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D&T2 Exam 2 > Drugs and Pregnancy - Chaffin > Flashcards

Drugs and Pregnancy - Chaffin Flashcards

(47 cards)

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1
Q

which gender gets addicted is less time and develop larger harbits

A

women

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2
Q

if mother uses amphetamines, is it found in cord CHS neonates vs. cord study

A

no

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3
Q

if mother uses cocaine, is it found in cord for CHS neonates vs. cord study

A

no

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4
Q

what is the most common drug found in cord in CHS neonates vs. cord study

A

THC

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5
Q

if you decrease the pain clinics then what other drug rises

A

opioid use

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6
Q

Source where pain relievers were obtained for most recent nonmedical use among past year users aged 12 or older are fom

A

free from friend/relative

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7
Q

will you take care of a pregnant opiate addict in your 3 rd year

A

yes

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8
Q

naturally occuring: papavor somniferium poppy

codiene morphine

A

opiates

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9
Q

what opioid has the greatest addiction potential of all narcotics and easily crosses the BBB

A

heroin

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10
Q

MOA of opioids

A

stimulate the mu receptor in CNS

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11
Q

what are 4 clinical effects of opiates

A

drowsy
slurred speech
impaired attention
impaired memory

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12
Q

opioids are unable to develop tolerance to what

A

miotic effects
constipation
respiratory depression

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13
Q

when does tolerance occur for opioids

A

after 3 weeks of dialy usage

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14
Q

Withdrawal symptoms from opioids

A 
yawning           myalgia 
piloerection     muscle spasms
lacrimation       anorexia
rhinorrhea        nausea/vomiting
perspiration      Abdominal cramps 
tremor               Diarrhea
restlessness      fever/chills/fush
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15
Q

how long can opioid withdrawal symptoms last

A

10 days

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16
Q

what is the PE for opioid withdrawal

A

hypertension
hyperventilation
tachycardia

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17
Q

timeline of withdrawal ( short acting opioid): 3-4 hours after last dose

A

drug craving, anxiety, fear of withdrawal

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18
Q

timeline of withdrawal ( short acting opioid): 8-14 hours after last dose

A

anxiety, restlessness, insomnia, yawning, rhinorrhea, lacrimation, diaphoresis, stomach cramps, mydriasis

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19
Q

timeline of withdrawal ( short acting opioid): 1-3 days after last dose

Study These Flashcards
A

tremor, muscle spasm, vomiting, diarrhea, hypertension, tachycardia, fever, chills, piloerection

20
Q

are opioids teratogenic

21
Q

what temporary substitution of long-acting opioid reduces withdrawal severity

Study These Flashcards
A

methadone

Buprenorphine

22
Q

what can you give for treatment of withdrawal from opioid in pregnant women

Study These Flashcards
A

Pentzocin
Nalbuphine
butorphanol

23
Q

can you give antagonist for treatment of withdrawal? why or why not

Study These Flashcards
A

NO

can precipitate immediate withdrawal

24
Q

chronic relapsing condition which untreated may lead to what

Study These Flashcards
A

severe complications and death

25
is addiction as a chronic disease treatable? curable?
treatable yes | but not curable
26
what is the key to treatment of addiction as a chronic disease? what needs to change in the patient
retention | behavioural changes
27
what do you want to avoid in managing a pregnant women? why?
withdrawal | - fetus: hypoxia, bradycardia, intrauterine demise,
28
what is an indicator of fetal withdrawal
increased fetal movement
29
what is the main issue with medication assisted treatment ( MAT) for addiction during pregnancy
replase
30
what is the current treatment of choice for opiate addicted pregnant women
methadone
31
what happens in the first day of methdone maintenance
Starting dose: 10-20m mg evaluate at 6 hours interval 5-10mg additional dosing for persistent signs and symptoms of withdrawal
32
what happens in the second day of methdone maintenance
total methadone dose in first 24 hours, may be given as single of split dose
33
how do you treat someone on illicit narcotics
- start methadone at 20 mg BID - increase dose by 10-20 mg/day until on stable once daily dose - dosage needs to change as pregnancy progresses
34
during the pregnancy when do you consider detoxification
of on dosage less than 40 mg daily and gestational age less than 20 weeks
35
can you prescribe opioid as an outpatient
no, due to addiction maintenance
36
how do you detoxify from methadone maintenance? for inpatient and outpatient?
gradually secondary to risk of fetal compromise inpatient: 2mg/day decreases in daily dose outpatient: 5-10 mg/week decrease in dose
37
what is the alternative approach to detoxify from methadone maintenance
Ativan .5- 1 mg every 8 hours decrease methadone 5mg/day every 1-2 days once methadone discontinued taper Ativan
38
MOA of Buprenorophine? how is it given to patient
partial opioid agonist | sublingual with naloxone
39
what can happen to Naloxone if given parenterally
may precipitate withdrawal
40
compare buprenorphine and methadone
Buprenorphrine: lowers rates of illicit opioid consumption, fewer withdrawal symtpoms, lower potential for respiratory depression methadone: more effective for polypharmacy
41
Maternal addiction and recovery center MARC
by Chaffin
42
for the MARC, long standing addiction to what drug is contraindication? what must be done if this is the case.
benzodiazopine, | - monitor withdrawal prior to initializing buprenorphine
43
what is the correlation of Bupronorphrine dose and median hospital days for MARC
directly related
44
does maternal dose or cord tissue level of Buprenophrine correlate with neonatal abstinence substance severity or length of hospital day
NO
45
neonatal abstinence syndrome is most common in what drug
methadone exposed babies
46
treatment for neonatal abstinence sydnrome
Diazepam Chlorpromazine Phenobarbital Methadone
47
Finnegan scale
The neonatal abstinence syndrome scoring system

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