39: Medications and Substance Abuse - Hills Flashcards Preview

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

withdrawal from alcohol can cause…

A

seizures
hallucinations
death

2
Q

management of alcohol withdrawal

A

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
Q

medication to decrease cravings or compulsion to drink

A

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
Q

disulfuram MOA

A

inhibits acetaldehyde dehydrogenase

exposure to alcohol causes the person to become very ill

compliance is not good

5
Q

management of opiate detox S

A

symptomatic

  • clonidine
  • dicyclomine
  • loperamide
  • benzos

OR

opiate replacement

  • methadone (long-acting opiate to taper off)
  • buprenorphrin (mixed agonist/antagonist) (started after withdrawal)
6
Q

Suboxone ***

A

buprenorphine (mixed) combined with naloxone (antagonist)

  • naloxone isn’t orally absorbed but is present is someone tires IV –> prevent euphoria and immediate withdrawal
7
Q

Naltrexone ***

A

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
Q

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

A

varenicline (chantix)

9
Q

bupropion

A

antidepressant and anti–smoking

Ne/DA reuptake inhibitor

10
Q

help for cannabis/psychaldelic withdrawal

A

no meds for withdrawal or maintaining abstinence

treat symptoms

11
Q

cocaine/stimulant withdrawal

A

no med to aid in acute withdrawal

12
Q

*** risk meds for someone using alcohol

A

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
Q

don’t mix opiates with

A

other sedating medications (increase risk of respiratory suppression)

14
Q

don’t mix cocaine/stimulants with…

A

prescribed stimulants for ADHD (cardiac risks)

antipsychotics that affect cardiac rhythm

15
Q

nicotine increases the metabolism of …

A

antipsychotics

results in reduced effectiveness for a given dose

16
Q

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

A

continuation of med should be seriously considered