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

By M.D. Peter G. Bourne

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Conclusion A c u t e heroin toxicity is a c o n d i t i o n increasing in frequency and which carries with it t h e i m m i n e n t possibility of d e a t h . It is a true emergency situation in which t i m e t o treat and k n o w l e d g e of t h e p r o p e r steps are essential factors in survival. T h e i m m e d i a t e manage­ m e n t , however, is n o t particularly c o m p l i c a t e d , can be p e r f o r m e d by t h e average physician with m i n i m a l e q u i p m e n t , and can p r o d u c e dra­ matic lifesaving results.

Neurology, 21:453,1971. X4M^, 206:1255, 1968. ; and Ramsey, W. Clin Res, 18:695,1970. AmerJMed, 45:555,1968. THE TREATMENT OF ACUTE HEROIN TOXICITY H e r b e r t D . Kleber I. Introduction II. Diagnosis III. General Management A. Immediate Steps B. Maintenance of Respiration C. Maintenance of Circulation D. Narcotic Antagonists E. Other Measures IV. FollowupCare V. Conclusion VI. Etiologic Factors 33 ^5 35 35 36 37 38 39 39 39 I. I n t r o d u c t i o n In t h e past t h e t r e a t m e n t of a c u t e h e r o i n t o x i c i t y ( m o r e c o m m o n l y k n o w n as heroin overdose or j u s t O D ) , was mainly confined t o t h e emergency r o o m s of large city hospitals.

In n o case should large doses of m e t h a d o n e be given at this t i m e since it will add t o or p r o d u c e CNS depression after cessation of t h e i n d u c e d withdrawal. V. General M a n a g e m e n t A. Close Monitoring Closely observe t h e p a t i e n t ' s respiration and level of consciousness at least every 15 m i n . T h e d u r a t i o n of action of n a l o x o n e is only 2—3 h r , b u t respiratory depression from m e t h a d o n e can o c c u r u p t o 36—48 hr after its a d m i n i s t r a t i o n .

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