Ch. 40

Question 1

Oxycodone

Answer 1

• opioid similar to morphine
• intended as controlled-released drug
• abusers crush tablet
• snort powder or dissolve in water for IV
• entire dose absorbed immediately with high risk of death

Question 2

Meperidine

Answer 2

• nurses and HCp who abuse opioids often select meperidine
• highly effective in oral route
• minimal effect on smooth muscle: fewer problems with constipation and urinary retention

Question 3

Tolerance and Physical Dependence

Answer 3

• prolonged use
• effects for which tolerance develops and does not develop
• cross-tolerance
• physical dependence: long-term use; abstinence syndrome; acute phase and second phase

Question 4

Treatment of Acute Toxicity

Answer 4

• triad of symptoms and treatment

- resp. depression; coma; pinpoint; Naloxone (careful titration)

Question 5

Opioid Detoxification

Answer 5

• clonidine-assisted withdrawl
• centrally acting alpha2-adrenergic agonist
• most effective against symptoms related to autonomic hyperactivity (nausea, vomiting, diarrhea)
• provides modest relief from muscle aches, restlessness, anixety, and insomnia
• does not diminish opioid craving

Question 6

Ultrarapid Withdrawl

Answer 6

• admin of naloxone or natlrexone
• withdrawl process accelerated
• ultrarapid procedure: general anesthesia or heavy sedation with IV midazolam
• in both procedures, clonidine may be added to ease symptoms
• no more effective than standard withdrawl techniques
• considerably more expensive

Question 7

Detoxification

Answer 7

• methadone substituation: long-lasting oral opioid; most commonly used agent; approx. 10 days
• Buprenorphine: substituted for opioid the addict is physically dependent on
• prevents symptoms of withdrawl

Question 8

Drugs for Long-Term Opioid Addiction

Answer 8

• 3 groups of meds
• Methadone: maintenance and supressive therapy
• buprenorphine: maintenance therapy and detox facilitation
• Naltrexone: discourges renewed opioid abuse

Question 9

Sequelae of Compulsive Opioid Use

Answer 9

• few direct detrimental effects
• Individuals on methadone maintenance can be successful socially and at work
• indirect hazards: Septicemia, cellulitis, abscesses, endocarditis, tuberculosis, hep C, HIV, and foreign body emboli
• accidental overdose

Question 10

Therapeutic Use of Marijuana

Answer 10

• approved uses for cannabinoids
• unapprovaed uses for cannabinoids
• medical research on marijuana
• legal status of medial marijuana
• synthetic marijuana

Question 11

Weed VS Alcohol

Answer 11

• aggressive behaviour is rare
• less loss of judgemnt
• increased appetite; fewer problems with nutritional deficiencies
• wedd produces increased toxic psychosis, dissociative phenomena, and paranoia, more so than alcohol does