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Addiction Meds - Jaynstein Flashcards

(54 cards)

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1
Q

Addiction defined as ?

A

chronic, relapsing disorder characterized by compulsive drug seeking, continued use despite harmful consequences, and long-lasting changes in the brain

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2
Q

Addiction risk factors

A
  • Genetics
  • Psychological
  • Age (early encounter risk for addiction)
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3
Q

What are the treatment barriers?

A
  • Misunderstanding of the disease
  • Negative public attitude
  • Lack of information and resources
  • Insufficient social support
  • Privacy concerns
  • Cost
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4
Q

Speaking with patients about addiction

A

Recommend patients stop but acknowledge how hard it is and discuss a way to decrease over time

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5
Q

Tobacco is just as addictive as what?

A

Heronin

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6
Q

On average, how many attempts does it take for successful at quitting?

A

four

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7
Q

What are the symptoms of nicotine withdrawal?

A
  • Feeling irritable, angry, or anxious
  • Having trouble thinking
  • Craving tobacco products
  • Feeling hungrier than usual
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8
Q

After how many years, the risk of heart attack drops?

A

one year

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9
Q

What happens after 2-5 years after quitting?

A

the risk for stoke reduces to a non-smoker

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10
Q

What happens after smoking cessation?

A

risk of lung cancer drops by half

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11
Q

What are the smoking cessation option?

A
  • varenicline (Chantix), - bupropion (Wellbutrin)
  • nicotine replacement (gum, patches, lozenge)
  • Quitline
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12
Q

T/F Alcohol use screening as part of a routine exam

A

True!

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13
Q

Is CAGE questionnaire clinically useful?

A

Yes

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14
Q

CAGE score of 0 has a

A

good negative predictive value

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15
Q

CAGE score of 3-4 has a

A

supports the diagnosis of alcohol abuse

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16
Q

CAGE score of 1-2 has a

A

interpreted with caution

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17
Q

T/F alcohol withdrawal can be life-threatening

A

True

  • Withdrawal symptoms can start 8-12 hours after last drink
  • and last 48-72 hours
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18
Q

What is mild onset of alcohol dependence?

A

tremor, tachycardia, anxiety, GI upset

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19
Q

When does seizures come on?

A

(24-48 hours): generalized tonic-clonic, risk: h/o prior seizures

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20
Q

When does delirium come on?

A

(onset 24-72 hours, may occur up to 10 days out thou!): confusion, hallucinations (tactile and visual), tremor, autonomic dysfunction, CV instability – can be fatal

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21
Q

What is wernicke encephalopathy?

A

confusion, ataxia, ophthalmoplegia (CN VI), reversible

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22
Q

What is the sequela of wernicke?

23
Q

What is Korsakoff?

Study These Flashcards
A

psychosis, often non-reversible
THIAMINE, THIAMINE, THIAMINE!

24
Q

What are the symptoms of mild withdrawal?

25
What are the symptoms of moderate withdrawal?
?
26
What are the symptoms of severe withdrawal?
?
27
What is the legal blood alcohol levels?
0.08 or 80mg/dL
28
T/F patients can withdrawal at any level
True
29
What is the strategies for cutting down?
- Keep track - Be aware of sizes - Set goals - Eat while drinking - Drink slower – one drink per hour
30
What are the four alcohol dependence treatment?
(PO) naltrexone, acamprosate, and disulfiram Injectable (ER naltrexone)
31
What is the goal of alcohol dependence treatment?
Reduce drinking, avoid relapse to heavy drinking, achieve and maintain abstinence, or gain a combination of these effects
32
How long is the duration of treatment for alcohol dependance treatment?
3 months - if meds doesn't work try another. - No evidence from combo medications
33
Naltrexone
- helps reduce drinking by stopping the pleasurable effects of alcohol - Patient can be actively working towards abstinence Vivitrol is the injectable long-acting form
34
Acamprosate
- reduces cravings - Patients must be abstinent prior to initiation
35
Disulfiram (Antabuse)
- blocks the metabolism of alcohol (toxic alcohol compounds cause people to become very ill). - Patients must be abstinent prior to initiation
36
What are the two cornerstone of treatment for acute alcohol withdrawal?
Benzodiazepines and Barbiturates Barbs are better
37
T/F Pharmacotherapy for alcohol dependence is most effective when combined with some behavioral support,
True This doesn’t need to be specialized, intensive alcohol counseling
38
When is relapse most common?
first 12 months after abstinence
39
T/F
Treat depression related to relapse aggressively
40
What are the alcohol reduction resources?
-
41
What are the common opioid meds?
Hydrocodone, Oxycodone, Percocet, Vicodin, Morphine, Codeine, Fentanyl
42
what is illicit opiods?
Heroin
43
What is the maintenance medication?
Methadone
44
T/F opiate dependence is estimated to effect nearly 10% of modern day medical practitioners
True!
45
what is the goal for opioid analgesics
50T?
46
T/F Fentanyl is 50-100x more potent than morphine
True!
47
can you die from opioid withdrawl?
No! but they will feel really crappy
48
Two you can die from is
benzo and alcohol with drawl
49
What is the opiate withdrawal time line?
50
T/F you need to be in significant with drawl before giving suboxone
True, you have to wait because you can push into early with drawl.
51
What is the treatment for opioid addiction treatment?
- supervised detox - inpatient care - Long-tern outpt care - cognitive behavioral therapy
52
What are the three med approved for opioid use disorder?
- Methadone - Buprenorphine (Suboxone) - Naltrexone
53
T/F studies show MAT increase treatment retention and decreases the risk of overdose
True
54
If patient is not ready to stop, what can you offer?
Naloxone (Narcan) at minimum!

Clinical Pharm (8 decks)

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