drug dep

Answer 1

Question: Can you tell me about Buprenorphine?
Answer:

Class: Opioid Receptor Partial Agonist

Mechanism:

Partial agonist/antagonist that attaches to mu and kappa opioid receptors

Used in opioid maintenance therapy due to its slow reversible binding with mu receptors, which minimizes opioid cravings and withdrawal symptoms

Use:

Treatment for opioid dependence and pain

Side Effects:

Common: Arrhythmias, confusion, constipation, dizziness, dry mouth, euphoric mood, flushing, hallucinations, headache, hyperhidrosis, miosis (constricted pupils), palpitations, respiratory depression (with high doses), skin reaction, vertigo, urinary retention, nausea, vomiting (common at initiation)

Answer 2

Question: What is the role of Lofexidine in opioid withdrawal treatment?
Answer:

Class: Alpha-2 Adrenergic Agonist

Mechanism:

Replaces opioid-driven inhibition of cAMP production by activating alpha-2 adrenergic receptors

Reduces withdrawal symptoms by inhibiting norepinephrine (NE) and sympathetic nervous system (SNS) outflow

Use:

Symptomatic treatment of acute opioid withdrawal to aid in opioid discontinuation

Side Effects:

Common: Bradycardia, dizziness, drowsiness, hypotension, mucosal dryness

Important: First non-opioid treatment for symptomatic management of opioid discontinuation

Answer 3

Question: Can you explain the mechanism of Clonidine?
Answer:

Class: Alpha-2 Receptor Agonist

Mechanism:

Presynaptic: Inhibits NE release and reduces sympathetic tone

Postsynaptic: Decreases firing of sympathetic neurons in the CNS, reducing sympathetic signals to the heart and blood vessels, leading to lower BP and HR

Analgesic effects by modulating pain in the spinal cord

Withdrawal suppression by reducing NE activity and sympathetic overactivity

Use:

Opioid withdrawal symptom management

Side Effects:

Common: Dizziness, drowsiness, hypotension, dry mouth, sedation

Answer 4

Question: What is Methadone used for in opioid dependence treatment?
Answer:

Class: Synthetic Opioid

Mechanism:

Full mu-opioid receptor (MOR) agonist and NMDA antagonist

Mimics the effects of natural opioids (endorphins) by releasing neurotransmitters involved in pain transmission

Use:

Opioid dependence (adjunct therapy to prevent withdrawal and reduce cravings)

Management of severe pain not responsive to other treatments

Side Effects:

Low risk of neuropsychiatric toxicity compared to other opioids

Longer half-life and duration of action than other opioids, making it useful in opioid maintenance therapy

Answer 5

Question: Can you tell me about the use of Naloxone?
Answer:

Class: Short-Acting Opioid Antagonist

Mechanism:

Blocks/reverses the effects of opioid drugs by acting as an inverse agonist at the mu-opioid receptors

Rapidly removes other drugs bound to opioid receptors, reversing opioid overdose effects

Use:

Rapid reversal of opioid overdose

Side Effects:

Common: Arrhythmias, vomiting, diarrhea

Answer 6

Question: How does Naltrexone work in opioid dependence treatment?
Answer:

Class: Opioid Antagonist

Mechanism:

Pure opioid antagonist that blocks the effects of opioids by binding to opioid receptors in the CNS

Prevents the subjective effects of opioid use

Use:

Adjunct in maintenance of opioid cessation after detoxification

Adjunct to prevent relapse in alcohol dependence

Side Effects:

Common: Nausea, headache, dizziness, insomnia, anxiety