Question

1. Describe the difference between drug dependence and drug tolerance; 2. Describe how withdrawal symptoms can be avoided; 3. What assessment findings would be expected in a patient who has stimulation of the sympathetic nervous system or who uses sympathomimetic (adrenergic) drugs? 4. Order: loxapine (Loxitane) 75 mg, IM, daily Available: loxapine (Loxitane) 50 mg/1 ML How many milliliters (ML) will the patient receive?

Answer 1

Features	Drug Dependence	Drug Tolerance
Definition	Dependence specifically refers to a physical condition in which the body has adapted to the presence of a drug to attain a certain Effect.	It is defined as a person’s diminished response to a drug that is the result of repeated use.
Withdrawal Symptoms	Seen if Individuals Stops Taking Drugs All of A Sudden For Example patient will Experience- Irritability Joint pain Tremors Disturbed sleep Weakness Fatigue	Not seen with the Drugs that Cause Tolerance
Developed	Mostly in illicit Drugs but also in Certain Prescibed medications.	Both illicit Drugs and prescription Medications.
Addiction	Can be Seen	Not Seen
Types	There are 2 types of Drug Dependence- Physical Dependence- It means that the body has developed a physiological reliance on a drug because it has caused changes in its natural state of being. Examples- Opiates, tobacco, and alcohol Psychological dependence affects a person emotionally and mentally. This develops from the memory of the sense of euphoria that the drug creates, causing a person to long for that feeling and think of it often. Examples- Cocaine and Amphetamines.	Acute tolerance occurs over a relatively short period of time. Example- Cocaine Chronic or long-term tolerance occurs when an individual’s body adapts to the effects of a drug under constant exposure over a long period of time, such as weeks or months. Learned tolerance can result from exposure to certain addictive substances such as alcohol.
Treatment	Can Be done Medically along With Detox Programs. For Example- Steroid Tolerance can be treated by Tapering the Drug dose Slowly.	Can be Done Medically. For Example Opoid Tolerance Can Be Dealth With- alpha2-adrenoreceptor agonists such as clonidine and NMDA antagonists such as ketamine or dextromethorphan have been Used.

2.Withdrawal Symptoms Can be Stopped by-

• Attend a medical detox program. This is considered the optimal method for managing withdrawal
• Exercise regularly. Healthy amounts of exercise can help the brain to release endorphins and thus positively restore chemical balance
• Eat balanced and nutritious meals. Diet can play a big role in healing both the mind and body.
• Stay hydrated. Dehydration is common during withdrawal. It is important to drink enough water to allow the body to heal properly.
• Stick to a proper sleep schedule. Getting the proper amount of sleep is vital to healing and emotional health.
• Join a support group. Groups like 12-Step programs and peer support groups (such as Alcoholics Anonymous, or AA) can offer encouragement and tips to come through the other side.
• Complement more traditional medical detox strategies. Chiropractic care, massage therapy, acupuncture, and other alternative medicine options have shown promise in helping to manage withdrawal symptoms and cravings during detox.
• Stretch often, and consider yoga and/or mindfulness meditation. Stretching and yoga poses can stimulate blood flow and circulation, and relieve tension and muscle pain.
• Communicate with a family member, loved one, therapist, or counselor regularly.
• Participate in relaxation techniques. Learning how to slow down thoughts and regulate breathing can help to reduce anxiety and other negative emotions.

4. Order Loxapine = 75 mg

Available = 50mg/ ml

50 mg drug is contained in = 1 ml solution  

1 mg drug is contained in = 1/50 ml solution

75 mg drug is contained in = (1/50) X 75 = 75/50 = 1.5 ml solution

So, We will Order 1.5 ml Of Loxapine.

3. Assesment or findings in a patient with Activation of Sympathetic System are-

ORGAN	ACTION
Eye	Dilation
Heart	Increases rate and force of contraction ( Tachycardia)
Lungs	Dilates bronchioles via circulating adrenaline
Blood vessels	Dilate in skeletal muscle
Digestive system	Constricts in gastrointestinal organs ( Constipation)
Sweat glands	Activates sweat secretion ( Sweating)
Digestive tract	Inhibits peristalsis
Kidney	Increases renin secretion
Penile	Inhibits tumescence
Ductus deferens	Promotes emission prior to ejaculation