Ott Substance Use Disorder

Question 1

substance use criteria

Answer 1

two of the following in 12 months:
- larger amount /longer period than intended
- desire or no success trying to cut out
- lots time spent obtaining and recovering
- craving, desire, urge to use
- failure to fulfill major role obligations
- use despite it causing problems
- important activities given up/ reduced
- use when it is hazardous (driving)
- using while knowing you have a problem
- tolerance
- withdrawal sx

Question 2

does a person with a SUD recover?

Answer 2

always recovering

Question 3

what is the legal limit for alcohol in most states

Answer 3

80 mg/dL
0.08mg%

Question 4

0.05% presentation

Answer 4

motor function impairment observable

Question 5

0.08% presentation

Answer 5

moderate impairment

Question 6

450 mg/dL presentation

Answer 6

respiratory depression

Question 7

500 mg/dL presentation

Answer 7

LD 50 for alcohol

Question 8

stage 4 of alcohol withdrawal time of onset

Answer 8

3-5 days

Question 9

stage 4 of alcohol withdrawal clinical features

Answer 9

DTs in 5% of pts, confusion, hallucinations, illusions, agitation, tachycardia, hyperthermia

Question 10

risk factor for DTs

Answer 10

prior DTs
number of detoxifications
early withdrawal sx
hepatic dysfunction
consuming 1 pint of whiskey for 10 of 14 days prior to admission

Question 11

consuming what puts you at higher risk for DTs

Answer 11

equivalent of 1 pint of whiskey for 10 of 14 days leading up to admission

Question 12

prophylaxis/fixed dosing advantage and disadvantage

Answer 12

advantage: prevent withdrawal
disadvantage: unnecessary benzo dosing

Question 13

individualized dosing uses what

Answer 13

CIWA-Ar scale

Question 14

when to use non-pharm

Answer 14

CIWA < 8

Question 15

when to medicate

Answer 15

CIWA 8+

Question 16

when do we have risk if we don’t treat

Answer 16

CIWA >15

Question 17

benefits of individual dosing

Answer 17

reduce treatment duration
decreased benzo dosing

Question 18

alcohol withdrawal treatmen

Answer 18

good liver: diazepam/chlordiazepoxide
bad liver: lorazepam/oxazepam

Question 19

lorazepam use in alcohol withdrawl

Answer 19

PRN

Question 20

what drug is recommended with alchol use

Answer 20

thiamine

Question 21

which drug does not work for pts with seizures in alcohol disorder?

Answer 21

phenytoin

Question 22

what is Wenicke’s encephalopathy a result of

Answer 22

thiamine deficiency
high glucose loads

Question 23

when do we give thiamine?

Answer 23

before dextrose containing fluids

Question 24

thiamaine is a cofactor in what

Answer 24

glucose metabolism

Question 25

disulfiram

Answer 25

aversive therapy unpleasant effects if used highly motivated person

Question 26

disulfiram reaction for how many days after discontinuation

Answer 26

14 days

Question 27

disulfuram dosing

Answer 27

250 mg daily

Question 28

acamprosate considerations

Answer 28

avoid in severe renal impairment suicidality warning

Question 29

acamprosate side effects

Answer 29

diarrhea constipation depression anxiety

Question 30

naltrexone does what

Answer 30

decreases binge drinking increase time between drinking days

Question 31

side effects with naltrexone

Answer 31

elevated LFTs injection site reactions

Question 32

what happens if you take opioids with naltrexone

Answer 32

opioids wont work

Question 33

opioid withdrawl sx

Answer 33

like the flu muscle aches abdominal cramping diarrhea sweating

Question 34

treatment of anxiety or agitation with withdrawal

Answer 34

hydroxizine

Question 35

alpha 2 agonists used in opioid withdrawal sx

Answer 35

clonidine lofexidine

Question 36

clonidine side effect

Answer 36

hypotension

Question 37

lofexidine benefit

Answer 37

less CV hypotension side effects

Question 38

whats FDA approved for withdrawal FDA approved

Answer 38

lofexidine

Question 39

pregnant recomendations for OUD

Answer 39

buprenorphine methadone

Question 40

what drug must be given in a licensed treatment program?

Answer 40

methadone

Question 41

buprenorphine must be given how

Answer 41

sublingually with naloxone

Question 42

methadone CYPs

Answer 42

2B6 3A4 2C19 2D6

Question 43

qtc med

Answer 43

methadone

Question 44

when to initiate buprenorphine

Answer 44

clear signs of withdrawal divided doses on day 1

Question 45

buprenorphine CYP

Answer 45

3A4 substrate

Question 46

buprenorphine concern

Answer 46

LFTs serotonin syndrome

Question 47

buprenorphine injection can be given to who?

Answer 47

patients on sublingual for at least 7days prior to administration

Question 48

abstinenece treatment of opioid use disorder

Answer 48

naltrexone

Question 49

risk of overdose if they discontinue treatment

Answer 49

naltrexone