Downloaded 13 times
More Related Content
Similar to Inhalant use disorder.pptx
Inhalant use disorder.pptx
- 1. INHALANT(VOLATILE) USE DISORDER AND NICOTINEABUSE Presentation by : Arshid Ahmad B.Sc Nursing 3rd year, MMINSR, SKIMS
- 2. Contents • INHALANT USEDISORDER • Introduction • Defnition • Commonly used inhalants • Epidemiology • Methods of use • Clinical effects • Intoxication • Tolerance and dependence • Complications • Diagnosis • Managment-medical and nursing • Nicotine abuse • Introduction • Defnition • Addiction statistics • Methods of use • Symptoms • Effects • Intoxication • Withdrawl symptoms • Management- medical and nursing
- 3. Introduction • Inhalant abuse– also known as volatile substance abuse, solvent abuse, sniffing, huffing and bagging – is the deliberate inhalation of a volatile substance to achieve an altered mental state. • Inhalant use–related problems affect youths worldwide, particularly socioeconomically disadvantaged children and adolescents . • Inhalant use is a serious public health concern and has several adverse medical consequences. It is associated with substantial cardiac, renal, hepatic, and neurological morbidity and mortality.
- 4. DEFINITION Inhalant use isdefined as the deliberate inhalation of volatile substances (e.g., glue, shoe polish, gasoline, paint, cleaning fluids, amyl nitrite), either by sniffing, snorting, bagging, or huffing the substance, in order to induce a psychoactive or mind- altering effect.
- 5. What are Inhalants? •Inhalantsare legal, everyday products which have a useful purpose, but can be misused. . COMMONLY ABUSED INHALANTS 1. Volatile solvents: Includes Glues(toulene), correction fluids, marker pens,paint thinners and removers,petrol etc. 2. Aerosols: Deodorants , hair sprays etc. 3. Gases: Butane , propane,ansthetic gases( nitrous oxide) 4. Nitritis
- 6. EPIDEMIOLOGY •Volatile Substance Misuseis a worldwide problem. The psychiatric morbidity survey(2009) suggests that in households in England, lifetime use of volatile Substance was about 1.4%. •Amyl Nitrite (poppers) appears to be more commonly used. •Volatile Substance Misuse is highly prevalent among the young homeless population in south American countries. •It is found mainly in men and is more common in individuals from lower socioeconomic groups.
- 7. Methods of use •Themethod of injestion depends on the substance used and include inhalation from: . ✓ Top of bottles ✓ Beer cans ✓ Cloths held over a mouth. ✓ Plastic bags ✓ Sprays
- 8. Clinical effects ofinhalant abuse
- 10. Tolerance and dependence 1.Dependence can develop if its use is regular 2. Physical withdrawl symptoms • Sleep disturbance • Irritability • Nausea • Tachycardia • Anxiety • Hallicunations • Dillusions 3. With sustained use over a period of 6-12 months tolerance can develop.
- 11. Complications •Chronic users mayshow evidence of Neurotoxic effects. •Severe and disabling peripheral neuropathy (in teenage misusers). •Impaired cerebral function. •Encephalitis •Dementia. •It can also cause irreversible damage to liver, kidneys,heart and brain. •It increases the risk of accidents Due to hallucinations.
- 12. Diagnosis ✓It is suggestedby Several features including • Glue on the hands, face ,cloths. • Chemical smell on breath. • Rapid onset and waning of intoxication. • Disorientation in time and space. ✓ Chronic misuse is diagnosed mainly on the basis of an admitted history of habitual consumption, increasing tolerance and dependance. ✓ A suggestive feature is a Facial Rash(glue-Sniffers rash) caused by repeated inhalation from a bag.
- 13. Management General principles: •Acute medicalmanagement(in case if intoxication) •Detailed history (including product used, other substances and psychiatric symptoms) •Physical examination including detailed neurological examination (especially chronic abusers) •Lab investigation for liver and kidney and liver function, ECG. •Pharmological management for withdrawal symptoms. •Psychosocial interventions.
- 14. Pharmacotherapy • Benzodiazepines likediazepam ( acute intoxication) • Baclofen(around 50 mg/day) • Buspirone(40 mg/day) • Lamotrigine(100mg/day) Psychosocial interventions • Cognitive behaviour therapy: • Motivational intervention: • Family counseling: • Activity and engagment Programmes:
- 15. Nurses Role • Teachthe family about the inhalant abuse and it’s effects on entire family • Meeting the potential health problems and nutrition advice to patients and families. • Nurses meet the basic needs like safety, hygiene, comfort,calm and quite environment of the patients. • Adminster substitution therapy • Prompt interventions in emergencies like LOC and respiratory arrest. • Monitoring withdrawal symptoms and their appropriate management. • Teach the patient/family how to recognise psychosocial stressors that may exacerbate inhalant abuse and how to avoid or prevent them. • Teach patient/family about the availability of self help programs to strengthen patient recovery.
