Acute Drug Abuse Emergencies (eBook)

Front Cover 1
Acute Drug Abuse Emergencies: A Treatment Manual 4
Copyright Page 5
Table of Contents 6
LIST OF CONTRIBUTORS 16
PREFACE 20
PART I: DIFFERENTIAL DIAGNOSIS 22
Chapter 1. Differential Diagnosis of Emergency Drug Reactions 24
I. Introduction 24
II. Drug Intoxication 25
III. Drug Withdrawal 29
IV. "Flashback" Reactions 30
V. Concurrent Illness or Injury 30
VI. Complications of "Needle Habit" 31
VII. Nonspecificity of Symptoms 32
VIII. Laboratory Identification of Etiologic Agent 33
References 34
Chapter 2. Differential Diagnosis of Emergency Drug Reactions 36
I. Introduction 36
II. Clinical Manifestations 37
III. Biochemical Manifestations 41
References 41
PART II: EMERGENCY TREATMENT OF OPIATE OVERDOSE 42
Chapter 3. The Treatment of Acute Heroin Toxicity 44
I. Introduction 44
II. Profile of a Heroin Overdose Victim 45
III. The Management of Opiate Overdose 46
IV. Unusual Clinical Situations 51
V. Conclusion 52
References 53
Chapter 4. The Treatment of Acute Heroin Toxicity 54
I. Introduction 54
II. Diagnosis 55
III. General Management 56
IV. Followup Care 60
V. Conclusion 60
VI. Etiologic Factors 60
References 61
Chapter 5. The Management of Methadone Intoxication 62
I. Pharmacology and Use of Methadone 62
II. Elements of the Medical History 63
III. Physical Examination and Differential Diagnosis 64
IV. Immediate Management 65
V. General Management 67
VI. Followup Car 69
References 71
Chapter 6. The Management of Narcotic Withdrawal Syndrome in the Neonate 72
Chapter 7. The Herom Withdrawal Syndrome of Newborn Infants 76
I. Prevalence 76
II. Prenatal Hazards and Birth Complications 77
III. Onset of Symptoms 77
IV. Symptomatology 78
V. Laboratory Investigations 80
VI. Treatment 80
VII. Prognosis 81
References 83
Chapter 8. Management of the Opiate Abstinence Syndrome 84
I. Introduction 84
II. Procedure 85
III. Problems 88
IV. Results 89
Chapter 9. Management of Acute Medical Complications Resulting from Heroin Addiction 90
I. Introduction 91
II. Cardiac 91
III. Pulmonary 95
IV. Gastrointestinal 98
V. Renal 100
VI. Neurologic 101
VII. Musculoskeletal and Cutaneous 104
VIII. Hematologic and Vascular 105
Bibliography 106
PART III: TREATMENT OF ACUTE CNS DEPRESSANT EMERGENCIES 108
Chapter 10. Emergency Treatment of Acute Barbiturate Intoxication 110
1. Introduction 110
II. Pulmonary 110
III. Cardiovascular 111
IV. History 111
V. Physical Examination 112
VI. Neurological Exammation 113
VII. Laboratory 115
VIII. General Therapy 115
IX. Summary 117
Reference 118
Chapter 11. Managing the Barbiturate Withdrawal Syndrome 120
Chapter 12. The Treatment of Nonbarbiturate Sedative Overdosage 126
I. Introduction 126
II. Supportive Measures 127
III. Specific Drugs 130
IV. Summary 133
References 133
PART IV: EMERGENCY TREATMENT OF ADVERSE REACTIONS TO CNS STIMULANTS 134
Chapter 13. Emergency Treatment of Acute Adverse Reactions to CNS Stimulants 136
I. Introduction 136
II. Management of Acute Medical Complications 137
III. Treatment of Acute Amphetamine Psychosis 140
IV. Psychiatric Management of Amphetamine Withdrawal 142
References 143
Chapter 14. The Treatment of Amphetamine Psychosis 144
I. Introduction 144
II. Diagnostic Interview 145
III. Physical Examination 147
IV. Treatment 148
References 150
PART V: EMERGENCY TREATMENT OF ADVERSE REACTIONS TO HALLUCINOGENIC DRUGS 152
Chapter 15. Management of Acute Panic Reactions and Flashbacks Resulting from LSD Ingestion 154
I. Introduction 154
II. Acute Panic Reactions 155
III. LSD Flashbacks 157
References 159
Chapter 16. Emergency Treatment of Acute Adverse Reactions to Hallucinogenic Drugs 160
