Shared Flashcard Set

Details

Exam 3
Lecture 11- treatment of substance abuse
82
Archaeology
2nd Grade
10/29/2013

Additional Archaeology Flashcards

 


 

Cards

Term
for substance abuse must have _ criteria met for how long?
Definition
2
12 months
Term
what are 4 criteria for susbtance abuse?
Definition
craving
continued use despite social/interpersonal problems bc of use
devlopment of tolerance
withdrawal occurs if stop using
Term
early remission of subst abuse is no criteria met for >_ but < _
Definition
3 months
12
Term
for both early and sustained remission what is the only cirteria the pt cna have?
Definition
craving
Term
to have sustained remission of substance pt cant meet criteria for how long?
Definition
12 months
Term
what is the scale most used for alcohol use disorder
Definition
CAGE
Term
alcohol withdrawal peaks how long after last drin?
how long can it last?
Definition
24 hrs
5 days
Term
is stage 1 or 4 hgiher for severity of alcohol withdrwal?
Definition
stage 4
Term
alcohol withdrwal what stage?
-anxious, sweating, hyperthermia
Definition
stage 1
Term
stage 1 of alcohl withdrwal begins? and lasts?
Definition
6 hrs after last drink
5 dyas
Term
alcohol withdrawal what stage?
-begin to have hallucinations (visual, auditry)
Definition
stage 2
Term
when does stage 2 of alcohol withdrawal begin?
how long last?
Definition
24 hrs after last dirnk
1-3 days
Term
alcohol withdrawal, what stage?
-begin to have seizures
Definition
stage 3
Term
when can stage 3 of alcohl withdrawal occur?
Definition
48 hrs
Term
which alcohol wtihdrawal stage has delirium tremens ?
when does this occur?
Definition
stage 4
3-5 dyass after alst dirnk
Term
what is delirium tremens?-3
Definition
mydriasis, hgih fever, arrythmia
Term
what test is used to assess alcohol withdrawal symtpoms?
Definition
CIWA
Term
for CIWA, what score is mild?
what is mode?
what is severe?
Definition
8
8-15
>15
Term
preferred method for alcohol withdrawal symptoms?
how are they dosed?
Definition
BDZs
symtpom triggered dosing
Term
Dose of BDZ if:
CIWA: >15
Definition
mod-high dose
Term
dose of BDZ if:
CIWA 8-15
Definition
lower dose
Term
dose of BDZ if CIWA <8
Definition
no dose given!!!
Term
CIWA usually done for first _ days
if still > 8 after this what happens?
Definition
3
continue protocol longer
Term
if pt has history of seizures or delirium tremens what should be given for alcohol withdrawal?
Definition
BDZs for 24 hrs pre-symptom triggered dosing
Term
DBZs cant be given until pt's blood alclhol is below?
Definition
.08%
Term
fixed dosing not reccomedned for BDZ why?
Definition
pt getting more than they need
Term
fixed dosing of BDZ works how?
Definition
have dose and titirate down in 3-7 dyas
Term
what are the 5 BDZs used?
Definition
clonazepam
diazepam
chlordiazepoxide
lorazepam
oxazepam
Term
which 2 BDZ are longer acting and may provide better coverage to reduce seizures?
Definition
diazepam
chlordiazepoxide
Term
what two BDZ are preferred if pt has permament liver damage?
Definition
lorazepam
oxezapam
Term
what drug can be used for outpt management of alcohol withdrawal?
Definition
gabapentin (only use for mild )
Term
dosing for gabapentin genralized-
Definition
400 mg x3 days and then decrease by 100
Term
when is psychosocial therapy strongly enocurage?
why?
Definition
treatment for relapse prevention
meds wont be useful without this
Term
disulfuram isnt used a lot bc?-2
Definition
ADes and limited effiacy
Term
MOA of disulfuram
Definition
inhibits aldehyde dehydrogenase
Term
when can you starts disulfuram-2
Definition
after blolod alc 0
12 hrs after last drink
Term
ADEs of disulfuram-3
Definition
headache, metallic tase, smell diustrubed
Term
monitoring for disulfuram if pt drinks again?
Definition
disulfuram reaction
Term
drug interacitons with disulfuram-2
Definition
3A4
metronidazole (increase psychosis)
Term
