Page 2306 - Saunders Comprehensive Review For NCLEX-RN

benzodiazepine overdose to reverse the effects.
6. Withdrawal effects include nausea, vomiting,
tachycardia, diaphoresis, irritability, tremors,
insomnia, and seizures; withdrawal must be treated
with a carefully titrated similar drug (abrupt
withdrawal can lead to death).
7. Withdrawal from CNS depressants such as
barbiturates is generally treated with a barbiturate
such as phenobarbital or a long-acting
benzodiazepine.
B. CNS stimulants
1. CNS stimulants include substances such as
amphetamines, cocaine, and crack.
2. Intoxication (Box 66-7)
3. Overdose can produce respiratory distress, ataxia,
hyperpyrexia, seizures, coma, stroke, myocardial
infarction, and death.
4. Overdose is treated with antipsychotics and
management of associated effects.
5. Withdrawal effects include fatigue, depression,
agitation, apathy, anxiety, insomnia, disorientation,
lethargy, and craving.

6. Withdrawal is treated with antidepressants, a

dopamine agonist, or bromocriptine; withdrawal is
primarily supportive, particularly when dealing with
the severe depression and suicidal ideation that
accompanies stimulant withdrawal.
C. Opioids
1. Opioids include substances such as opium, heroin,
meperidine, morphine, codeine sulfate, methadone,
hydromorphone, oxycodone, hydrocodone, and
fentanyl.
2. Intoxication (Box 66-8)
3. Overdose can produce respiratory depression, shock,
coma, seizures, and death.
4. Overdose is treated with an opioid antagonist such as
naloxone.

5. Withdrawal effects include yawning,

insomnia, irritability, rhinorrhea, diaphoresis, cramps,
nausea and vomiting, muscle aches, chills, fever,
lacrimation, and diarrhea.
6. Withdrawal may be treated by methadone
detoxification or tapering dosage with other opioids.
7. Clonidine, an α-adrenergic blocker, assists in reducing
the severity of sympathetic nervous system–

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