Management of Opiate Misuse Flashcards

1
Q

heroin has a ___ half life

A

short

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2
Q

2 main constituents of opium

A

morphine

codeine

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3
Q

what do you add to morphine to get heroin?

A

add 2 acetyl rings to the morphine molecule

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4
Q

medical term for snorting?

A

insufflation

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5
Q

why does heroin cross the BBB easily?

A

due to its 2 acetyl groups

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6
Q

heroin is metabolised to ___ in the body

A

morphine

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7
Q

if you do a drug screen and you detect 6-mono-acetylmorphine what does this mean?

A

indicative of recent definite heroin use

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8
Q

if you do a drug screen and detect morphine, what does this mean?

A

the patient could have had either codeine or heroin as both metabolise to morphine

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9
Q

effect of heroin?

A
initial euphoria
analgesia
respiratory depression
bradycardia and hypotension
pupillary constriction
constipation
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10
Q

what is gouching?

A

nodding off due to drowsiness

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11
Q

why can teeth look in bad condition in heroin addicts?

A

depressed salivary production

increased analgesia so cant feel toothache

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12
Q

withdrawal symptoms typically occur between _ to _ hours

A

6-8 hours

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13
Q

how often do heroin addicts use the drug per day?

A

3

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14
Q

withdrawal symptoms from heroin?

A
dysphoria
cravings
agitation
tachycardia and hypertension
diarrhoea/N+V
piloerection
join pains
dilated pupils
yawning
runny nose/watery eyes
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15
Q

local complications of IV drug use?

A

cellulitis
abscess
thrombophlebitis
NF

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16
Q

distant complications of IV drug use?

A

infective endocarditis

17
Q

systemic complications of IV drug use?

A

hep b/c

HIV

18
Q

thrombotic/embolic complications of IV drug use

A

DVT
PE
ischaemic limb

19
Q

main reason for death of heroin?

A

respiratory depression

20
Q

what combination of drugs are commonly causative of multi-drug related deaths in heroin addicts?

A

opiates
benzodiazepines
gabapentin/pregabalin

21
Q

heroin causes psychosis T or F

A

F

22
Q

heroin causes delirium T or F

A

F

23
Q

what does opiate substitution therapy do?

A

replaces a short acting opiate with a long acting opiate eg methadone

24
Q

why is OST good?

A

reduces HIV risk
reduces mortality
no longer having to seek drugs

25
Q

what long acting opiates are used in OST

A

methadone

buprenorphine

26
Q

methadone is given in what preparation?

A

liquid

27
Q

how does heroin assisted treatment

A

give methadone 1x per day

prescribe heroin 3x a day under supervision

28
Q

clozapine side effects?

A
constipation
agranulocytosis
myocarditis
weight gain
sialorrhoea (Excessive salivation)
29
Q

what antipsychotic medication is most antisuicidal?

A

clozapine