Narcotics Opiates; opium, morphine, heroin, codeine Dilaudid Synthetic nonopiates, Methadone Demerol, Darvon, Percodan, Percoset OxyContin Vicodin Snow, stuff, H, junk, smack, scag, dreamer, Ska Central nervous system depres-sant 3–24 hours Addicting Interaction with alcohol, antihista-mine, barbitu-rates, benzodia-zepine, causes respiratory depression. Oral; smoked; sniffed; injected under skin (skin popping); intra-muscular (IM); intravenous (IV); cough medicine containing codeine Euphoria Prevention of withdrawal discomfort Drowsiness, sedation, nodding stupor. Eye and nose secretions. Euphoria. Relief of pain. Impaired intel-lectual functioning and coordination. Constricted pupils that do not respond to light. Excessive itching. Poor appe-tite. Constipation. Urinary retention. Loss of sexual desire, temporary impo-tence or sterility Slow pulse and respiration(s); hypo-tension. Death from overdosage caused by respiratory and cardiovascular depression and collapse. Effects on fetus. Severe infection at injection sites (needle marks and tracks) Barbiturates Nembutol, Seconal, Amytal, Fiornal, Tuinol, Phenobarbital Sleepers, downers, goofballs, redbirds, yellow jackets, heavens, red devils, barbs, phennies
Central nervous system (CNS) depressant 1–16 hours Can be lethal with
alcohol or other CNS depressants. GABA activity Oral, or injected IM or IV Relaxation and euphoria
Relief of anxiety and muscular tension, relaxation, sleep. Respirations slow, shallow. Slowed reactions. Euphoria. Impaired emotional control, judgment, and coordination. Irritability or unusual excitement. Apathy. Confused. Poor hygiene. Slurred, slow speech. Poor memory. Weight
Yes High.
Controlled substance
High Abdominal pain. Muscle
cramps, tremors, spasms. Nausea, vomiting, diarrhea. Lacrimation, watery eyes. Goose bumps, sweating, chills. Hyper-tension, tachycardia, increased respirations. Anxiety, irritability, depression. Craving for drugs occurs 48–72 hours after last dose; subsides within a week.
(1) Observe for symptoms of withdrawal and report to physician.
(2) Give medications prescribed to suppress withdrawal symptoms. (3) Monitor for vital signs at
least qid for first 72 hours following admission. (4) Carry out nursing
measures to promote safety, general health, and sense of security.
(5) Observe and take precau-tion for seizure activity. (6) Promote general health
and sense of security.
Yes Moderate.
Controlled substance.
Moderate to high. Nausea, vomiting,
diarrhea. Bleeding. Tremors. Diaphoresis. Hypertension or hypotension. Tempera-ture above 99.6°F. Irri-tability, hostility, restlessness, agitation. Sleep disturbance. Impaired cognitive function. Acute brain syndrome. Seizures.
(1) Observe for withdrawal symptoms and report to physician.
(2) Give prescribed medica-tion to suppress symptoms.
(3) Provide calm, quiet, safe environment, as free of external stimuli as possible, for acute or severe withdrawal symptoms.
(4) Observe for insomnia and nightmares and provide nursing measures to promote sleep.
Sedatives Doriden Chloralhydrate, Methaquolone Placidyl Central nervous system depres-sant 3–4 hours Can be lethal with
alcohol
Oral Sleep,
relaxation
May be same effect as barbiturates but not as severe Minor tranquilizers Valium Librium Miltown Equanil Downers, Candy, Tranus Central nervous system depressant 3–4 hours Oral, or injected IM or IV Relaxation, sense of calm
Relieve anxiety. Varied onset and duration of effect according to preparation and administration. Inhalants (Glue sniffing, aerosols, butane prepa-rations, airplane glue, amyl nitrate, nitrous oxide, any spray, including paint) Whippits, Poppers, Snappers Central nervous system depressant Intoxicant lasts a few minutes. Users extend this effect by breathing inhalant repeatedly. Inhaled through tubes, glue smears on paper or cloth Intoxication, relax-ation, euphoria Rapid high, resembles alcohol intoxication
Excess nasal secretion. Watering of eyes. Tinnitus. Diplopia. Poor muscular control, lack of coor-dination. Appears dreamy, blank, or drunk. Impaired perception and judgment. Possibility of violent behavior. Sleepy after 35 to 45 minutes or uncon-scious. Damage to lungs, nervous
Yes Controlled substance Yes Anxiety. Insomnia. Tremors. Delirium. Convulsions.
(1) Observe and treat if taken in suicide attempt. (2) Provide environment for
safety and sleep. (3) Teach measures to
promote sleep and rest.
Yes Controlled substance Yes Anxiety. Irritability. Poor
concentration.
(1) Observe for withdrawal symptoms or if a suicide attempt and treat. (2) Provide calm, safe
environment.
(3) Teach stress management. (4) Promote general health.
Yes No Yes Withdrawal symptoms
have not been recorded
(1) Emergency care for respi-ratory damage or neuro-logical complication. (2) Provide for safety. (3) Implement other nursing
measures related to presenting symptoms, especially if this drug has been used in combination with others.
