E4: Drug Abuse/Addiction Part III Opioids Flashcards
What is the opioid WIDELY used by dentists?
OxyCodone
What is the legitamet medical use?
painkillers
Opioids are abused because they produce complete _______ of all drives in the body: Elevate mood, Cause euphoria.. Reduce sexual desires…Diminished response to provocation
satiation
Opiods: ________ dependency increases motivation to obtain the drug, because its mainly fear of _______ overriding motivation to stop
Physical…withdrawal
INTERESTING! ________ was designed for morphine tolerant patients?
Oxycodone
Oxy is “_______” – which dissolve slowly for extended release
layered
Which opioid is a RED FLAG request?
Roxicet (easier to dissolve, less binder)
What are the two main ingredients in Percocet and Roxicet?
Oxy + aCETaminophen…GET IT?!
In general _______-release, oral-dosage forms of opiates are highly monitored c/o abuse.
extended.. (they have much more drug in them!!)
SAY WHAT _______ deaths are now second only to major vehicle fatalities for number of deaths per year.
drug-induced
Number of _____ dying from opioid painkiller overdose has increased fivefold between 1999 to 2010
WOMEN
6600 women (18 women per day) died from prescription painkiller overdose in 2010….More than ________ and ______ combined
cocaine and heroin
What age range is most hit by this women and pain killers phenomenon?
25-54
Abuse of prescription painkillers by pregnant women can put an infant at risk….its called ______ and it grew by _____% from 2000 to 2009!
Neonatal Abstinence Syndrome…300%
The 5 CDC Opioid recommendations: 1. Follow guidelines for responsible opioid prescribing: _______ for substance abuse and mental health problems
screening
The 5 CDC Opioid recommendations: 2. Use ____’s prescription drug monitoring programs
State’s
The 5 CDC Opioid recommendations: Discuss pain treatment options, including :
those that DO NOT INVOLVE prescription drugs
The 5 CDC Opioid recommendations: Discuss risks/benefits of taking prescription painkillers like: _________ and ______
Chronic conditions and during pregnancy
The 5 CDC Opioid recommendations: AVOID prescribing combinations of prescription painkillers and ________!!
benzodiazepines!!
Clinicians must avoid ________ and limit quantities of prescribed pain medications and other controlled substances in an effort to help combat intentional drug abuse.
overprescribing
What is the most RAPIDLY acing opiate?
heroin
3 out of 4 NEW heroin users report having abused _______ prior to using heroin
prescription opioids
Know These What are the 7 signs of ACUTE OPIOID OVERDOSE??
PCDS-SDH 1.pinpoint pupils 2.depressed respiration 3.Hypotension 4.Shock 5.Slow/Absent Reflexes 6.Drowsiness 7.Coma
What are the two drugs used to treat overdose/withdrawal?
1.Naloxone(Narcan) and 2.Methadone
Which drug am I? Used to reverse respiratory depression, pinpoint pupils and coma…Oral surgeons have this drug in office emergency kits….Used for acute narcotic overdose
Naloxone
Which drug am I? Long-acting opioid that can replace heroin then be gradually withdrawn….Physiologically equivalent drug to heroin that is used during long-term rehabilitation programs
METH-A-DONE with heroine…(i think Tanner is on this one.)
Watch for ____________: patients asking for very potent pain meds following dental procedures = a sign of addiction…..use ______ instead
drug-seeking behaviors (you know, you fit the MODEL for drug seeking behavior). use NSAIDS
What are the 3 main consequences of using IV when abusing opioids?
1.Hep B 2.HIV 3.Damaged heart valves (antibiotic PREmed)
T/F: Dentists prescribe prophylactic antibiotics to patients with a history of abusing IV drugs.
True
What are 4 popular Benzo’s?
1.Diazepam (Valium) 2.Lorazepam(Ativan) 3.Triazolam (Halcion) 4.Midazolam(Versed)
Which benzo I used as a sedative/ hypnotic sleeping pill?
Triazolam (Halcion)
Which Benzo is used for pre-op sedation and for the induction of general anesthesia?
Mid-az-o-lam (Versed)
Prescribers rarely understand addictive quality of Benzo’s with related complications in _____ patients
elderly
Patients develop “____________” due to unavailability of benzo’s or during hospitalization for other medical problem
benzo-abstinence syndrome
What are the 3 main indications for Benzodiazapines?
1.Chronic Anxiety 2.Depression 3.Sleep Disturbance (4.undercover staties’)
If you suspect some one has chronic anxiety, you shold automatically check for _________
DEPRESSION
Why aren’t Benzo’s a very good way to improve sleep disturbances?
Nightly use loses effectiveness in 3-6 months c/o tolerance
Benzo’s: Significant ______ effect with other sedative hypnotic drugs (opiates, alcohol)
additive (TAG TEAM)
Why do Benzo’s cause EASY intoxication?
They have a PROLONGED HALF LIFE!
WE ALL KNOW that Benzo’s and EtOH DO NOT MIX. Why?
CNS depression–>RESPIRATORY depression-STOP breathing
How long does the risk for mixing EtOH and benzo’s last, even after your last dose of Benzo?
Valium lasts 20-50 hours in its half life…SO DAYS after last dose!!
What is the ANTIDOTE for BDZ Overdose? How does it work?
FLUM-AZ-EN-IL..its a BDZ antagonist (blocker)
Why can FlumAZenil not reliably reverse the respiratory depression associated with BZD overdose?
It does not block the respiratory effects of the other combination drugs that caused an OD
BDZ reversal may cause _______ = be prepared to manage
seizures
