Intoxication with opiates causes miotic pupils, euphoria, altered level of consciousness, constipation, and respiratory depression. Treatment of opiate overdose involves providing respiratory support and administering naloxone, a pure opiate antagonist. Naloxone is typically administered IV but may also be administered SC, intramuscularly (IM), via endotracheal tube, or intranasally until IV access is established (Barton et al., 2005). The initial dose is typically 0.4 to 0.8 mg, with a 2-minute onset of action when given IV. Doses are repeated and escalated as needed to reverse the overdose. After reversal, patients need to be monitored for 1 to 3 hours for repeated dosing, and sometimes longer if longer-acting opiates such as methadone have been used in the overdose. Naloxone treatment can initiate a rapid and intense withdrawal syndrome (Ries et al., 2009).

Opiate withdrawal is rarely fatal but is extremely uncomfortable and typically is accompanied by strong cravings. Withdrawal signs and symptoms include vomiting, diarrhea, body aches, rhinorrhea, thermoderegulation, insomnia, anxiety, dysphoria, gooseflesh, yawning, and pupil dilation. Treatment can be symptomatic, as with the alpha-2-adrenergic agonist clonidine, or can involve receptor agonist or antagonist activity. Methadone can be used with short- or long-taper protocols. Buprenorphine, a partial opiate agonist can similarly be used. The antagonist, naltrexone in combination with clonidine has been used effectively in both inpatient and outpatient settings (Ries et al., 2009).

Constipation Prescription

Constipation Prescription

Did you ever think feeling angry and irritable could be a symptom of constipation? A horrible fullness and pressing sharp pains against the bladders can’t help but affect your mood. Sometimes you just want everyone to leave you alone and sleep to escape the pain. It is virtually impossible to be constipated and keep a sunny disposition. Follow the steps in this guide to alleviate constipation and lead a happier healthy life.

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