Chemical mediators Histamine Stored in granules of basophils, mast cells, platelets Causes vasodilation and increased capillary permeability Serotonin Stored in platelets, mast cells, enterochromaffin cells

Cellular response Blood flow through capillaries in area of inflammation slows as fluid is lost and viscosity increases Neutrophils and monocytes move to inner surface

Inflammation Sequential response to cell injury that: Neutralizes and dilutes inflammatory agent Removes necrotic materials Establishes an environment suitable for healing and repair Inflammatory response

Health Promotion Prevention Teach about negative effects Provide support Early detection Initiate brief interventional techniques Refer for treatment Gerontologic Considerations Older adults are often unaware

Nursing Management Substance Use Nursing Assessment Screening, Brief Intervention, and Referral to Treatment (SBIRT) Screening for problems using standardized screening tools Brief intervention or teaching

Inhalants Household and workplace products contain chemicals with psychoactive properties when inhaled Rapidly absorbed and reach CNS quickly Most are depressants Long-term use can result

Depressants Rapid development of tolerance and dependence Commonly used with alcohol Commonly types used: Sedative-hypnotics Barbiturates Benzodiazepines Barbiturate-like drugs Depress CNS Tolerance develops to drug’s

Stimulants Highly addictive Increase cardiac activity Excite CNS by increasing neurotransmitters Norepinephrine Serotonin Dopamine Toxicity Sympathetic overdrive Can be fatal No antidote Emergency management is

Alcohol Withdrawal Delirium Serious complication Can occur 2-3 days after the last drink Lasts 2-3 days Risk increases with greater alcohol dependence Manifestation Interprofessional Care

Manifestations Interprofessional Care Agitation Anxiety Increased Heart rate Increased BP Sweating Nausea Tremors Insomnia Hyperactivity Benzodiazepines e.g. lorazepam (Ativan) or midazolam (Versed) to prevent seizures

  Effects of aging Drug-receptor interaction Brain receptors become more sensitive, making psychoactive drugs very potent. Metabolism Liver mass shrinks. Hepatic blood flow and enzyme

Nursing management Nurses play a critical role Conducting a comprehensive history and physical assessment Participating in plan of care Teaching patient and caregiver Symptom management