chapter 18- drugs of abuse Flashcards
what is the mechanism of action of disulfiram
inhibits aldehyde dehydrogenase and prevents metabolism of acetaldehyde
what is the clinical application of disulfiram
alcoholism
what is the clinical application of naloxone
opioid overdose; rapid reversal of opioid activity
what is the clinical application of naltrexone
opioid dependence; alcohol dependence
what is the clinical application of methadone
opioid detoxification; severe pain
what are some adverse reactions seen with disulfiram
hepatitis, peripheral neuropathy, psychotic disorder, metallic/garlic-like aftertaste
what are some adverse reactions seen with naloxone
cardiac arrhythmia, blood pressure lability
what are some adverse reactions seen with naltrexone
hepatotoxicity; abdominal pain, constipation, nausea, headache, anxiety
what are some adverse reactions seen with methadone
cardiac arrest, shock, respiratory arrest; constipation, asthenia
what are some contraindications for disulfiram
psychoses; coronary occlusion severe myocardial disease
what are some contraindications for naltrexone use
acute hepatitis or liver failure; concomitant opioid analgesics
what does acetaldehyde accumulation cause
facial flushing, headache, nausea, orthostatic hypotension
what co-administration with disulfiram can cause adverse CNS effects
isoniazid
what are some therapeutic consideration for naloxone
interactions with opioid analgesics; short half life
what is the clinical application of buprenorphine
opioid dependence; moderate to severe pain
what is the clinical application of acamprosate
maintenance of abstinence in alcoholism
what is the clinical application of vareniciline
smoking cessation aid
what are some adverse reactions seen with varenicline
suicidal thoughts, erratic/aggressive behavior, abnormal dreams
what are some adverse reactions seen with buprenorphine
brady/tachyarrhythmia, hyper/hypotension, cyanosis
what are some adverse reactions seen with acamprosate
cardiomyopathy, suicide attempt, back pain
what is the mechanism of action of buprenorphine
partial u-opioid receptor agonist and k-opioid receptor antagonist
what is the mechanism of action of acamprosate
analog of homotaurine, a GABAergic agonist
what is a contraindication for acamprosate use
severe renal impairment
how does acamprosate reestablish a more stable state for the treatment of alcohol dependence
modulates glutamate hyperactivity
what is the mechanism of action of varenicline
partial neuronal alpha4beta2 nicotinic receptor agonist that prevents nicotine stimulation of mesolimbic dopamine system
what is a contraindication for varenicline use
exercise caution with preexisting psychiatric illnesses because patients with these illnesses were not included in clinical trials
when should varenicline be started
1 week before target quit date and titrated to maintenance dose over that week
