3. Iszard- Agents associated with substance use disorder and Tx Flashcards
What is Schedule I drug?
No medical use; high addiction potential
What is Schedule II drug?
Medical use; high addiction potential
What is Schedule 3 drug?
Medical use; moderate abuse potential
What is Schedule Iv drug?
Medical use; low abuse potential
Flunitrazepam, heroin, LSD, mescaline, PCP, MDA, MDMA, STP
are what type of drugs?
Schedule I
Amphetamines, cocaine, methylphenidate, short acting barbiturates, strong opioids
Are what type of drugs?
Schedule II
Anabolic steroids, barbiturates, dronabinol, ketamine, moderate opioid agonists
are what type of drugs?
Schedule III
Benzodiazepines, chloral hydrate, mild stimulants (eg, phentermine, sibutramine), most hypnotics (eg, zaleplon, zolpidem), weak opioids
Schedule IV
Agitation, hypertension, tachycardia, delusions, hallucinations, hyperthermia, seizures, death are overdose sx of what drugs?
- Amphetamines,
- methylphenidate
- cocaine
Slurred speech, drunken behavior, dilated pupils, weak and rapid pulse, clammy skin, shallow respiration, coma, death are overdose sx of what drugs?
- Barbiturates
- benzodiazepine
- ethanol
Constricted pupils, clammy skin, nausea, drowsiness, respiratory depression, coma, death are overdose sx of what drug?
- Heroin
2. Other strong opioids
Apathy, irritability, increased sleep time, disorientation, depression- CRASH are withdrawal sx of what drugs?
- Amphetamines,
- methylphenidate
- cocaine
Anxiety, insomnia, delirium, tremors, seizures, death are withdrawl sx of what drugs?
- Barbiturates
- benzodiazepine
- ethanol
Nausea, chills, cramps, lacrimation, rhinorrhea, yawning, hyperpnea, tremor are withdraw sx of what drugs?
- Heroin
2. Other strong opioids
PCP can have what long term effect?
PCP may lead to irreversible schizophrenia-like psychosis
LSD can have what long term effect?
LSD can cause flashbacks of altered perception years after consumption
What drug is used to:
- Improve mental alertness
- treat migraine headaches
- treat headaches after epidural anesthesia
Caffeine
- also used by mouth for asthma, ADHD, and memory
- can be sued for weight loss and T2DM
What is a standard drink?
- 6 oz of pure alcohol
- 12-ounces of beer (5% alcohol content).
- 8-ounces of malt liquor (7% alcohol content).
-5-ounces of wine (12% alcohol content).
-1.5-ounces of 80-proof (40% alcohol content) distilled spirits or liquor
What type of Kinetics is alcohol metabolism?
Zero-Order Kinetics
• Rate remains constant and is
independent of concentration or amount of chemical
- The biological system is the rate-limiting factor
- t1/2 increases with dose (not a true t1/2)
What are key enzymes in alcohol metabolism?
- Alcohol dehydrogenase (alcohol–> acetaldehyde)
2. Acetaldehyde dehydrogenase (acetaldehyde–> acetic acid)
What is alcohol metabolism?
- ethanol undergoes extensive first-pass metabolism
- typical 70 kg adult can metabolize 7-10 g of alcohol per hour ~ 1 drink
What withdrawl:
• Can be life threatening
• Major pharmacological objective is to prevent
seizures, delirium, and arrhythmias,
electrolyte rebalancing, thiamine therapy
• Benzodiazepines tx
Alcohol
What drugs are used for acute alcohol withdrawal syndrome?
- Thiamine (vitamine B1)
- Oxazepam
- Lorazepam (Ativan)
- Diazepam (Valium)
I TOLD you not to drink!
What drugs are used to prevent alcohol abuse?
- Disulfiram (Antabuse)
- Acamprosate
- Naltrexone
DAN
What drugs are used to treat acute methanol or ethylene glycol poisoning?
- Ethanol
2. Fomepizole
What drug used to treat alcohol and opiate dependence is a μ opioid receptor antagonist (long-acting) that:
• Reduces the craving for alcohol and the rate of relapse to either drinking or alcohol
dependence for the short term (12 weeks)
Naltrexone
• Individuals physically dependent on alcohol and opioids must be opioid-free before
initiating therapy because naltrexone precipitates an acute withdrawal syndrome
What drug is a weak NMDA-receptor antagonist and GABAA receptor agonist (also affects serotonergic, noradrenergic, and dopaminergic systems)?
Acamprosate
• Reduces short-term and long-term relapse rates (more than 6 months)
What drug irreversibly inhibits aldehyde dehydrogenase and causes extreme discomfort in patients who drink alcoholic beverages (flushing, throbbing headache, nausea, vomiting, sweating, hypotension, confusion due to the accumulation of aldehyde)?
Disulfiram
- Should not be administered with any medications that contain alcohol (cough syrups, cold preparations, mouthwashes)
- PATIENTS MUST BE HIGHLY MOTIVATED