Stimulants Amphetamines Dexedrine Methedrine Methamphet-amine (“crystal meth”) Cocaine
Pep pills, uppers, A, speed, heat, crystal, dexies, bennies, lid poppers, black beauties, truck driver crosses Leaf, snow, coke,
speedballs Ilake, gold dust, crack, smack, blow Rock Fire Crack C Ice Charlie Toot Central nervous system stimulant Varies in duration of action 2–4 hours Crack, immediate Depression and exhaustion can last several days Dopamine and
nor-epinephrine overstimulates CNS
Oral; or injected under skin or IV. Smoked Snorted Cocaine sniffed, snorted, IV, or smoking (free-basing) Sense of well-being Alertness, feelings of activity and increased initiative Excitation Overconfidence
Giggling, silliness, talk-ativeness. Rapid speech. Dilated pupils. Hyperten-sion, dizzy, tachy-cardia. Loss of appetite, loss of weight. Diarrhea. Extreme fatigue. Dry mouth, bad breath. Chills, sweating, increased muscle tension; shakiness, tremors, restless-ness. Irritability. Confused, grandiose thinking. Deep depression. Mood swings. Aggressive behavior. Paranoid ideas which may persist. Feelings of persecution. Delusions. Hallucina-tions. Panic. Toxic psychosis. Possible seizures. Tachycardia may cause heart damage or heart attack. Death from cardiac damage, hypertensive crisis, stroke, paralysis of respiratory center, fatigue or overdose. Caffeine (Found in tea, coffee, cocoa, cola, and tablet form, including many over-the-counter drugs.) Kiddie dope (caffeine, ephedrine, phenylo-propanolamine), black beauty, speckled eggs, speckled birds, pink heart, 20–20’s, blue Central nervous system stimulant. Cardiac stimulant 2–4 hours High similar to amphetamines Oral A “pick-up”; to increase alertness and decrease fatigue. More rapid, clearer flow of thoughts Restleness. Disturbed sleep or insomnia. Nausea, abdominal distention. Anorexia. Myocardial stimula-tion, palpitastimula-tion, and tachycardia. Dizzy. Large amounts have led to irrational or
hyster-Yes Yes High Tremors. Neurological hyperactivity. Paranoia. Assaultive behavior. Irri-tability. Depression. Possible suicidal behavior or psychotic reaction. Tachycardia, hypertension. Oversen-sitivity to stimuli. Insomnia. Intense craving
(1) Observe for symptoms of withdrawal and report to physician.
(2) Give medication as prescribed to suppress agitated state and prevent exhaustion
(3) Take precautions for staff and client safety according to client’s paranoia and depression.
(4) Monitor vital signs at least qid for first 72 hours following admission. (5) Provide calm,
nonthreat-ening, quiet environment and sense of security. (6) Provide for sleep and
nutrition.
(7) Cocaine—observe for chronic nose-bleed and perforated nasal septum. (8) Detoxification.
(9) Teach stress management, alternate leisure activities.
Yes
Develops quickly
Yes Yes In moderate heavy users,
there may be headache, irritability, nervousness, tremors, lethargy
(1) Introduce substitute decaf-feinated beverage
(2) Provide for general health needs and teaching (3) Observe for caffeinism;
irritability, tremors, tics, insomnia, sensory distur-bance, tachypnea, arrhythmias, diuresis, GI distress.
(4) Teach cognitive methods and stress management techniques to reduce fatigue, promote alertness.
Hallucinogens Synthetic D-lysergic acid (LSD) 4-methyl-2 (STP, DOM) Phencyclidine (PCP) Dimethyltryp-tamine (DMT) Natural cactus (mescaline, peyote) Mushroom (psilocybin)
Acid, Big D, sugar, trips, cubes Serenity, tranquility, peace Businessman’s special Hallucinogenic, varies: LSD 10–12 hours; STP 6-8 hours Mescaline 12–24 hours
Primarily oral; some are inhaled or injected Insight. Distortion of senses Exhilaration Increased energy Severe hallucinations, feelings of persecu-tion and detach-ment. Amnesia. Incoherent speech Laughing, crying. Exhilaration, depres-sion, or panic alter-nates with sense of invulnerability. Suicidal or homicidal tendencies. Suspi-cious. Impaired judgment. Cold, sweaty hands and feet; shivering, chills. Vomiting. Weight loss. Irregular breathing. Exhaus-tion. Dilated pupils. Hypertension. Brain damage from chronic use. Acci-dental death. Flash-backs. May intensify psychosis; long-lasting mental illness has resulted. Symptoms may persist for an indefi-nite period after discontinuation of drug. Nicotina (Found in cigarettes, cigars, pipe and chewing Variable action. Central nervous system toxin. Can act as stimulant or depressant: 15 Smoked, sniffed, chewed Calmness, sociability Increases alertness.
Can have stimulating and/or calming effect Nausea, Vomiting, Reduces appetite Factor in lung cancer,
Yes Yes Probable Severe apprehension, fear, or panic. Percep-tual distortions and hallucinations. Hyper-activity. Diaphoresis. Tachycardia.
(1) Have someone who is close to client stay with client at all times to provide support and comfort.
(2) Provide nonthreatening environment with subdued, pleasant stimuli. (3) Provide orientation and
diversion to pleasant expe-riences.
(4) Avoid use of sedative/ tranquilizers, if possible. (5) Monitor vital signs. (6) Provide for general health
needs.
(7) Teach stress management and cognitive methods to increase energy, insight, feelings of health, and life satisfaction.
(8) Teach alternate leisure activities.
Yes Yes Yes Headache. Anorexia,
irri-tability, nervousness. Decreased ability to concentrate. Craving for cigarette. Energy loss. Fatigue. Dizziness. Sweating. Tremor and palpitations.
(1) Provide support. (2) Explore behavioral
changes necessary to quit smoking as well as provide information as to available self-help groups.
(3) Provide for general health needs.
(4) Teach smoking cessation program.
