By M.D. Peter G. Bourne
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Additional resources for Acute Drug Abuse Emergencies. A Treatment Manual
NIGHTINGALE 43 t h e t i m e of t h e overdose incident. It should be r e m e m b e r e d t h a t t h e d u r a t i o n , frequency, and dosage of n a r c o t i c drug use prior t o t h e present poisoning i n c i d e n t d e t e r m i n e s t h e degree of tolerance and physical d e p e n d e n c e . Unavailability and unreliability of i n f o r m a n t s m a k e t h e latter difficult t o ascertain in t h e case of c o m a t o s e p a t i e n t s . With a child w h o inadvertently takes a relative's m e t h a d o n e prepara tion, an i m m e d i a t e a t t e m p t should be m a d e t o c o n t a c t t h e t r e a t m e n t program t o ascertain t h e size of t h e m e t h a d o n e t r e a t m e n t p a t i e n t ' s daily dose and n u m b e r of individual doses last t a k e n o u t from t h e clinic.
SUBACUTE Once these measures have b e e n carried o u t a n d t h e p a t i e n t is stable, o n e should t h e n t u r n t o a search for t h e c o m m o n a c u t e c o m p l i c a t i o n s of heroin a d d i c t i o n and overdose. Cardiac a r r h y t h m i a s can o c c u r b u t only infrequently require specific t h e r a p y . T h o s e p a t i e n t s w i t h atrial fibrillation almost always s p o n t a n e o u s l y convert t o sinus r h y t h m o n c e h y p o x i a a n d acidosis are c o r r e c t e d .
III. IV. Pharmacology and Use of Methadone Elements of the Medical History Physical Examination and Differential Diagnosis Immediate Management A. Respiratory Support B. Gastric Lavage C. Specific Antidote V. General Management A. Close Monitoring B. Narcotic Antagonist C. Oxygen D. Pulmonary Edema E. Aspiration Pneumonitis F. Overdose from a Combination of Drugs: Further History and Laboratory Tests G. Hospitalization VL FollowupCare 41 42 43 4^ 44 4^ 45 46 ^ 47 47 47 48 48 I. Pharmacology and Use of M e t h a d o n e M e t h a d o n e is an opioid drug which, like h e r o i n and m o r p h i n e , has analgesic, sedative, and euphorigenic p r o p e r t i e s .
Acute Drug Abuse Emergencies. A Treatment Manual by M.D. Peter G. Bourne