Drug Dependence Flashcards
what liquid can be used to help people come off opiates by stopping cravings for opiates?
methadone - green liquid that must be drunk in front of the pharmacist. blocks acute effects of other opioids
what is an opioid antagonist that can be used to prevent opioid use in people who are no longer using opioids?
naltrexone
what is the antidote to an opioid overdose
naloxone
what are the symptoms of delirium tremens?
- shaking, vomiting, tachycardia, HTN, sweating, pyrexia
what can you give alcoholics who are withdrawing to prevent Wernicke-Korsakoff’s syndrome?
pabrinex (thiamine and vitamines)
what is a partial opioid agonist that activates the opioid receptor, diminishing cravings for opiates and preventing euphoria if the patient abuses opiates?
buprenorphine (given sublingually)
name some effects of cocaine?
intense euphoria alertness and wakefullness increased confidence and strength heightened sexual feelings indifference to concerns and cares anxeity, paranoia, restlessness, tactile hallucinations severe psychological, but not physical, dependence tolerance
what would a cocaine overdose cause?
convulsions
HTN
cardiac arrhythmias
hyperthermia (due to excessive muscle activity)
death from respiratory depression and circulatory collapse
what is the mecahnism of action of amfetamines?
block re-uptake of DA, 5-HT and NA thus increasing their concentrations in the cytoplasm
what are teh effects of amphetamines?
euphoria increaed self confidence alertness and wakefullness anorexia irritability, agitation psychotic behaviour
what does acute intoxication of amfetamines cause?
hyperthermia, panic, tremor, confusion, hallucinations and aggressiveness.
how does nicotine-replacement therapy work?
reduces cravings for nicotine
what is bupropion and what is it used for?
atypical antidepressant used to help people quit smoking. should be started 1-2wks before a ‘quit date’.
less likely to gain weight if person uses thsi alongside quitting.
unwanted effects: anxiety, headache, insomnia, dry mouth
what is varenicline used for?
partial agonist at nicotine receptors.
causes modest release of dopamine which reduces cravings and withdrawal symptoms from somking cessation. should be started 1-2wks before ‘quit date’ and combined with behavioural support
name some hallucinogens
LSD
psilocybin (‘magic mushroonms’)
mescaline
DMT
what are the effects of hallucinogens?
visual hallucinations - may get sensory impressions such that music is ‘seen’ or colours’ heard’ (synaesthesia) which can produce anxiety.
time appears to pass slowly
altered emotions - elated or depression
rapid mood swings can occur
dizziness, weakness, drowsiness and parasethesia
how quickly can tolerance occur with hallucinogens?
5 days
what is the mechanism of action of cannabis?
cannabinoids interact with CB1 receptors in the brain which reduce intracellular signals.
what effects do you get from cannabis?
psychomotor effects - euphoria, heightened intensity of sensations and relaxation
ocasionally panic reactions, hallucinations and depersonalisation
can increase risk of developing schizophrenia
recent memory is markedly impaired
tachycardia and increased BP
what can alcohol raise in a FBC?
MCV, GGT
what is given for controlled alcohol detoxification?
sedative agent e.g. chlordiazepoxide or diazepam,
clonidine to reduce excessive sympathetic stimulation,
pabrinex to prevent Wernicke’s encephalopathy
what is acamprosate used for
reduces cravings for alcohol
name two opioid antagonists that cna reduce the reinforcing effects of alcohol?
nalmefene, naltrexone (not licenced for this in UK)
what is the mechanism of action of disulfiram?
acetaldehyde dehydrogenase inhibitor - causes unpleasant hangover symptoms after just small amounts of alcohol so can help put people off drinking.
why is chlordiazepoxide used for alcohol withdrawal?
to prevent fitting
what do you need to watch out for on an ABG in alcoholics?
high lactate due to high breakdown
what are physical signs of opioid overdose?
reduced GCS
respiratory depression or arrest
can vomit and aspirate
pinpoint pupils that dilate sluggishly
what is the effect of alcohol on pupils?
dilates them
how much naloxone can you give for an opioid overdose?
400mg IM
how long does methadone prevent withdrawal symptoms for?
> 24hrs
who is naltrexone recommended for?
people who were formerly opioid dependent but are not detoxified and are highly motivated to remain in an abstinence programme
what is an antidote for TCAs?
sodium bicarb
