Opiate Cessation Flashcards

1
Q

3 opioid cessation programs

A
  • 12 step programs
  • narcotics anonymous
  • mutual help programs-health systems
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2
Q

What is the antidote for opioid overdose?

A

naloxone

opioid antagonist

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3
Q

Naloxone is structurally similar to ___, but has no analgesic properties.

A

morphine

no abuse potential
not a controlle substance

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4
Q

Which type of opioid receptor does naloxone bind too?

A

Mu

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5
Q

Is naloxone an agonist or antagonist?

A

antagonist

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6
Q

Naloxone has no effect in the absence of opioids.

a. true
b. false

A

a. true

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7
Q

Which route of naloxone administration has fastest onset of action?

A

IV

IV: 2mins
Nasal: 8-10mins
IM: 2-5mins

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8
Q

Does naloxone have a PO formulation?

A

no

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9
Q

The naloxone profiled syringe is what concentration?

A

2mg/mL

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10
Q

How is naloxone profiled syringe administered?

A
  • 1mL in each nostril PRN

- inject 2mL IM in outer thigh PRN

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11
Q

What is the concentration of the naloxone vial?

A

0.4mg/mL

comes in 2 vials

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12
Q

How is naloxone vial administered?

A

inject 1mL in outer thigh PRN, repeat in 2 mins PRN

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13
Q

What is the concentration of the naloxone auto-injector?

A

2mg/0.4mL

or 0.4mg/0.4mL

comes as a two pack

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14
Q

How is the naloxone auto injector (Evzio) administered?

A

inject in outer thigh PRN, repeat in 2mins PRN

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15
Q

__ maintenance therapy is the cornerstone for opiate addiction.

A

methadone

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16
Q

R methadone binds to which receptor?

17
Q

S methadone binds to which receptor?

A

NMDA receptor

18
Q

Methadone is a substrate for efflux pump?

A

P-glycoprotein

19
Q

Methadone is primarily metabolized by what two CYPs?

20
Q

Methadone can cause what type of heart problem?

A

torsades de pointes

21
Q

Which CYP may be genetic tested for methadone?

22
Q

Which 2B6 allele is associated with higher concentrations?

23
Q

What is buprenorphine MOA?

A

partial mu opiate receptor agonist and kappa opiate antagonist

24
Q

Buprenorphine can be used alone as an alternative to methadone for opiate addiction.

a. true
b. false

25
Naloxone has very low bioavailability. a. true b. false
a. true < 10% half life 1.1 hrs glucuronidation
26
What ratio of buprenorphine:naloxone (Suboxone) is FDA approved?
4:1 2mg: 0.5mg 8mg: 2mg
27
The buprenorphine implant is better than sublingual formulation over longer periods of time. a. true b. false
a. true can start on sublingual and switch to implant
28
Which two opioids have combination formulations with naltrexone?
- morphine | - oxycodone
29
What is the time of onset for the therapeutic actions of naloxone given nasally?
8-10 mins