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[CK] Opioid withdrawal.

Heroin/Opioid overdose -> withdrawal.

Sx>
Anxiety,
Pain,
Diarrhea,
Lacrimination/Rhinorrhea,
N/V,
HTN

Objective eval> COW score(>7 will be indicated for treatment.)

AP>

1. Wait for previous opioid clearance(for 4times of half life. Oxy 3HR X4 = 12HR)
2. Restless and BP: Ativan + Clonidine
    N/V/Agitation: Compazine/Promethazine/Hydroxyzine + Benadryl
3. m. pain: Dicyclomine, Baclofen, Tylenol, NSAIDS
4. Diarrhea: Loperamide

And

5. Suboxone protocol(4mg Q12HR -> 8mg Qday -> 4mg Qday -> 2mg Qday)
6. Consult for methadone protocol: super long action. (10mg once - would not cause toxicity)


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[CK] Preventing aspiration.

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[CK] Stress-dose gluticocorticoid(steroid) [v ] read and sum! (50mcg IVP solucortef vs 125mg solumedrol=for steroid user>5mg pred.)

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