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BNF CNS > Substance dependence > Flashcards

Substance dependence Flashcards

1
Q

What 2 medications are used in opioid substitution therapy

A

Buprenorphine and Methadone

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2
Q

How long does compelte withdrawal from opioids takw?

A

12 weeks in community, 4 weeks in rehab facility

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3
Q

How many mised doses puts a patient at risk of overdose due to tolerance?

A

3 missed doses

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4
Q

What is suboxone

A

Buprenorphine and Naloxone

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5
Q

Symptoms of neonatal withdrawl syndrome

A

High pitched cry, hypertonicity, convulsions, ineffective suckling, excesive wakefullness

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6
Q

What drug can be used in combination with opioid substitution therapy or alone for people with mild or uncertain dependence?

A

Lofexidine

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7
Q

What medication precipitates opioid withdrawl in opioid dependent subjects?

A

Naltrexone

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8
Q

what medicastions are used in fixed dosing egimes for alcohol withdrawl?

A

Long acting benzo e.g. Chlordiazepoxide reducing doses over 7 to 10 days

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9
Q

What is the risk of alcohol in combination with Clomethiazole?

A

can lead to fatal respiratory depression even with short term use

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10
Q

Symptoms of Delirium tremens

A

agitation, confusion, paranoia, visual and auditory hallucinations

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11
Q

First line treatment for Delirium tremens

A

Lorazepam

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12
Q

Indication of use of Acamprostate calcium

A

relapse prevention in patients with moderate - severe alchol dependence

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13
Q

What drug can be used to treat patients who have alchohol dependence without physial withdrawl symptoms

A

Nalmefene

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14
Q

What can be given to alcohol dependent patients who have severe alcohol related hepatitis with a discriminant function of 32 or more?

A

Corticosteroids

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15
Q

What is the medication is used for Wernickes encepthalopathy

A

Thiamine (IV) followed by PO

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16
Q

How often should patients taking Disulfiram be monitored?

A

Every 2 weeks for first 2 months then each month follwing 4 months then every 6 months

17
Q

What should patients on disulfiram be counselled on?

A
  1. Risk of Disulfiram related reactions - may pccur when exposed to alcoho in perfume, aerol spray etc/ causes nausea, flushing, palpitations, htypotension and arrhythmias
  2. reporting signs of hepatoxicity
18
Q

How old do you have to be to have Acamprosate

A

> 16

19
Q

If patient has nicotine cravings on waking, what NRT patch is most appropriate?

A

24 hour patch

20
Q

Side effects of NRT patches

A

Mild local reactions due to irritant effects of nicotone, nightmares

21
Q

How long is Bupropion treatment for?

A

7-9 weeks

22
Q

Pharmacotherpay options ofr smoking cessastion

A

NRT, Varenicline, Bupropion

23
Q

What is an ADR associated with Nicotine replacement patches?

A

Nightmares - use the 16 hour patch if this occurs (break overnight)

24
Q

Side effects of nicotine chewing gum

A

GI disturbance, N&V, dyspepsia, hiccup

25
Q

What are the 3 strengths of the 24 hour patches

A

21mg, 14mg, 7mg

26
Q

hat are the 2 strengths of the 16 hour patches

A

15mg, 10mg

27
Q

What conditions are NRT cautioned in?

A

Diabetes (monitor BMs initially), CVD, GI disease, uncontrolled hyperthyroidism –> although NRT is also betterthan smoking

28
Q

What is smokings affect on theophylline

A

Smoking increases theophylline clearance, so if stopping, dose reduction may be needed

29
Q

Can a patient have a can of coke before using nicotine gum?

A

No - acidic drinks can decrease absorption of nicotine through the buccal mucosa and should be avoided for 15 mins before use of NRT

30
Q

What conditions is Varenicline and Bupropion contraindciated in?

A

<18 years and pregnant/breastfeeding

31
Q

How long Varenicline treatment for?

A

12 weeks (start 1-2 weeks before stop date)

32
Q

What conditions is Varenicline and Bupropion cautioned in?

A

Mental health (risk of suicial ideation), Seizures and CVD

BNF CNS (9 decks)

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