently aversive to exert a motivational effect This can be tested by whether rodents will avoid an enviromnent associated with precipitated nicotine abstinence syndrome, in comparison with an enviromnent associated only with a saline injection. Significant place aversion conditioned to nicotine withdrawal has been repeatedly observed in rodent models (Balfour 2002 Goktalay et al. 2006 Malin et al. 2006 Suzuki et al. 1996 Watkins et al. 2000). 

It is well established that nicotine stimulation of the mesolimbic dopamine (DA) pathway is essential to the reinforcing action of nicotine (Balfour 2004 Corrigall and Coen 1991). Considerable evidence suggests that alterations in this pathway may also be essential to the nicotine abstinence syndrome, particularly to its depression-like dimension. During withdrawal from continuous nicotine infusion, rats displayed reduced activity levels and reduced DA content in the striatum... 

Symptoms of withdrawal -The opioid agonist abstinence syndrome is characterized by some or all of the following restlessness, lacrimation. 

Withdrawal withdrawal signs, abstinence syndrome, physiological effect. 

The continued use of opioids results in the development of physical dependence, as demonstrated by the appearance of a characteristic abstinence syndrome upon interruption or cessation of use. The symptoms of withdrawal include hyperactivity, anxiety, restlessness, yawning, diarrhea, vomiting, chills, fever, lacrimation, and runny nose. Piloerection (gooseflesh or cold turkey), mydriasis, increased blood pressure and heart rate, and hyperpyrexia may be observed. Tremors, abdominal cramps, and muscle and joint pain may be present. Drug craving is an important feature of opioid withdrawal. In contrast to some other drugs of abuse, withdrawal is not life threatening. 

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