I. Hallucinogenic Drugs 160
II. Acute Adverse Reactions 161
III. Emergency Management 162
References 164
Chapter 17. Emergency Treatment of Acute Adverse Reactions to Hallucinogenic Drugs 166
I. Introduction 166
II. The Hallucinogenic Drugs 167
III. The Adverse Reaction 167
IV. Management 168
V. Prognosis and Conclusion 170
Bibliography 171
PART VI: EMERGENCY TREATMENT OF ACUTE REACTIONS TO CANNABIS DERIVATIVES 172
Chapter 18. Emergency Management of Marihuana Psychosis 174
I. Adverse Reactions to Marihuana 175
II. Expected or Usual Effects of Marihuana 176
III. Types of Adverse Reactions to Marihuana 177
IV. Variables Affecting Marihuana Effects 179
V. The Treatment of Marihuana Psychosis 180
References 181
Chapter 19. Emergency Treatment of Marihuana Complicating Diabetes 184
I. Introduction and Comment 184
II. Differential Evaluation 185
III. Treatment Methods 186
IV. Followup 187
V. Summary and Abstract 187
References 188
Appendix: A–Walter Reed General Hospital Protocol for Treatment of Diabetic Acidosis and Coma 188
PART VII: EMERGENCY TREATMENT OF INHALATION PSYCHOSIS AND RELATED STATES 196
Chapter 20. Inhalation Psychosis and Related States 198
I. Introduction 198
II. Materials and Techniques 199
III. The Nature of Inhalation Psychosis 201
IV. The Inhaler 204
V. The Etiology of Inhalation Psychosis 207
VI. Treatment 210
VII. Summary 211
References 211
PART VIII: EMERGENCY TREATMENT OF ACUTE ALCOHOL INTOXICATION 216
Chapter 21. Treatment of Alcohol Intoxication and the Withdrawal Syndrome: A Critical Analysis of the Use of Drugs and Other Forms of Therapy 218
I. Introduction 218
II. Alcohol Intoxication 220
III. The Abstinence or Withdrawal Syndrome 224
IV. Nutritional Diseases of the Nervous System (Secondary to Alcoholism) 233
V. Summary and Conclusions 234
References 235
Chapter 22. Diagnosis and Therapy of Acute Withdrawal from Alcohol 240
I. Introduction 240
II. Sedation 243
III. Fluid and Electrolyte Metabolism 245
IV. Carbohydrate Metabolism 246
V. Anticonvulsant Therapy 246
VI. Antibiotic Therapy 247
VII. Summary 247
References 249
PART IX: SPECIAL PROBLEMS 250
Chapter 23. Drug Dependence in Hospitalized Patients 252
I. Drug Abuse 252
II. Drug Dependence 253
III. Tolerance 254
IV. Types of Abused Drugs 255
V. Alcohol Type 255
VI. Barbiturate Type 261
VII. Morphine Type 264
VIII. Amphetamine, Cocaine and Marihuana Types 266
IX. Hallucinogenic Type 267
X. Solvent Sniffing 268
XI. Drug Dependence among Physicians and Nurses 269
XII. Dependence upon Several Drugs 269
XIII. Summary 269
References 269
Chapter 24. Surgery for Drug Abusers—Anesthesia 272
I. Introduction 272
II. Detoxification 273
III. Premedication 275
IV. Anesthetic Management 275
V. Abstinence Syndrome 277
References 279
Chapter 25. Accidental Poisoning in Children and Adolescents by Drugs of Abuse 280
I. Introduction 280
II. General Management Guidelines 281
III. Opiates 282
IV. Sedatives 283
V. Amphetamines 284
VI. Hallucinogens 284
References 285
Chapter 26. Confidentiality and the Drug Abuse Patient 286
I. Introduction 286
II. Confidentiality Regulations 287
III. Medical Issues 288
lV. Administrative Issues 291
V. Conclusion 296
Chapter 27. Chemotherapy for Drug Abuse Related Emergencies 298
I. Introduction 298
II. Chemotherapeutic Approaches 302
References 316
Chapter 28. Management and Treatment of Acute Phencyclidine Intoxications 318
I. Introduction 318
II. Presenting Picture 319
III. Clinical Findings 319
IV. Diagnosis 323
V. Early Management 323
VI. The Recovery Phase 325
VII. Treatment 325
VIII. Conclusion 326
Bibliography 326
Subject Index 328