Chapter 17: Substance Use Disorder Flashcards
Drugs to help with Alcohol Withdrawal
(Benzodiazepines)
- Disulfiram (causes unpleasant taste to alcohol).
- Naltrexone (blocks pleasure effects of alcohol and reduces desire to drink).
- Acamprosate (reduces alcohol withdrawal symptoms)
Drugs to help treat Opioid Addiction
- Methadone (eliminates withdrawal symptoms and cravings by binding to opioid receptor in the brain).
- Buprenorphine (decreases pain and increases positive feelings).
- Naltrexone (blocks pleasure effects of opioids and reduces desire to use them).
- Suboxone ( combo of buprenorphine & naltrexone).
- Lofexidine (only FDA approved to treat opioid withdrawal sx)
Disulfiram
(Treats alcoholism)
Treats alcoholism by decreasing frequency of drinking.
Action: inhibits the conversation of enzyme (aldehyde dehydrogenase) which becomes toxic in the blood. This accumulation creates unpleasant and harmful effects.
Side effects:
- intense HA
- n/v
- chest pain
- weakness
- blurred vision
- mental confusion
- sweating
- anxiety
- palpitations
- breathing problems
Adverse reactions: fully developed acetaldehyde syndrome can be lethal, respiratory depression
Onset: 12 hours
Peak: 8-10 hours po
Duration: up to 20% of drug can stay in the body for 1-2 weeks after last dose
Half life: 60-120 hours
Pre-treatment : no alcohol for atleast 12-24 hours to avoid serious medication-alcohol reaction.
Contraindication: cardiac disease, psychosis, recent ingestion of metronidazole
Naltrexone
(Treats opioids addiction)
An opioid antagonist which inhibits the pleasure effects.
Action: blocks release of dopamine
Side effects: may initiate withdrawal symptoms
Adverse reactions: Nausea, tachycardia and hepatic injury
Onset of action:
- PO 15-30 minutes
- IV 1-2 minutes
- IM injection 2-5 minutes
- SubQ 2-5 minutes
Pre-treatment: patient has to be opioid free for 7-10 days and alcohol free for 3-5 days
Contraindication: hepatitis or other liver dysfunction
Which symptom associated with Naltrexone should be reported immediately?
Jaundice (liver damage)
Which dose of Naltrexone can be prescribed to a patient who is being discharged and last alcohol drink was 6 days ago.
50 mg orally po
Based on oral Naltrexone, which instruction regarding dosing would be included in patient teaching?
Take the prescribed dose at the same time each day
Which substances should be avoided while taking Disulfiram?
Beer
Vinegar
Cough syrup
Cologne
Cold remedies
Disulfiram treats alcoholism
Which substances may cause adverse reactions with Disulfiram?
St. John wort
Warfarin
Isoniazid
Alprozolam
(Xanax)
An anxiolytic (benzo class). Available ORAL only.
Provides short term relief of anxiety symptoms, panic disorder, anxiety with depression.
Onset of Action: 30-60 min
Peak: 1-2 hours
Half life: 10-15 hour
Duration of action: 6 hours
Adverse effects: confusion, ataxia, HA.
Which medication is indicated to help manage withdrawal symptoms while detoxifying from alcohol abuse?
Benzodiazepines
Which condition would a patient have if they are on lithium?
Manic and bipolar disorders