CIWA & COWS Exam
What is the COWS? - ✔✔clinical opiate withdrawal scale
What Is Precipitated Withdrawal? - ✔✔It is a rapid and intense
onset of withdrawal symptoms
initiated by a medication.
To avoid precipitated wi
...
CIWA & COWS Exam
What is the COWS? - ✔✔clinical opiate withdrawal scale
What Is Precipitated Withdrawal? - ✔✔It is a rapid and intense
onset of withdrawal symptoms
initiated by a medication.
To avoid precipitated withdrawal, physically
dependent patients must no longer be? - ✔✔experiencing the agonist effects of an opioid
Short-acting Opioids: - ✔✔(Heroin, Crushed OxyContin, Percocet, Vicodin, Oxycodone and
others)
Long-acting Opioids: - ✔✔OxyContin, taken orally
Points to know about the COWS and giving Buprenorphine: - ✔✔-cant be actively high on
opioids, COWS scores 5-24
-if transitioning from methadone to Buprenorphine, do it slowly
In the
case of Buprenorphine, - ✔✔because it has a higher binding strength at the opioid receptor, it
competes for the receptor, "kicks off" and
replaces existing opioids.
-If a significant amount of opioids are expelled from the receptors and replaced, the opioid
physically dependent patient will feel the rapid loss of the opioid effect, initiating withdrawal
symptoms.
The goal of induction is to safely suppress opioid withdrawal as rapidly as
possible with? - ✔✔adequate doses of Buprenorphine. Failure to do so may cause patients to use
opioids or other medications to alleviate opioid withdrawal symptoms or may lead to early
treatment dropout
What is the CIWA-ar? - ✔✔Alcohol Withdrawal Assessment Scoring
Prophylactic medication should be started for any patient with a total CIWA-Ar score of? - ✔✔8
or greater
If started on
scheduled medication, additional PRN medication should be given for a total CIWA-Ar score of?
- ✔✔15 or greater
The CIWA-Ar scale is the most sensitive tool for assessment of the patient experiencing? - ✔✔-
ETOH withdrawal
Early intervention for CIWA-Ar score of 8 or greater provides the best means to prevent? -
✔✔progression of withdrawal
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