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Pharmacotherapy 3 Exam 1 > Substance Use Disorders > Flashcards

Substance Use Disorders Flashcards

1
Q

“When a dose of a medication gives less effect over time” is the definition of ___

A

Tolerance

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2
Q

“When decreased doses of a medication leads to withdrawal symptoms” is the definition of ___

A

Physical dependence

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3
Q

“Drug use exceeding recommended therapy which leads to increased adverse effects” is the definition of ___

A

Drug abuse

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4
Q

What are the “Five Cs” of addiction?

A 
Compulsive
Chronic 
decreased Control
Continued use
Cravings
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5
Q

What scheduled control is cocaine?

A

Schedule II

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6
Q

What is the MoA of cocaine?

A

Prevents reabsorption of 5HT, NE, EPI, and DA

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7
Q

How is cocaine withdrawal treated?

A

Supportive care, fluids, multivitamins+B+C

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8
Q

True or False? There are no FDA-approved medications to treat cocaine use disorder

A

True. Psychosocial therapy is first-line

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9
Q

___ converts acetaldehyde to acetic acid

A

Aldehyde dehydrogenase

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10
Q

What is the MoA of disulfuram?

A

Disulfuram inhibits aldehyde dehydrogenase, which causes a buildup of acetaldehyde and makes the patient feel sick if they ingest alcohol

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11
Q

Disulfuram is contraindicated with ___ and ___

A

Ethanol

Metronidazole

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12
Q

What is the BBW of disufuram?

A

Do not administer to an alcohol intoxicated patient (< 12 hours since last drink) or without their full knowledge

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13
Q

What is the MoA of acamprosate?

A

Acamprosate decreases cravings for alcohol

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14
Q

Acamprosate is contraindicated in ___

A

CrCl < 30

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15
Q

What is the dose for acamprosate?

A

666mg TID

If CrCl is between 30-50, 333mg TID

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16
Q

What is the MoA of naltrexone?

A

Naltrexone decreases cravings for alcohol

17
Q

Naltrexone is contraindicated with ___

A

Opioid use

18
Q

What is the dose for naltrexone?

A

PO: 50-100mg/day
IM: 380mg every 28 days

19
Q

What is the mechanism of topiramate?

A

Increases GABA and decreases cravings for alcohol

20
Q

True or False? Topiramate is FDA approved for the treatment of alcohol use disorder

A

False. It decreases cravings, but is not FDA approved for treatment of alcohol use disorder

21
Q

How do you treat alcohol withdrawal?

A

To prevent wernicke-korsakoff syndrome, give folate, thiamine (B1), multivitamin, crystalloid fluids (D5W+KCl), benzodiazepines

22
Q

What are the three opioid receptors?

A

Mu, Kappa, Delta

23
Q

What medication is an opioid antagonist used for reversing opioid overdose?

A

Naloxone

24
Q

What is the acronym for the opioid withdrawal scale?

A

COWS

25
Q

What medications are used for maintenance of opioid use disorder?

A

Naltrexone (mu opioid antagonist)
Methadone: CII (full mu opioid agonist)
Buprenorphine: CIII (partial mu opioid agonist)

26
Q

What is the MoA of naloxone

A

Mu antagonist

27
Q

JB is going to be induced on Suboxone. What would you tell him about how Suboxone works? It is a:

a. Mu agonist
b. Mu antagonist
c. Partial mu agonist

A

B & C. Mu antagonist and partial mu agonist

28
Q

SB is a 33 yo F with a history of alcohol use disorder. SB states she drinks 1 liter of vodka daily. She reports alcohol is her drug of choice, but also states she uses $50 worth of heroin every few days. She presents to inpatient substance use program for treatment of alcohol and heroin. What medication would be preferred for SB?

a. Methadone
b. Naltrexone
c. Acamprosate
d. Topiramate

A

B. Naltrexone is FDA indicated for both alcohol use disorder and opioid use disorder

29
Q

What are examples of depressants?

A 
Alcohol
Benzodiazepines
Barbiturates
Sedative-hypnotics
Opioids
Cannabis
30
Q

What are examples of stimulants?

A

Caffeine
Cocaine
Amphetamine/Methamphetamine
MDMA/Ecstasy

31
Q

What are examples of hallucinogens?

A 
Lysergic acid diethylamide (LSD)
Psilocybin (mushrooms)
DMT
Mescaline (peyote)
Phencyclidine (PCP)
32
Q

What are the effects of stimulant intoxication?

A 
Tachycardia or bradycardia
Pupillary dilation
Elevated or lowered blood pressure
Perspiration or chills
Nausea or vomiting
Evidence of weight loss
Psychomotor agitation or retardation
Muscular weakness
Respiratory depression, chest pain, or cardiac arrhythmias
Confusion, seizures, dyskinesias, dystonias, or coma
33
Q

What are symptoms of alcohol withdrawal?

A 
Tachycardia
Hypertension
Anxiety
Dysphoria
N/V
Tremors
Anxiety
Confusion, agitation, fever, and/or seizures if prolonged
34
Q

What are symptoms of opioid withdrawal?

A 
NV
Stomach cramps
Diarrhea
Goosebumps
Depression
Drug cravings
35
Q

LB is a 27 yo M with PMH of migraines. LB presents to the ED sweating, nauseous, and very agitated. BP:172/90; HR: 86; T: 98.9
Which of the following substances may be the offending agent?
a. Heroin
b. Alcohol
c. Cocaine
d. Oxycodone

A

c. Cocaine

Pharmacotherapy 3 Exam 1 (6 decks)

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