Medication MOA Nursing Considerations

 Used to treat a narcotic

overdose, these drugs block
Opioid Antagonists  Monitor patient condition, including respiratory rate, and
narcotic receptor sites and
anticipate the need for pain management as narcotic effects
 Naloxone quickly reverse the effect of
are reversed.
the narcotic if administered
via IV therapy.
 Diminishes anxiety;
Benzodiazepines anticonvulsant qualities  Monitor for over-sedation
 Chlordiazepoxide help provide safe  Caution patients not to mix with alcohol; can cause
withdrawal. respiratory depression
 Diazepam
 May be ordered q4h or prn  High potential for addiction; should be used for short
 Oxazepam
to manage effects from term only
 Lorazepam withdrawal; then dose is  Taper dosage; stopping abruptly may trigger seizures
tapered to zero.
 Disulfiram can cause flushing of the face, headache,
Abstinence Meds vomiting, and other unpleasant sensations if alcohol is
consumed.
 Disulfiram  Diminishes cravings for
 Naltrexone will cause opioid withdrawal if given to an
 Naltrexone alcohol and opioids; blocks
individual who has not detoxed.
 Acamprosate cravings for heroin.
 Methadone is addictive and can be abused. Monitor for
 Methadone
cardiac arrhythmias. Overdose can cause respiratory
depression, especially if mixed with alcohol.
 Implement seizure precautions to maintain patient safety.
If a seizure occurs, place a pillow under the patient’s head
Antiseizure Drugs and time the seizure, noting patient behavior during and
 Phenytoin after the event.
 Carbamazepine  Reduces and controls
 Phenobarbital can cause a serious allergic reaction;
seizure activity resulting
 Valproic acid monitor for hypersensitivity response. Phenobarbital is a
from withdrawal syndrome.
 Phenobarbital teratogen and should not be taken by pregnant women.
 Magnesium sulfate  Magnesium sulfate can cause dizziness; flushing; irregular
heartbeat; muscle paralysis or weakness. Patients should
be assisted when standing or transferring.
 Medication MOA
 Some antidepressants have
been shown to reduce the
Antidepressants craving for nicotine and
 Bupropion
support smoking cessation
hydrochloride
programs. Can also be
 Fluoxetine administered to reduce
 Sertraline depression occurring as the
result of substance
withdrawal.
 Stimulates nicotine receptors
Nicotine Acetylcholine more-weakly than nicotine
Receptor Agonists itself does, reducing cravings
 Varenicline for and decreasing the
pleasurable effects of tobacco.
Vitamins  Prevents alcohol-related
Wernicke encephalopathy.
 Thiamine (vitamin B1)
 Corrects vitamin deficiency
 Folic acid
caused by heavy, long-term
 Multivitamins
alcohol abuse.
Nursing Considerations
 Monitor and assess for suicidal ideation.
 Assess for drug side effects, including drowsiness,
insomnia, and blurred vision.
 Teach patient about self-administration of medications
and symptoms to report.
 Teach patient not to mix drug with alcohol because of
increased risk of seizures.
 Teach patient that antidepressants can take 3–4 weeks
to become effective and not to discontinue abruptly;
medication should be tapered off.
 Assess for nicotine withdrawal symptoms such as
depression, agitation, and exacerbation of preexisting
mental health disorders.
 Suicide and suicidal ideation have been associated with
use of varenicline. Assess patients for thoughts of suicide
or changes in mood and affect.
 May not be absorbed properly in patients with impaired
liver function.
 High-dose folic acid may increase risk of heart attack in
some patients.
 Water-soluble vitamin overdoses can cause nausea and
diarrhea.