Opioid Intoxication

The word "opioid" is used to refer to the overall class including the semisynthetic and fully synthetic agents, but the word "opiate" only refers to the naturally occurring opioids, such as heroin, opium, and morphine.

Patients who are acutely intoxicated with an opioid usually present with miosis, euphoria, slow breathing and slow heart rate, low blood pressure, and constipation. Seizures may occur with certain agents, such as meperidine (Demerol). It is critically important to monitor patients carefully to avoid cardiac/respiratory depression and death from an excessive dose of opioids. One strategy is to reverse the intoxication by utilizing naloxone (Narcan) 0.4 to 2 mg IV every 2 to 3 minutes up to 10 mg. Alternatively, the IM or subcutaneous (SC) route may be used if an IV access is not available. Because naloxone is shorter acting than most abused opioids, it may need to be readministered at periodic intervals; otherwise the patients could lapse into cardiopulmonary arrest after a symptom-free interval of reversed intoxication. In addition, naloxone can induce withdrawal symptoms in opioid-dependent patients, so patients may awaken feeling quite distressed and agitated. The other critical issue is to secure the airway and breathing of a patient. In some cases, intubation and manual/mechanical ventilation might be required. This is a necessary measure to avoid oxygen desaturation leading to brain hypoxia or anoxia that may cause brain damage or death.

Overall, intoxication with any of the substances discussed above is evidence of substance abuse and is strongly suggestive of substance dependence. In all cases, it is important to strongly emphasize to the patient that this is an issue that needs to be addressed, and that entry into a treatment program could be very beneficial.

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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