Ch. 40 Flashcards Preview

Pharmacology > Ch. 40 > Flashcards

Flashcards in Ch. 40 Deck (11):


- opioid similar to morphine
- intended as controlled-released drug
- abusers crush tablet
- snort powder or dissolve in water for IV
- entire dose absorbed immediately with high risk of death



- nurses and HCp who abuse opioids often select meperidine
- highly effective in oral route
- minimal effect on smooth muscle: fewer problems with constipation and urinary retention


Tolerance and Physical Dependence

- prolonged use
- effects for which tolerance develops and does not develop
- cross-tolerance
- physical dependence: long-term use; abstinence syndrome; acute phase and second phase


Treatment of Acute Toxicity

- triad of symptoms and treatment
- resp. depression; coma; pinpoint; Naloxone (careful titration)


Opioid Detoxification

- clonidine-assisted withdrawl
- centrally acting alpha2-adrenergic agonist
- most effective against symptoms related to autonomic hyperactivity (nausea, vomiting, diarrhea)
- provides modest relief from muscle aches, restlessness, anixety, and insomnia
- does not diminish opioid craving


Ultrarapid Withdrawl

- admin of naloxone or natlrexone
- withdrawl process accelerated
- ultrarapid procedure: general anesthesia or heavy sedation with IV midazolam
- in both procedures, clonidine may be added to ease symptoms
- no more effective than standard withdrawl techniques
- considerably more expensive



- methadone substituation: long-lasting oral opioid; most commonly used agent; approx. 10 days
- Buprenorphine: substituted for opioid the addict is physically dependent on
- prevents symptoms of withdrawl


Drugs for Long-Term Opioid Addiction

- 3 groups of meds
- Methadone: maintenance and supressive therapy
- buprenorphine: maintenance therapy and detox facilitation
- Naltrexone: discourges renewed opioid abuse


Sequelae of Compulsive Opioid Use

- few direct detrimental effects
- Individuals on methadone maintenance can be successful socially and at work
- indirect hazards: Septicemia, cellulitis, abscesses, endocarditis, tuberculosis, hep C, HIV, and foreign body emboli
- accidental overdose


Therapeutic Use of Marijuana

- approved uses for cannabinoids
- unapprovaed uses for cannabinoids
- medical research on marijuana
- legal status of medial marijuana
- synthetic marijuana


Weed VS Alcohol

- aggressive behaviour is rare
- less loss of judgemnt
- increased appetite; fewer problems with nutritional deficiencies
- wedd produces increased toxic psychosis, dissociative phenomena, and paranoia, more so than alcohol does