Clonidine (Catapres) can be used to treat conditions other than hypertension. Nurse Sally is aware that the following conditions might the drug be administered?
A. Phencyclidine (PCP) intoxication
B. Alcohol withdrawal
C. Opiate withdrawal
D. Cocaine withdrawal
Correct Answer: C. Opiate withdrawal
Clonidine is used as adjunctive therapy in opiate withdrawal. Symptomatic treatment in opioid withdrawal includes loperamide for diarrhea, promethazine for nausea/vomiting, and ibuprofen for myalgia. Clonidine can be given to reduce blood pressure. Opioid withdrawal syndrome is a life-threatening condition resulting from opioid dependence. Opioids are a group of drugs used for the management of severe pain. They are also commonly used as psychoactive substances around the world.
Option A: Benzodiazepines and neuroleptic agents are typically used to treat PCP intoxication. Benzodiazepines are the preferred medication for chemical sedation in patients with PCP toxicity. Lorazepam 2 to 4 mg intravenous (IV) or intramuscular (IM), or diazepam 5 to 10 mg IV or IM are recommended. Benzodiazepines are also the first-line treatment for PCP-induced hypertension and seizures. Hyperthermia from PCP toxicity is due to psychomotor agitation and can be successfully treated with benzodiazepines as well.
Option B: Benzodiazepines, such as chlordiazepoxide (Librium), and neuroleptic agents, such as haloperidol, are used to treat alcohol withdrawal. The hallmark of management for severe symptoms is the administration of long-acting benzodiazepines. The most commonly used benzodiazepines are intravenous diazepam (Valium) or intravenous lorazepam (Ativan) for management. Patients with severe withdrawal symptoms may require escalating doses and intensive care level monitoring.
Option D: Antidepressants and medications with dopaminergic activity in the brain, such as fluoxetine (Prozac), are used to treat cocaine withdrawal. Central nervous system (CNS) stimulants like cocaine and amphetamine can also produce withdrawal symptoms. Like opioids, the withdrawal symptoms are mild and not life-threatening. Often the individual will develop marked depression, excessive sleep, hunger, dysphoria, and severe psychomotor retardation but all vital functions are well preserved. Recovery is usually slow, and depression can last for several weeks.