Download Acute Drug Abuse Emergencies. A Treatment Manual by M.D. Peter G. Bourne PDF

By M.D. Peter G. Bourne

ISBN-10: 0121195651

ISBN-13: 9780121195656

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T h e vast majority of h e r o i n overdose fatalities result from respiratory depression. T h e r a p y m u s t therefore be directed at respiratory s u p p o r t and an a t t e m p t t o reverse t h e CNS effects of t h e h e r o i n . Sufficiently large doses of heroin can p r o d u c e extensive peripheral vasodilation and h y p o t e n s i o n . Circulatory s u p p o r t m a y be required. Finally, heroin p r o d u c e s a m a r k e d decrease in gastric motility and a m a r k e d increase in antral t o n e .

Drip should be s t a r t e d w h e n possible and 50 m l of s o d i u m b i c a r b o n a t e ( 3 . 7 5 g m ) given. This reverses t h e acidotic state and aids in improving cardiac functioning. 2. ). 3. PULMONARY EDEMA If p u l m o n a r y e d e m a has developed, t r a c h e o s t o m y with positive pressure respiration m a y be necessary. Such respirators should n o t be used with e x t e r n a l cardiac compression. 4. THE PATIENT MUST NOT BE LEFT UNATTENDED UNTIL FULLY RESPONSIVE T h e increased illicit use of m e t h a d o n e which has a m u c h longer d u r a t i o n t h a n t h e n a r c o t i c antagonists m a y bring a b o u t situations in which t h e p a t i e n t is fully responsive and t h e n lapses back i n t o c o m a (Dole et al, 1 9 7 1 ; Kjeldgaard et al, 1 9 7 1 ) .

There is c u r r e n t evidence t h a t m e t h a d o n e diversion has been limited b y these a p p r o a c h e s b u t m e t h a d o n e is still available, particularly in certain geographical areas. IL E l e m e n t s of t h e Medical History Generally, t h e victim of m e t h a d o n e poisoning is either (a) a hard­ core heroin addict w h o has o b t a i n e d m e t h a d o n e illicitly and used it instead of heroin t o o b t a i n e u p h o r i c effects; (b) a drug e x p e r i m e n t e r w h o will take any drug or m i x t u r e w h e t h e r or n o t h e k n o w s w h a t it is or d o e s , and w h o might never have t a k e n a n a r c o t i c drug before; or (c) a n o n d r u g user, child or a d u l t , w h o i n a d v e r t e n t l y swallows a m e t h a d o n e p r e p a r a t i o n belonging t o a p a t i e n t in t r e a t m e n t .

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