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GT BSN/CNL PHARM > Drugs to Treat Addiction > Flashcards

Drugs to Treat Addiction Flashcards

1
Q

When are schedule I drugs prescribed

A

No approved medical use in the US at this time

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2
Q

List some schedule I drugs

A

Heroin
Psilocybin
MDMA
LSD
Marijuana

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3
Q

How are scheduled drugs placed in schedule II through V?

A

Schedule II = highest potential for abuse, psychological or physical dependence

Schedule V = those risks still exist, but lowest

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4
Q

List some schedule II drugs

A

Most pure opioid agonists
Amphetamine, cocaine
Barbiturate pentobarbital

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5
Q

What schedule drug is THC?

A

III

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6
Q

What schedule drug is ketamine

A

III

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7
Q

What schedule drug are benzodiazepines

A

IV

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8
Q

What schedule drug is zolpidem (Ambien)

A

IV

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9
Q

Definition of drug abuse

A

Use not in accordance with medical or social norms

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10
Q

Definition of substance use disorder

A

Continued use of drug despite significant use related problems

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11
Q

Definition of drug tolerance

A

Higher dose of drug is required to elicit the same response

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12
Q

Definition of cross tolerance

A

Tolerance to one drug confers tolerance to another
(I.e. opioids)

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13
Q

Definition of psychologic drug dependence

A

Subjective need for a psychoactive drug

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14
Q

Definition of physiologic dependence

A

State in which a physical abstinence syndrome will occur upon drug D/C

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15
Q

Definition of withdrawal syndrome

A

Signs and symptoms that occur in a physiologically dependent person upon drug d/c

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16
Q

List some effects of chronic alcohol use

A

CNS dysfunction
heart failure
Respiratory depression
Liver disease
Gastritis
Esophageal varies
Pancreatitis
Cancer risk
Teratogenesis
(Others as well!)

17
Q

What is the pattern of alcohol metabolism?

A

Zero order kinetics
(Set amount metabolism per hour, not set % metabolism per hour)

18
Q

Major drug class with cross tolerance with alcohol

A

Benzodiazepines

19
Q

As tolerance to alcohol develops, tolerance does not develop to _____

A

Respiratory depression

20
Q

Severe s/s alcohol withdrawal?

A

Cramps, vomiting, hallucinations, seizures, tachycardia, HTN, hyperthermia

Can be life threatening

21
Q

Treatment of alcohol OD

A

Supportive
(Resp support, hemodynamic support, manage fluids/electrolytes/glucose)

22
Q

Pharmacological treatment of acute alcohol withdrawal

A

Benzodiazepines!
Adjunct = antiseizure meds, a2 agonists, beta blockers

23
Q

List three meds used in alcohol abstinence. Which is the most effective?

A

Disulfiram
Naltrexone- most effective
Acamprosate

24
Q

How does disulfiram work?

A

Inhibits alcohol dehydrogenase, thus toxic levels of acetaldehyde accumulate

This causes negative reactions if etoh is consumed

25
Q

Disulfiram with etoh can cause:

A

Nausea, vomiting
Sweating
Weakness, blurred vision
Hypotension —> CV collapse
Resp depression
Death

(This is due to acetaldehyde accumulation)

26
Q

How does naltrexone work?

A

Pure opioid antagonist that blocks the pleasurable effects of EtOH (decreased dopamine release)

27
Q

How does acamprosate work

A

Decreases desire to drink (since it decreases subclinical withdrawal symptoms, likely through NMDA actions)

28
Q

At doses ingested in smoking, what are the effects of nicotine?

A

Agonism at SNS/PSNS ganglia and adrenal medulla

  • vasoconstriction
  • tachycardia
  • vomiting
  • CNS stimulation
29
Q

With tolerance to nicotine, a person does not develop tolerance to _____

A

CV effects

30
Q

S/s nicotine withdrawal

A

Anxiety & irritability
Impaired concentration
Increased appetite, weight gain

31
Q

How does nicotine replacement therapy work in smoking abstinence

A

Pharmacological nicotine doesn’t result in as much pleasure but avoids the withdrawal symptoms.

Then we can slowly decrease nicotine dose

32
Q

How does bupropion work in smoking abstinence?

A

Reduces cravings and some other w/d symptoms d/t cns stimulation

33
Q

How does varencline work in smoking cessation?

A

Partially agonizes nicotine receptors- allows for pleasurable effects but prevents pleasurable effects from nicotine from occurring

34
Q

Which drug is most effective in smoking cessation?

A

Varenicline

35
Q

Three drugs used in the treatment of opioid abstinence

A

Methadone
Buprenorphine
Naltrexone

36
Q

How does methadone work in opioid abstinence

A

Less euphoria and increases tolerance to street opioid (thus the street opioid won’t cause euphoria either)

37
Q

How does buprenorphine work in opioid abstinence?

A

Alleviates cravings but since there is a ceiling to resp depression, it’s safer

38
Q

How does naltrexone work in opioid abstinence?

A

Blocks euphoria if opioids are used

39
Q

Antidote for benzodiazepines

A

Flumazenil

GT BSN/CNL PHARM (26 decks)

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