Drug withdrawal symptom

Adverse effects can be based on the pharmacodynamics of the drug i.e. side effects (occur at therapeutic dose of the drug), toxic effects (occurs at overdose or poisoning) and drug withdrawal symptoms (i.e. 

For amphetamine addicts and drug abusers, the controlled, therapeutic environment of residential rehab provides a safe place to learn new behaviors and explore the emotional issues behind their drug use. And for patients experiencing amphetamine or other drug withdrawal symptoms, an inpatient facility is the best option for a safe and gradual detoxification from the drug. 

Once an amphetamine abuser stops taking the drug, withdrawal symptoms begin as the body tries to adjust to the absence of the stimulant. This results in very uncomfortable and potentially life-threatening physical symptoms, called withdrawal syndrome. According to the World Health Organization (WHO), withdrawal is experienced by 87% of amphetamine users who stop the drug. 

Emmett-Oglesby MW, Mathis DA, Moon RTY, Lai H (1990) Animal models of drug withdrawal symptoms. Psychopharmacology 707 292—309. 

Smith L, Yonikura ML, Wallace T, Berman N, Kuo J, Berkowitz C. Effects of prenatal methamphetamine exposure on fetal growth and drug withdrawal symptoms in infants born at term. Dev Beh Pediatrics 2003 24 17-23. 

Opioids (especially methadone and heroin) are the most common cause of serious neonatal drug withdrawal symptoms. Other dmgs for which a withdrawal syndrome has been reported include phencyclidine (POP), cocaine, amphetamines, tricyclic antidepressants, phenothiazines, benzodiazepines, barbiturates, ethanol, clonidine, diphenhydramine, lithium, meprobamate, and theophylline. A careful dmg history from the mother should include illicit drugs, alcohol, and prescription and over-the-counter medications, and whether she is breast-feeding. 

Dependence is a somatic state which develops after chronic administration of certain dtugs. This condition is characterized by the necessity to continue administration of the drug to avoid the appearance of withdrawal symptoms. Withdrawal symptoms are relieved by the administration of the drug upon which the body was dependent . Psychological dependence is due to (e.g., social) reinforcement processes in the maintenance of drug-seeking behavior. 

Chronic administration of opiates and alcohol leads to physical dependence a phenomenon, which is only weakly expressed following chronic administration of psychostimulants or other drugs of abuse. Physical dependence results from neuroadaptive intracellular changes to an altered pharmacological state. Abstinence from chronic opiate or alcohol use leads to a variety of physiological and psychological withdrawal symptoms based on these adaptations of the neuronal system. 

Treatment of drug addicts can be sqDarated into two phases detoxification and relapse prevention. Detoxification programs and treatment of physical withdrawal symptoms, respectively, is clinically routine for most drugs of abuse. However, pharmacological intervention programs for relapse prevention are still not veiy efficient. 

Maintenance therapy is designed to reduce the patient s desire to return to the drug that caused addiction, as well as to prevent withdrawal symptoms. The dosses used vary with the patient, die length of time die individual has been addicted, and the averse amount of drug used each day. Fhtients enrolled in an outpatient methadone program for detoxification or maintenance therapy on methadone must continue to receive methadone when hospitalized. 

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. 

These dm may produce withdrawal symptoms in those physically dependent on the narcotics. The patient must not have taken any opiate for the last 7 to 10 days. Naloxone may prevent die action of opioid antidiarrheals, antitussives, and analgesics. This drug is used cautiously during lactation. 

Antianxiety drugp are used in the management of anxiety disorders and short-term treatment of the symptoms of anxiety. Long-term use of these dru is usually not recommended because prolonged therapy can result in drug dependence and serious withdrawal symptoms. 

When discontinuing use of an antianxiety drug in patients who have used these drugs for prolonged periods , the physician will prescribe a decrease of dosage gradually for a period of 4 to 8 weeks to avoid the possbility of withdrawal symptoms. 

Benzodiazepine withdrawal may occur when use of the antianxiety drugs is abruptly discontinued after 3 to 4 months of therapy. Occasionally, withdrawal symptoms may occur after as little as 4 to 6 weeks of therapy. Symptoms of benzodiazepine withdrawal include increased anxiety, concentration difficultiesi, tremor, and sensory disturbances, such as paresthesias photophobia, hypersomnia, and metallic taste. To help prevent withdrawal symptoms, the nurse must make sure the dosage of the benzodiazepine is gradually decreased over a period of time, usually 4 to 6 weeks... 

Control of early withdrawal symptoms, which prevents their progression to more serious symptoms, is the indication for which medications are most widely prescribed in the treatment of alcohol dependence. The most commonly used agents to treat alcohol withdrawal are the benzodiazepines, a class of drugs that, by virtue of their agonist activity at the GABA receptor complex, suppress the hyperexcitability associated with alcohol withdrawal. With widespread use of anticonvulsant medications for bipolar disorder and other disorders associated with behavioral disinhibition and CNS hyperexcitability, anticonvulsants have also been examined for use in the treatment of alcohol withdrawal. 

At present in the United States, methadone is the most commonly used drug to treat withdrawal symptoms. Detoxification can be accomplished over a period as long as 6 months in an ambulatory methadone maintenance program or as brief as several days in a hospital setting. The goal in brief detoxification is to make the experience less distressing, but the suppression of all with-... 

When patients elect detoxification from maintenance, a very gradual reduction of dosage is preferred, with careful monitoring of drug craving and withdrawal symptoms. Three to 6 months is recommended for most elective detoxifications. As many as one-third of methadone maintenance clients have been found to have a marked fear of detoxification (Milby et al. 1986). 

A dramatically different pattern is found in surveys of drug abuse treatment facilities. Substance abuse treatment centers have reported that more than 20% of patients use benzodiazepines weekly or more frequently, with 30%— 90% of opioid abusers reporting illicit use (Iguchi et al. 1993 Stitzer et al 1981). Methadone clinics reported that high proportions ofurine samples are positive for benzodiazepines (Darke et al. 2003 Dinwiddle et al. 1996 Ross and Darke 2000 Seivewright 2001 Strain et al. 1991 Williams et al. 1996). The reasons for the high rates of benzodiazepine use in opioid addicts include self-medication of insomnia, anxiety, and withdrawal symptoms, as well as attempts to boost the euphoric effects of opioids. 

Antidepressants Desipramine, imipramine, sertraline, fluoxetine, paroxetine, venlafaxine, bupropion, nefazodone, mirtazapine, gepirone, amineptine Mixed findings suggest that better designed studies may find a niche for some of these drugs. Amineptine was effective for withdrawal symptoms. 

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