Nursing Management of a Patient with Alcohol Withdrawal Stephan is a 25-year-old, 75 kg male who presents to the emergency department via paramedics after suffering a general tonic-clonic seizure during his first day at a local alcohol and drug rehabilitation facility. He was ordered by the county court to attend this inpatient treatment program following his second drunk driving violation in one year. The seizure lasted approximately one minute, and resolved spontaneously without drug intervention. It has been about 36 hours since his last drink.
Pathophysiology
Alcohol abuse and dependence represents a serious condition that has many social, interpersonal, and legal implications. Amato (2011) describes alcohol withdrawal syndrome (AWS) …show more content…
Benzodiazepines are anxiolytics, antiepileptics, muscle relaxants, and sedative-hypnotics (Lippincott, 2013). Their exact mechanism of action is not well-understood, but it is known that benzodiazepines potentiate the effects of GABA. Benzodiazepines are used for anxiety and seizure disorders, and have an off-label use for acute alcohol withdrawal syndrome. They are contraindicated in patients with hypersensitivity to the drug, shock, coma, and acute alcohol intoxication. Some side effects include sedation, depression, disorientation, constipation, diarrhea, dry mouth, and nausea. With prolonged use, benzodiazepines may lead to drug dependence. Benzodiazepines cause increased central nervous system (CNS) depression with alcohol, and have an increased effect when taken with cimetidine, disulfram, omeprazole, and hormonal contraceptives. As an RN treating a patient taking this drug, it is important to monitor liver function tests, establish a bowel program, provide frequent small meals and oral care, and taper the dosage gradually after long-term therapy. It is important to teach the patient to take the drug exactly as prescribed; to not abruptly stop taking the drug; to avoid alcohol, sleep-inducing drugs, or over-the-counter drugs; to be aware of common …show more content…
Valerian seems to act like a sedative on the brain and nervous system. Dosing for insomnia is 400-900 mg valerian extract up to 2 hours before bedtime for as long as 28 days. Valerian can cause some side effects such as headache, excitability, uneasiness, and even insomnia in some people. Valerian should not be combined with alcohol, Xanax, and sedative medications, including benzodiazepines, barbiturates, and CNS depressants. The RN managing a patient taking valerian should monitor liver function tests and monitor for hypersensitivity to the herb. The RN should teach the patient to not consume alcohol or other sedatives with valerian, and to take it up to two hours before
Pathophysiology
Alcohol abuse and dependence represents a serious condition that has many social, interpersonal, and legal implications. Amato (2011) describes alcohol withdrawal syndrome (AWS) …show more content…
Benzodiazepines are anxiolytics, antiepileptics, muscle relaxants, and sedative-hypnotics (Lippincott, 2013). Their exact mechanism of action is not well-understood, but it is known that benzodiazepines potentiate the effects of GABA. Benzodiazepines are used for anxiety and seizure disorders, and have an off-label use for acute alcohol withdrawal syndrome. They are contraindicated in patients with hypersensitivity to the drug, shock, coma, and acute alcohol intoxication. Some side effects include sedation, depression, disorientation, constipation, diarrhea, dry mouth, and nausea. With prolonged use, benzodiazepines may lead to drug dependence. Benzodiazepines cause increased central nervous system (CNS) depression with alcohol, and have an increased effect when taken with cimetidine, disulfram, omeprazole, and hormonal contraceptives. As an RN treating a patient taking this drug, it is important to monitor liver function tests, establish a bowel program, provide frequent small meals and oral care, and taper the dosage gradually after long-term therapy. It is important to teach the patient to take the drug exactly as prescribed; to not abruptly stop taking the drug; to avoid alcohol, sleep-inducing drugs, or over-the-counter drugs; to be aware of common …show more content…
Valerian seems to act like a sedative on the brain and nervous system. Dosing for insomnia is 400-900 mg valerian extract up to 2 hours before bedtime for as long as 28 days. Valerian can cause some side effects such as headache, excitability, uneasiness, and even insomnia in some people. Valerian should not be combined with alcohol, Xanax, and sedative medications, including benzodiazepines, barbiturates, and CNS depressants. The RN managing a patient taking valerian should monitor liver function tests and monitor for hypersensitivity to the herb. The RN should teach the patient to not consume alcohol or other sedatives with valerian, and to take it up to two hours before