4 - Drug Seeking Drug Dependence and Tobacco Cessation Flashcards
What describes the “non-use” in the substance use spectrum?
States the avoiding of use of substances (abstinence)
What describes the “beneficial use” in the substance use spectrum?
Use that can have positive health, social, or spiritual effects
What is described in the “lower-risk use” in the susbtance use spectrum?
Use that has a minimal impact on a person, their family, friends and others.
What is described in the “higher-risk use” in the substance use spectrum?
Use that has a harmful and negative impact to a person, their family, friends and others.
What is described in “addiction” in the substance use spectrum?
A treatable medical condition that affects the brain and involves compulsive and continuous use despite negative impacts to a person, their family, friends and others
What is substance abuse?
It is the inappropriate or misuse of drugs or chemicals or the self-administration of a drug in a manner inconsistent with a culture’s medical or social patterns.
Does included non-sanctioned use of controlled substances of the use of legal pharmaceuticals outside of the scope of medical and dental practices
T or F, addiction is a treatable disease.
True, addiction is a treatable disease.
What is addiction?
It is a compulsive use of a drug despite adverse medical and social consequences, where acquiring and using a drug becomes the most important activity in the user’s life (drug-seeking behaviour); loss of control regarding drug use
What are the most commonly abused classes of drugs?
1.) Opioids
2.) CNS depressants/ Benzodiazipines
3.) Stimulants
What questions do we ask to our patients in regards to drug use?
- Comprehensive health history
- Ask about prescription and non-prescription drugs
- Ask about a history of substance abuse.
What is tolerance?
- It is when an individual becomes accustomed to a dose.
- Where they need a higher amount to notice the same effects.
- Develops over time.
- Greater risk of overdose
What is dependence?
It is when the body becomes accustomed to the amount
- Natural reaction when used for a period of time
- Lower dose causes withdrawal symptoms
- Physical dependence can occur with prescription medication: negative impact on the individual and others
What is withdrawal?
It is the natural reaction when the drug is stopped.
It is dependent upon:
- which drug?
- how much of the drug?
- How long the drug was used?
- How long alcohol was used?
What are the risks and adverse effects of drug dependence?
- Sympathomimetic effects (can induce hart attacks)
- Amphetamines
- Methamphetamines
- Cocaine
In who is benzodiazepine most often prescribed to?
Women and seniors
What are the 2 types of benzodiazepines that exist?
Diazepam (Valium)
Midozolam (Ativan)
What are the risks of benzodiazepines?
- Risks of cognitive impairment
- Possible Falls
- Vehicle collisions
- Adjustments to the care plan are required
If a patient is intoxicated, it it right to defer treatment?
Yes as the patient is responsible for remaining sober if they prove to have no capacity of consenting for themselves
T or F, nicotine addiction is addictive as heroine or cocaine.
True
What percentage of individuals who experiment with nicotine become regular users?
33% to 50%
What percentage of individuals are addicted to nicotine?
70% to 90%
What are the withdrawal symptoms of nicotine addiction?
- Depression
- Insomnia
- Irritability
- Anxiety
- Decreased heart rate
- Increased appetite
- Weight gain
- Carving for nicotine
What are key points to remember in regards to quit smoking?
- Using meds and nicotine replacement products can double your chances of quitting
- counselling
- rare for someone to get addicted to nicotine medicines as they slowly release at low levels into your bloodstream.
When do nicotine withdrawal syndromes peak?
Peak after 3 days, subsides 3 to 4 weeks, may be prolonged
What are the symptoms of nicotine withdrawal syndrome?
- Cravings
- Anger
- Irritability/mood swings
- Anxiety
- Poor concentration
- Restlessness
- Insomnia
- Weight gain
What is smoking cessation?
Urge to resume is recurrent and persistent even after the withdrawal symptoms have dissipated
What are the medications used WITHOUT nicotine?
Varenicline (Champix)
Bupropion (Zyban)
What are the medications used as nicotine replacement therapy?
- Gum and lozenges
- Patches
- Inhalers
What are the nicotine replacement therapies used for clients using pharmacoterapeutic agents?
- Patch
- Lozenge
- Gum
- Inhaler
What are pharmacotherapeutic agents used for clients with nicotine addiction?
- Bupropion
- Varenicline
What are the mechanisms of action for Bupropion SR? (Zyban)
- Inhibits reuptake of dopamine
- Non-competitive nicotine receptor antagonist
What are the indications of use for Bupropion SR (Zyban)
Smoking cessation +/- nicotine replacement therapy
indicated for the symptomatic relief of major depressive illness.
What are the advantages of Bupropion?
- Oral formulation
- consider for patients with co-existing depression
- May delay weight gain
What are disadvantages of Bupropion ?
Side effects: dry mouth, insomnia, agitation, unease, risk for seizures
What are the mechanisms of action for Varenicline?
Partial agonist of a nicotinic receptor subtype
What are the indications of use?
Smoking cessation in adults
What are the side effects of Varenicline?
Nausea and vomiting, increased dreaming, headache, dizziness, trouble sleeping, constipation.
What are some precautions and warnings taken for Varenicline?
- Psychiatric symptoms - greater in patients with hx
- Avoid alcohol while taking
Slightly increased risk for patients with heart problems
