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Pharm 313 Fall 21 > SUD + Glucocorticoids > Flashcards

SUD + Glucocorticoids Flashcards

1
Q

route for prednisone

A

oral

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2
Q

route for methylprednisone (Solumedrol)

A

IV

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3
Q

which class of drugs provides the greatest anti-inflammatory action, NSAIDs or glucocorticoids?

A

glucocorticoids

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4
Q

MOA for glucocorticoids

A

suppresses immune system + inflammatory response

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5
Q

re: the MOA for glucocorticoids, what is the implication for clinical practice?

A

people might present with fewer or no inflammatory response to injuries - we are not cued in as much as we would be with patient with normal functioning immune system

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6
Q

re: MOA of glucocorticoids, these patients are at an increased risk of what?

A

infection

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7
Q

explain precautions with glucocorticoid therapy and vaccinations

A

these patients should avoid live vaccines, as well as any people they live with.

they will have a decreased response and need boosters!

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8
Q

8 SE of glucocorticoids

A
  1. hyperglycemia
  2. fluid retention –> weight gain
  3. Cushing’s Syndrome
  4. hyperactivity –> insomnia
  5. psychological reactions
  6. thinned skin
  7. capillary fragility
  8. increased GI bleeding risk
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9
Q

what should you monitor in patients with DM taking glucocorticoids?

A

blood glucose levels

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10
Q

what causes fluid retention with glucocorticoid use?

A

mineralcorticoid activity

–> Na retention + K loss

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11
Q

what should we monitor for with patients taking glucocorticoids and furosemide?

A

HYPOkalemia (it’s a K+ losing diuretic)

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12
Q

Cushing’s syndrome causes which 3 conditions? and which 3 hall mark signs can we observe?

A
  1. hyperglycemia
  2. f+e imbalances
  3. osteoporosis
  4. buffalo hump
  5. moonface
  6. potbelly
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13
Q

knowing some SE of glucocorticoids, when should we administer these meds?

A

9am, or as early as possible

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14
Q

how can we decrease PUD risk with glucocorticoids?

A

take with food or milk + caution when taking with ASA

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15
Q

what are things to know about stopping glucocorticoid treatment?

A

WEAN slowly to avoid adrenal insufficiency

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16
Q

S+S of adrenal insufficiency (4)

A

hypoglycemia, hypotension, myalgia, fatigue

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17
Q

S+S of MILD AUD withdrawal (5 things)

A
  1. disturbed sleep
  2. weakness
  3. nausea
  4. anxiety
  5. mild tremors
18
Q

when can SEVERE S+S occur with AUD withdrawal

A

12-72 hours after last drink

19
Q

S+S of SEVERE AUD withdrawal

A

cramping, vomiting, hallucinations, tremors, seizures, increased VS

(think neuro issues +VS)

20
Q

what is delirium tremens

A

severe hallucinations, CV collapse, death

21
Q

what is CIWA’s purpose

A

tool to assess severity of alcohol withdrawal; keep person from severe stages of withdrawal (medication management)

22
Q

3 classes of drugs for ACUTE alcohol withdrawal (name example of each)

A
  1. benzos (Ativan)
  2. BP meds (atenolol, clonidine)
  3. anti-eleptic drugs (carbamepazine - Tegretol)
23
Q

which is the MOST EFFECTIVE class of drugs for acute alcohol withdrawal? how does it work?

A

benzodiazepines (Ativan)

CNS depression - calms down gaba

24
Q

how do BP meds help with alcohol withdrawal

A

reduce cravings + improve VS

25
Q

what are the 2 drugs to maintain alcohol abstinence

A
  1. disulfram (Antabuse)

2. naltrexone (Re Via)

26
Q

which drug is the MOST EFFECTIVE for alcohol abstinence?

A

naltrexone (Re Via)

27
Q

MOA for disulfram (Antabuse)

A

unpleasant rx when ETOH consume - N/V, flushing, palpations, HA, hypotension

28
Q

a person can have disulfram effects how long after last dose?

A

up to 2 weeks

29
Q

MOA for naltrexone (Re Via)

A

blocks dopamine release

blocks pleasure effects + decreases cravings

30
Q

nicotine withdrawal symptoms

A

HA, irritability, nervousness, increased appetite, weight gain, insomnia

31
Q

name some nicotine agents for smoking cessation

A

gum, lozenge, patch, nasal spray, inhaler

32
Q

what is the MOST EFFECTIVE non-nicotine drug for smoking cessation

A

varenicline (Chantix)

33
Q

what combination of drug do they recommend with smoking cessation?

A

patch WITH short acting product (gum)

34
Q

what are the two non-nicotine agents for smoking cessation?

A

varenicline (Chantix) + buproprion (Zyban)

35
Q

MOA for buproprion

A

CNS stimulation

36
Q

early S+S of Opioid use disorder withdrawal

A

yawning, runny nose, sweating (parasympathetic nervous system)

37
Q

later S+S of opioid use disorder withdrawal

A

anorexia, irritability, tremor, goose bumps (SNS)

38
Q

worse S+S of opioid use disorder withdrawal

A

violent sneezing, weakness, N/V/D, muscle spasms

39
Q

between opioid use withdrawal and ETOH withdrawal, which is dangerous and life-threatening?

A

ETOH withdrawal

40
Q

COWS scale measures what?

A

clinical opioid withdrawal scale

41
Q

3 drugs to manage opioid addiction + their class

A
  1. methadone (agonist)
  2. buprenorphine - Suboxone (agonist-antagonist)
  3. naltrexone (antagonist)
42
Q

which drug is used AFTER opioid detox b/c it’s an antagonist?

A

naltrexone (Re Via)

Pharm 313 Fall 21 (16 decks)

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