Jack Osborne Rehab.... - page 2

I couldn't agree more! If you had seen the MTV interview (I know MTV isn't what it use to be) you would have seen Jack Osbourne talk about his mother having cancer, her hospitaliztions, and that many people kept the real facts of her illness from him. (She became quite sick from what I understand.) He couldn't handle it anymore, and his alcohol and marijuana use turned into alcohol and other drug bienging. He nearly broke down crying. He had then said he was sorry for putting his family, especially his mother through all of it.

Now, that isn't just a rich kid's recreation only because he didn't "fit in."

taken from http://www.headachepainfree.com/oxycontin.htm

What is Oxycontin?

OxyContin (Oxycodone hydrochloride controlled-release) is an opioid analgesic in time-release form. Which means a small amount of the drug is absorbed over a 12 hour period.

The active ingredient in Oxycontin is Oxycodone which is the main ingredient in Percocet, Percodan, Tylox, Roxicet, Oxycocet, OxyIR, Endodan, Endocet and probably a few more names not mentioned. Oxycodone has been around for years and is used for moderate to severe pain. It is a Schedule II controlled substance. It works by inhibiting ascending pain pathways in the Central Nervous System, increases the pain threshold, and alters pain perception.

The problem with Oxycodone is after using it for a while the body develops a natural tolerance to the medication, as it does with all opiates. In order to get the same affect the person needs to increase the dose. This does not mean the person is addicted. There is a difference between tolerance and addiction.

The problem that chronic pain sufferers have with opiates is the need to increase the dose to get the same affect. Before Oxycontin came along the patient would increase their dose as tolerance developed and this increased the risk of side effects of the other ingredient in the medication. For example: Percocet contains Oxycodone 5mg with Acetaminophen 325mg. Increasing the dose of this medication also increases the dose of Acetaminophen that the person gets.

Another downfall of fast acting medications is that you get a peak affect in 2 hours and then a sudden drop of the medication. So the patient was unable to keep a steady level of the drug in their system.

In the past in order to get adequate pain relief, the patient would have to switch to another medication and found it did not work as well as the Oxycodone.

In 1996 the Purdue Pharmaceutical company came out with the Oxycontin, the first oxycodone pain medication that is time released (MSContin is also made by Purdue and is a time released form of Morphine). These are the only two opiate pain relievers available in a sustained released formula.

With Oxycontin the patient can get Oxycodone (A very effective medication for pain) in a sustained released formula without the adverse affects of acetaminophen or aspirin that is in many of the fast acting formulas. It releases small amounts of Oxycodone over 12 hours, keeping the therapeutic levels of this drug in the blood stream. This was a Godsend for pain patients. For the first time they could get adequate pain control in a sustained released product. This gave many patients a new outlook on life. For many this was the first time they were able to get through their day Painfree! Because it is sustained released it does not cause an elevation in medication blood levels like the fast acting drugs do. It keeps a steady, constant level of Oxycodone in the bloodstream, resulting in adequate pain relief.

Contrary to popular belief you do not need to be a Cancer patient to take Oxycontin. It works very effectively for patients suffering with chronic pain. Most of these patients try hundreds of other medications before finally deciding to go on Opiate treatment. Contrary to popular belief, patients who take Oxycontin are not junkies, drug seekers, drug addicts or poor. They are normal people who suffer with a condition that causes excruciating daily pain and have tried everything to try and control this pain. They are your mothers, children, neighbors and friends. All they want is to be able to live their lives without pain.
What Dose of Oxycontin is safe?

OxyContin is supplied in 10 mg, 20 mg, 40 mg, 80 mg, and 160 mg tablet strengths. The tablet strengths describe the amount of Oxycodone per tablet. The medication is sustained released and lasts for 12 hours. The pills are given every 12 hours in order to keep a constant level of the drug in the system.

Oxycontin should not be used for quick pain relief. It should be used by those patients who suffer with chronic daily pain that is moderate to severe. It is not for mild pain or for temporary pain, such as after dental or surgical procedures.

Each patient has to be dosed individually. What works for one patient may not work for another. This is true for all the opiates. Physicians start out with the lowest dose and gradually increase that dose until they reach the point of pain relief.

There are different criteria for different people. It depends on age, weight, type of pain, history of taking opiate's in the past.

In a person who has never taken opiates they start them on the absolute lowest dose. In a person who has been on opiates in the past the starting dose will be higher.

