Substance Abuse and Abuse Q 65

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The nurse administers bromocriptine (Parlodel) to Bryan who is undergoing detoxification for amphetamine abuse. The rationale for this medication is to:

  

     A. Aid in GABA inhibition

     B. Prevent norepinephrine excess

     C. Restore depleted dopamine levels

     D. Treat psychotic symptoms

    

    

Correct Answer: C. Restore depleted dopamine levels

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Amphetamine abuse depletes the neurotransmitter dopamine. When withdrawing from amphetamines, dopamine depletion causes depression, insomnia, and intense craving for the drug. Bromocriptine (Parlodel) is a dopamine agonist that will help restore this neurotransmitter. GABA inhibition, prevention of norepinephrine excess, and treatment of psychotic symptoms are incorrect rationales for the use of this medication.

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Option A: Bromocriptine is a dopamine receptor agonist that has selective agonist activity on D2 dopamine receptors while simultaneously acting as a partial antagonist for D1 dopamine receptors. Dopamine agonism has variable effects depending on the target tissue.

Option B: The patient acutely intoxicated on amphetamines will require chemical and physical restraints to prevent self-harm or harm to others, as these patients can be hostile with severe paranoia. Some life-threatening signs and symptoms need to be addressed on an emergent basis such as trauma, compromised airway, seizures, and any cardiac dysrhythmias.

Option D: Amphetamine abuse is widespread and associated with a significant impact on cardiovascular and neurological systems in overdose. In many parts of the world, amphetamines have been an abused class of drugs since the 1930s. Methamphetamine (METH) and its derivative, 3,4-methylenedioxymethamphetamine (MDMA), are extensively abused drugs, and the acute effects of these drugs include increased alertness, hyperthermia, decreased appetite, and euphoria.

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