Addiction Medicine Flashcards
The majority of people with heroin addiction started on what drug?
- prescription opiates
To be diagnosed with a substance use disorder according to the DSM-5 the patient needs to have how many of the listed factors?
2 or greater
What viral infection is prevalent in IVDU?
-Hepatitis C infection
What are the basic differences between opiate intoxication and withdrawal?
- intoxication = patient will be lethargic, vitals will be diminished (everything slows down)
- withdrawal = patient will be restless, vitals will be increased (everything speeds up)
How do you manage opiate intoxication if the vital signs are unstable?
- Narcan
What drug is commonly used to control withdrawal symptoms?
- Suboxone
What is the main adverse effect with Naloxone (Narcan)?
- puts a patient into immediate withdrawal
If a patient is set to begin taking suboxone it is important that you instruct them to begin taking it after what?
- begin taking suboxone when they reach withdrawal
What is the main adverse effect with overdosing on Methadone?
- respiratory depression
What is the difference between suboxone and methadone in terms of MOA and half-life?
- subxone is a partial u-agonist and lasts ~24 hours
- methadone is a full u-agonist and lasts 8-59 hours
What is the main cardiovascular adverse effect of methadone?
- QT prolongation
What is the caveat with taking naltrexone/Vivitrol?
- needs to have opiates out of system for 10-14 days
What are the 3 common cocktail medications used to supplement the high of opiates?
- gabapentin
- clonidine
- benzodiazipines
When prescribing schedule II/III drugs to first time adults, you must limit the prescription amount to how many weeks?
- 1 week
What scale would you use to assess for alcohol withdrawal?
CIWA scale
What scale would you use to assess for opiate withdrawal?
COWS scale
What is the most common drug used to manage acute alcohol withdrawal?
benzodiazepines
What medical therapy is most commonly used for treatment of ETOH abuse disorder?
- Naltrexone/Vivitrol
Wernicke’s Korsakoff is caused by a deficiency in what?
thiamine deficiency
What are the 3 signs consistent with Wernicke’s Korsakoff?
- Confabulation
- Nystagmus
- Ataxia
Minor withdrawal from alcohol happens at _____ hours
seizures from alcohol happens at _____ hours
Hallucinosis from alcohol happens at _____ hours
Delirium tremens from alcohol happens at _____ hours
Minor withdrawal from alcohol happens at 6-36 hours
seizures from alcohol happens at 6-48 hours
Hallucinosis from alcohol happens at 12-48 hours
Delirium tremens from alcohol happens at 48-96 hours
What is motivational interviewing used for?
- harness a patient’s intrinsic motivation for change
