Okay, now let’s talk about CNS depressants
and the dangerous combinations
that they bring about.
The reason CNS depressants are a problem
is because CNS depressants,
that means the central nervous
reduces my brain's ability to
have a level of awareness
and it makes me kind of sleepy
and it definitely impairs your memory.
So, sometimes people want
that affect a little bit—
we want you to be a little drowsy,
we want some of that relief—
but if you take 2 types of medications
that both have CNS depressant effects,
that’s a dangerous combination.
So, let’s look at some of the medications.
Now, look at this first of all.
Alcohol is a drug.
I know we like to think that it is not,
but it is actually considered a drug
and a CNS depressant.
So, we don’t want to combine alcohol
with something like a benzodiazepine
which has another significant
CNS depressant effect.
When people combine alcohol
you end up with a real risk of overdose
or having significant CNS depressant
effects that can be life threatening.
Now, another one is a lot more available.
Antihistamines like diphenhydramine.
Now, you may know that from
the name Benadryl,
but you don’t want anyone kicking
back these drugs with alcohol.
So, we’ve got alcohol,
benzodiazepines, barbiturates, antihistamines,
or opioid narcotics like morphine
or heroin or oxycodone.
We don’t want these in combination
in any way, shape or form.
So, if I’m on a benzodiazepine, you don’t also
want to take something like Benadryl.
If I’m on a barbiturate, you don’t want
to take a drink of alcohol.
So, you don’t want any of
these drug categories
taken at the same time.
If you follow any of the news, you know that
this is often how people overdose
inadvertently or accidently because
they mix CNS depressants,
they take multiple pills, or multiple
pills with alcohol.
So, educate your patient so
they clearly understand
they should not combine
these types of drugs.
Now, we talked about CNS
depressants and alcohol,
let’s move on to vancomycin.
Now, you see that picture on the screen.
That’s a pretty graphic response right there.
This is a hypersensitivity reaction.
Now, when someone received vancomycin,
we know that they have the possibility
of experiencing this.
We think it’s probably more like an allergic
reaction or an anaphylactic reaction.
It has a name—it’s been called
this for a long time—
Red Man Syndrome, and that comes
from the rash that you see there.
So, the patient,
after the start of vancomycin,
usually given IV,
they get severe flushing, they get
a rash, severe itching,
their heart may race, and their
blood pressure may drop.
It’s pretty dramatic,
but you know we can prevent this.
We can minimize the risk
of a patient having
that type of reaction
if we’ll just infuse it slowly
and consider premedicating with
acetaminophen (which is Tylenol)
and maybe even some diphenhydramine
(remember that’s that CNS
that is an antihistamine).
So, I want you to start thinking
in your mind—
we’ve already talked about adverse effects
of alcohol, CNS depressants—
now, we’re moving to vancomycin
which is an IV.
So, when someone starts to
receive this medication,
if they start to tell you that
they are itching,
they’re flushing, you need
to slow down the rate
of that IV administration.
So, keep that in mind.
These pictures will help that
really stick out in your mind.
We can help minimize the risk of this
if we give it very slowly
and we premedicate before
we give it to them.