· Sedative-Hypnotics (Benzodiazepines) and Barbiturates
o Often co-ingestion with alcohol.
o S/S: Central nervous system and respiratory depression, slurred speech, incoordination, drowsiness.
o TX: Assist breathing, Flumazenil (Romazicon) competes with benzodiazepines at the receptor sites but can induce seizures so consider the benefit versus the risk.
· Gamma-hydroxybutyrate (GHB, “date-rape” drug)
o Odorless with salty taste so typically added to alcoholic beverages.
o S/S: Drowsiness, confusion, and amnesia last 3-6 hours.
· Rohypnol (flunitrazepam) Benzodiazepine
o S/S: drowsiness, amnesia, blackout, impaired motor coordination, bradycardia.
· Opiates (Opioids, Narcotics)
o S/S: Central nervous system and respiratory depression, miosis, pulmonary edema, apnea, coma.
o TX: Assist breathing, Naloxone (Narcan) IM, IM, SQ, or IN, in 0.2 mg increments to improve respiration only, repeating as needed every 20-60 minutes (short half-life) or titrate a continuous infusion. Full and sudden awakening with 2 to 4 mgs is dangerous for everyone.
o Heroin withdrawal causes restlessness, insomnia, vomiting, diarrhea, abdominal pain. TX: Methadone, buprenorphine, or naltrexone.