Oxycontin was produced to provide a time release of the active ingredient - oxycodone. The pills should not be broken in half, crushed, snorted, or injected. Doing this could cause a fatal dose of the medication to be released suddenly.
How it works

OxyContin is an opioid agonist. Opioid agonists are substances that act by attaching to specific proteins called opioid receptors, which are found in the brain, spinal cord, and gastrointestinal tract. When these drugs attach to certain opioid receptors in the brain and spinal cord they can effectively block the transmission of pain messages to the brain.
What are the side effects?
Side effects/Adverse Reactions

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CNS: Drowsiness, dizziness, confusion, headache, sedation, euphoria
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GI: Nausea, vomiting, anorexia, constipation, cramps.
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GU Increased urinary output, dysuria, urinary retention
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INTEG: Rash, urticaria, bruising, flushing, diaphoresis (Sweating), pruritus (itching)
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EENT: Tinnitus, blurred vision, miosis, diplopia
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CV: Palpitations, bradycardia, change in BP
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RESP: Respiratory depression

Contraindications

Hypersensitivity, addiction (narcotic)
Precautions

Addictive personality, pregnancy (B), lactation, increased intracranial pressure, MI (Acute), severe heart disease, respiratory depression, hepatic disease, renal disease, child <18.
Pharmacokinetics

Detoxified by the liver, excreted in the urine, crosses placenta, excreted in breast milk.
Interactions

Increased effects with other CNS depressants: Alcohol, narcotics, sedative/hypnotics, antipsychotics, skeletal muscle relaxants.
Lab Test Interference

Increases Amylase
Overdosage

Signs and Symptoms: Serious overdose of oxycodone HCl is characterized by respiratory depression (a decrease in respiratory rate and/or tidal volume, Cheyne-Stokes respiration, cyanosis), extreme somnolence, progressing to stupor or coma skeletal muscle flaccidity, cold and clammy skin, and sometimes bradycardia and hypotension. In serious overdosage, apnea, circulatory collapse, cardiac arrest, and death may occur.

Treatment: Primary attention should be given to the reestablishment of adequate respiratory exchange through provision of a patent airway and the institution of assisted or controlled ventilation. The narcotic antagonist naloxone is a specific antidote against respiratory depression which may result from overdose or unusual sensitivity to narcotics, including oxycodone. Therefore, an appropriate dose: 0.4 mg should be administered, preferably by the IV route, simultaneously with efforts at respiration resuscitation. Since the duration of action of oxycodone may exceed that of the antagonist, the patient should be kept under continued surveillance and repeated doses of the antagonist should be administered as needed to maintain adequate respiration.

An antagonist should not be administered in the absence of clinically significant respiratory or cardiovascular depression.

Oxygen, IV fluids, vasopressors and other supportive measures should be employed as indicated. Gastric emptying may be useful in removing unabsorbed drug.



Nursing Considerations
Assess

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I&O ratio; check for decreasing output; may indicate urinary retention
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CNS changes: dizziness, drowsiness, hallucinations, euphoria, LOC, pupil reaction
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Allergic reactions; rash, urticaria - NOTE* These type of pain relievers cause a release of histamine which can cause itching. This is a normal body response to the increase in histamine and not an allergic reaction. This symptom goes away after a few days of use. Rash and hives with the itching is a sign of allergic reaction.
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Respiratory dysfunction: respiratory depression, character, rate, rhythm; notify prescriber if respirations are <10/min
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Need for pain medication by pain, sedation scoring; physical dependence.

Administer

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With antiemetic if nausea, vomiting occur
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Do not break or crush tablets. Tablets should be give whole!
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You may need to give short acting pain medications for breakthrough pain. Usually OxyIR is used. If the patient needs more than 2 OxyIR, daily for breakthrough pain then a re-evaluation of the maintenance dose should be done.

Perform/Provide

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Support, support and more support. Reassure the patient that the need for an increase in medication does not mean that they are addicted to the medication. Reassure them that a natural "tolerance" develops with time. Reinforce this with family members.
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Safety measures: Side rails, nightlight, call bell within easy reach.

Evaluate

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Therapeutic response: Decrease in pain.

Treatment of Overdose

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Naloxone (Narcan) 0.2-0.8mg IV, O2, IV fluids, vasopressors.

Teach patient/family

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To report any symptoms of CNS changes, allergic reactions.
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That physical dependency may result from extended use.
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That withdrawal symptoms may occur if they suddenly stop their medication: nausea, vomiting, cramps, fever, faintness, anorexia.

Good points. For those of you who do not understnad why people would ever abuse drugs, I am so glad you have never had to deal with this in your family or close circle of friends. I have a friend from high school who became addicted to heroin. The struggle for her has been long and hard. Unfortunately for her, she is an heiress, and has millions of dollars at her disposal and her family is emotionally abusive. At 33, she has finally escaped her addiction (hopefully) and is living across the united states away from everyone she ever befriended after her addiction. There were times when I wanted to give up on her, but I never did. I told her not to call me when she was high, so sometimes I would not hear from her for a year, but I never gave up hope that she would beat this thing.

I don;t make excuses for her, but I have empathy. I have plenty of empathy. And it extends to even the most drug addicted and alcohol addicted. I do not pussyfoot around with the addicted; I tell them that what they do is wrong and list reasons, but I also allow them the human dignity of retaining their own individual perspective. I have not walked in their shoes. i do not know if I could withstand what they withstand. So I do not judge.

I hope that Jack Osbourne is able to receive the help he needs. His mother is the glue in that family. I think he is a very frightened and lonely teenager who has been thrust into the limelight at the time he found out that he might lose his mother to cancer. How much can a person take? I guess we will find out. I wish him the best.