39: Medications and Substance Abuse - Hills Flashcards Preview

CS3: Exam 3 > 39: Medications and Substance Abuse - Hills > Flashcards

Flashcards in 39: Medications and Substance Abuse - Hills Deck (16):
1

withdrawal from alcohol can cause...

seizures
hallucinations
death

2

management of alcohol withdrawal

benzodiazepines (lorazepman, diazepam, or chlordiazepoxide)

activate the GABA neurotransmitter system like alcohol (downregulated in chronic alcohol use)

benzos can also be used inw ithdrawal from other benzos and barbiturates

3

medication to decrease cravings or compulsion to drink

naltrexone
- an opiate antagonist that interferes with pleasure response to alcohol
- decreases heavy drinking - potential adverse effects on liver

ALSO

acamprosate
- affects the balance of GABA and glutamate
- reduces hyperarousal of early sobriety

ALSO

topiramate
- anti-epilepsy med that also helps put the brake on glutamate and increase GABA activity in brain

4

disulfuram MOA

inhibits acetaldehyde dehydrogenase

exposure to alcohol causes the person to become very ill

compliance is not good

5

management of opiate detox S

symptomatic
- clonidine
- dicyclomine
- loperamide
- benzos

OR

opiate replacement
- methadone (long-acting opiate to taper off)
- buprenorphrin (mixed agonist/antagonist) (started after withdrawal)

6

Suboxone ***

buprenorphine (mixed) combined with naloxone (antagonist)

- naloxone isn't orally absorbed but is present is someone tires IV --> prevent euphoria and immediate withdrawal

7

Naltrexone ***

same opiate antagonist that can be used for maintaining alcohol abstinence can be used to help maintain opiate abstinence

doesn't reduce craving but stops opiate from having pleasurable effect

8

nicotinic receptor partial agonist prescribed as way to transition away from tobacco

varenicline (chantix)

9

bupropion

antidepressant and anti--smoking

Ne/DA reuptake inhibitor

10

help for cannabis/psychaldelic withdrawal

no meds for withdrawal or maintaining abstinence

treat symptoms

11

cocaine/stimulant withdrawal

no med to aid in acute withdrawal

12

*** risk meds for someone using alcohol

lithium (diuresis for alcohol lead to dehydration and increased toxicity)

bupropion (lowers seizure threshold)

any sedating medicine - augmented by alcohol

benzos and barbiturates - additive effect with alcohol - dangerous inhibition

effectiveness of antidepressant meds is limited

13

don't mix opiates with

other sedating medications (increase risk of respiratory suppression)

14

don't mix cocaine/stimulants with...

prescribed stimulants for ADHD (cardiac risks)

antipsychotics that affect cardiac rhythm

15

nicotine increases the metabolism of ...

antipsychotics

results in reduced effectiveness for a given dose

16

if stopping a medication would likely worsen psychiatric symptoms that are promoting substance abuse for self-medicating...

continuation of med should be seriously considered