- 17. INTRODUCTION •Nicotine is foundin the tobacco plant. •Tobacco leaves are harvested while still green and undergo curing and fermentation to produce commercial products– cigarettes, cigars, snuffs, chewing tobacco and pipe Tobacco. •Tobacco has many constituents, but nicotine has the broadest and most immediate pharmacological action.
- 18. Definition Nicotine is acolourless, toxic alkoliod made up of carbon, hydrogen and nitrogen. • The primary reason why Nicotine use have turned into Worldwide concern is because of its ability to induce a state of Euphoria in the brain of the smoker, thus leading to addiction. • When a person smokes and inhales nicotine, the active substances are absorbed through alveoli into the lungs which initiate chemical reactions in the nerve endings which increases heart rate, Memory, alertness and reaction time.
- 19. • Neurotransmitters calleddopamine and later endorphins are released in the brain producing feeling of pleasure and satisfaction. • As an addictive drug, Nicotine has two very potent issues- it is a stimulant as well as depressent.
- 20. Addiction statistics •Nicotine isused most often in the form of smoking. •Tobacco addiction is the preventable cause of death in the US and the second Leading cause of death in the world •The WHO estimates that there are 1.3 billion smokers worldwide today and contributes approx. 5 million deaths each year. •In India Among adults (age 15+), 28.6% of the population currently uses tobacco products (men 42.4%; women 14.2%). Among youth (ages 13–15): 8.5% currently use some form of tobacco (boys 9.6%; girls 7.4%).
- 21. Methods of NicotineUse • Orally • Sniffed • Smoked( 90%) • Others- Nicotine patches, gums.
- 22. Symptoms of NicotineUse •Tolerance to Nicotine with Decreased effect and increased dose to obtain same effect. •Withdrawal symptoms after cessation. •Smoking more than usual. •Extensive time spent smoking or purchasing tobacco. •Postponing work,social or recreational events inorder to smoke. •Continuity of smoke despite health hazards.
- 23. Physical and psychologicaleffects of nicotine use Physical effects: ✓ increased heartrate ✓ acclerated BP ✓weight loss ✓ decreased appetite Psychological effects: ✓ Enhances Alertness ✓ Stimulate a frantic, almost Manic picture. . ✓ relaxation
- 24. Nicotine intoxication •Nausea. •Vomiting. •Salvation •Pallor •Abdominal pain •Diarrhoea •Cold sweat • Arrythmias • Shock • Death
- 25. Withdrawal symptoms •Cravings •Irritability, anxietyand depression •Restlessness •Weight gain •Trouble concentrating • Headache •Coughing •Sore throat •Aches and pains
- 26. Diagnostic criteria fornicotine addiction A. Daily use of nicotine for atleast several weeks. B. Abrupt cessation of tobacco use, followed within 24 hours by four or more of the following signs: • Dysphoric or depressed mood • Insomnia • Irritability, frustration and anger • Anxiety • Difficulity concentrating • Restlessness • Decreased heartrate • Increase appetite C. The symptoms in the criterion B cause clinically significant impairment in social, occupational and other important areas of functioning. D. The symptoms are not due to a general medical condition.
- 27. Management 1. Nicotine replacementtherapy: . ✓Transdermal nicotine patches ✓Nasal sprays ✓Orally adminsterd products (nicotine gum, lozenge,inhaler) 2. Non-Nicotine therapies: ✓Bupiropian(300 mg/day: 150mg BID) ✓Verenicline ✓Nortriptyline 3. Novel therapies: . ✓anti smoking vaccine (nic vax) ✓green smoke e-cigarette
- 28. • 4 Motivationaltherapies • 5. Councelling • 6. Aversion therapy Treatment of Nicotine intoxication •Benzodiazepines •Iv fluids To treat low bp •Ventilatory support
- 29. Nurses role 1. Clienteducation and prevention of nicotine use. 2. Nurses are involved in each level of prevention • Primary prevention • Secondary prevention • Teritary prevention 3. During acute episodes: • Continuously moniter the patients vital signs And input/output • Watch for complications of withdrawal and Overdose • Maintain a quite and safe environment • Approach the patient in non threatening way.
- 30. •Adminster IV fluidsto increase circulatory volume •Give medication as ordered •Teach the patient/family About Local self help groups to strengthen patients recovery •During withdrawal •Adminster medication as ordered, to decrease withdrawal symptoms, moniter and record their effectiveness. •Maintain a quite safe environment because excessive may agitate the patient.