9: Management of opiate misuse Flashcards Preview

Psychiatry Week 1 2018/19 > 9: Management of opiate misuse > Flashcards

Flashcards in 9: Management of opiate misuse Deck (40)
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1

What is diamorphine also known as?

Heroin

2

How does heroin affect your mood initially?

Euphoria

Sedation

3

What properties of heroin make it highly addictive?

Short onset of action

Short half life (provokes cravings)

4

Which plant does opium come from?

Poppy

5

What are the two main constituents of opium?

Morphine

Codeine

6

How is morphine, from opium, changed into diamorphine?

Addition of 2 acetyl groups

7

What are the two most common routes of administration of heroin?

Why?

IV

INH

fastest absorption into bloodstream

8

IV and INH heroin bypass ___ ___ ___.

first pass metabolism

9

What is diamorphine metabolised into?

Morphine

which is the active metabolite

10

What is the most common opioid receptor?

Mu receptor

11

Heroin and codeine are both broken down into morphine.

How do you tell what a patient has used in a drug screen?

Heroin has a unique intermediate which sticks around for 6h

12

What are the

a) desired

b) side effects

of heroin?

a) Euphoria, analgesia

b) Constipation, N&V, sedation, respiratory depression, hypotension and bradycardia

13

What is a sign, seen in the eyes, that someone has used an opioid?

Pupillary constriction

14

What process occurs with repeated use of opioids?

Tolerance

15

Patients using opioids may report that their teeth are rotting.

What causes this?

Analgesia - patient unaware of dental problems e.g abscess

Vomiting - breakdown by stomach acid

16

What are some symptoms of opioid withdrawal?

Opioid cravings

GI symptoms - N&V, diarrhoea

Cardio symptoms - tachycardia, hypertension

Joint pain

Rhinorrhoea

Watery eyes

17

In patients tolerant to opioids, how long without the drug does it take for withdrawal to start?

6 - 8 hours

18

Opioid withdrawal effects overlap with ___ symptoms.

Why?

sympathetic

locus caeruleus releases loads of NA

19

___ is a common complication of IV heroin use.

Infection

local, distant (e.g infective endocarditis) or systemic

20

As IV heroin use requires vascular access and damage to the endothelium, what vascular complication can occur?

Thrombosis

Embolism

21

What is naloxone?

Opioid receptor antagonist

used to reverse opioid overdose

22

What state does opioid overdose mimic?

Sleep

23

Which atypical analgesics have a street value and are often used at the same time as opioids?

Gabapentin

Pregabalin

24

Which commonly prescribed sedative drugs can be abused alongside opioids?

Benzodiazepines e.g lorazepam

25

Which psychiatric disorders are you more at risk of when using heroin?

Anxiety

Depression

26

Does opioid withdrawal cause psychosis or delirium?

NO

trainspotting isn't accurate

27

What is opiate substitution therapy?

Substitution of a SHORT-ACTING opioid with a LONG-ACTING one

28

What are long-acting opioids used in substitution therapy?

Buprenorphine

Methadone

29

How is opiate substitution therapy carried out?

Administration of ORAL buprenorphine or methadone

Once daily

Under direct supervision

30

Opiate substitution therapy removes the risks of ___ administration.

IV administration

infection, embolism