counseling with disulfuram-2
Definition
avoid all alcohol
avoid this until 14 days after disct med
Term
what drug redeuces heavy drinking?
Definition
naltrexone
Term
MOA of naltrexone
Definition
Mu opioid antagonist
Term
how cna naltrexone be admin?-2
Definition
PO
IM
Term
ADEs for naltrexone:
oral? -2
IM? -2
Definition
GI, cause opioid withdrawl syndrome
inject rxn, joint pain
Term
naltrexone is able to reduce what 2 htings?
Definition
cravings
drinking
Term
naltrexone interacts with what drugs?
Definition
opioids
Term
counseling for naltrexone-1
Definition
carry wallet card that says on naltrexone ICE
Term
MOA of acamprosate-2
Definition
reduce glut
acitvate GAB
Term
dosing fro acamprosate if cr cl 30-50
if less than 30?
Definition
333 TID
dont give!!!!!!
Term
ADEs of acamprosate-2
Definition
Nausea
anxiety
Term
whcih med doesnt have emd interactions?
Definition
acamprosate
Term
counseling fro acamprosate
Definition
encourage compliance
Term
withdrawal for opiod symtpoms start _
they have peak of _ and can last _
Definition
8 hrs after alst dose
36 hrs
5 days
Term
what drug cna only be used in opiate treatment programs?
Definition
methadone
Term
MOA of methadone
Definition
pure Mu agonist
Term
once get withdrawal suppresion how do you titrate methadone?
Definition
reduce by 5 mg daily over 7-21 days
Term
MOA of buprenorphine
Definition
partial Mu agonist
Term
_ mg of buprenorphine = 60 of methadone
Definition
16
Term
if pt needs burpenorphine dose higher than 16 mg what needs ot be done?
Definition
switch to methdone bc it doesnt have this celing dose
Term
pros about using buprenorphine-2
Definition
less resp depression and prolonged QTC compared ot methadone
Term
which med for opiod withdrawal can be used in outpatient?
if this is done what should be added?
Definition
buprenorphine
nalaxone
Term
for buprenorphine dosing, when do you give first dose?
what is formulation?
Definition
after in mild-mod withdrawal
sub lungual tab
Term
hwo do you taper burpenorphone?
Definition
go to 16 mg then decrease over 7 days
Term
opiod withdrawl:
what can be used for diarrhea?
Definition
loperamide
Term
opiod withdrawl:
what can be used to reduce autonomic activity
Definition
clindine
Term
opiod withdrawl:
what can be used for N?V
Definition
onadestron
Term
opiod withdrawl:
what can be used for insomnia
Definition
trazadone
Term
opiod withdrawl:
what can be used for muscle aches?
Definition
ibuprofen
Term
opiod withdrawl:
what can be used for anxiety
Definition
hydroxyzine
Term
what drug is more useful for maintenacne therapy to prevent opiod withdrawal
Definition
methadone
Term
what are benefits of maintenace methadone?-3
Definition
imrpove social, decrease criminal, decrease mortality
Term
pts that shoudl get opiod withdrawal main therapy-4
Definition
depedent> 1 yr
preggo, just released fro jail, those treated fro depeedn in past yr
Term
how long cna maintenance of opiodi withdrawal be used for?
Definition
years!
Term
what med is combined with buprenorphine to reduce damage if it is crushed or injected
Definition
nalaxone
Term
what are the 2 meds for prevention of nicotine releapse?
Definition
bupropion
varenicline
Term
formulation of buproion
when do you start taking the med?
how long do you take it for?
Definition
sustained release
1-2 weeks before quite nicotine
take for 3-6 mo
Term
which nicotine prevention drug has highest absitience rate?
Definition
varincline (chantix)
Term
MOA of bupropion-2
Definition
inhibits DA reuptake
anatag of nicotine recpt
Term
MOA of varenicline
Definition
nicotine partial recpt agonist
Term
when do you start chantix?
by day 8 taking?
Definition
1 week before quit
1 mg BID
Term
ADEs of chantix-3
Definition
nauseua (majoprity)
insomnia
vivid dreams
Term
Black box warning for varenicline
Definition
increase depression/suicide
Supporting users have an ad free experience!