Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Therapeutics III > Exam 5 (final) - Ott SUD > Flashcards

Exam 5 (final) - Ott SUD Flashcards

1
Q

BAC 80mg/dL (0.08mg%) significance

A

this is the legal limit to drive or operate machinery
-comes with moderate impairment usually

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

BAC 50mg/dL (0.05mg%) significance

A

motor fxn impairment visible

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

BAC 450mg/dL significance

A

respiratory depression

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

BAC 500mg/dL significance

A

LD50 for ethanol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

stage 1 alcohol withdrawal

A

~6-8 hours after withdrawal
-anxiety, increased HR, NV, craving for alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

stage 2 alcohol withdrawal

A

~24 hours after withdrawal
-same as stage 1 but may some with auditory or visual hallucinations for 1-3 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

stage 3 alcohol withdrawal

A

~1-2 days after withdrawal
-grand mal seizures in ~4% of those who are untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

stage 4 alcohol withdrawal

A

~4 days (96 hours) after withdrawal
-Delirium Tremens (DTs): not common but very high risk (severe)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

DT risk factors (5)

A

-prior history (#1 indicator of future ones)
-number of detoxifications
-consuming the equivalent of 1 pint of whiskey per day for 10-14 days prior to admission
-early sx of withdrawal
-hepatic dysfunction

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

CIWA-AR stands for what and is important why?

A

clinical institute withdrawal assessment
-this is the in-pt setting standard of care
-assesses withdrawal severity

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

treatment of alcohol withdrawal options

A

-benzodiazepines
-liver dysfxn: use lorazepam or oxazepam (can use these even if pt does not have liver dysfxn)
-no liver dysfxn: diazepam or chlordiazepoxide

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

when to medicate based on CIWA score?

A

score of <8: non-pharm
score of 8: medicate
score of 15+: risk of complications if untreated

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Thiamine importance w/ AUD

A

-always recommend thiamine if suspicious of alcohol use
-cofactor in glucose (dextrose) metabolism: if giving dextrose, make sure thiamine is given first

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

phenytoin importance w/ AUD

A

-not shown to be effective to treat withdrawal symptoms
-pts can sometimes be left on this for months or years after having withdrawal seizures —>D/C it

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Wernicke’s encephalopathy syndrome

A

-result of thiamine deficiency
-life threatening, characterized by ataxia/confusion

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

when to consider thiamine for a patient based on BAC

A

consider giving to any patient coming in with BAC of 0.08 or higher (won’t hurt them)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

disulfiram (Antabuse) clinical pearls

A

-NV or other unpleasant SE if alcohol is used
-pt must already be highly motivated to quit
-250mg maintenance dose
-effects seen up to 14 days after use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

acamprosate (Campral) clinical pearls (RSSDA)

A

-monitor renal fxn, AVOID in severe renal impairment
-suicide warning
-SE: Diarrhea, nausea, depression, anxiety
-333mg tablets (directions: take 2 tablets 3 times daily)
-safe to take if person uses alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

of disulfiram, acamprosate, and naltrexone, which is most effective for AUD?

A

naltrexone

20
Q

of the drugs used to treat it, which is least effective for OUD?

A

naltrexone

21
Q

naltrexone clinical pearls (BTLW)

A

-decreases binge drinking
-reduces time between drinking days
-monitor LFTs routinely
-pt should carry wallet card to alert emergency providers

22
Q

naltrexone ______ dosage form is preferred

A

injection

23
Q

name 5 sx of opioid withdrawal

A

muscle aches/tension
agitation/anxiety
NV, ab cramping
diarrhea
sweating, runny nose

24
Q

in opioid withdrawal sx, how do you treat muscle aches

A

NSAIDs or APAP

25
Q

in opioid withdrawal sx, how do you treat anxiety/agitation

A

hydroxyzine or benzos

26
Q

in opioid withdrawal sx, how do you treat NV or ab cramping

A

ondansetron

27
Q

in opioid withdrawal sx, how do you treat diarrhea

A

loperamide

28
Q

in opioid withdrawal sx, how do you treat sweating/runny nose

A

clonidine or lofexidine
-clonidine preferred bc of price

29
Q

clonidine dosing based on severity of withdrawal

A

mild: 0.3-0.6mg/day
severe: up to 1.2mg/day
-these are given in divided dose (0.1-0.2mg/dose up to hourly)

30
Q

lofexidine dosing (0.18mg tablets)

A

0.54mg (3 tabs) four times daily for 5-7 days (up to 14 days)
-max daily dose: 2.88mg/day (16 tabs)
-max single dose: 0.72mg (4 tabs)

31
Q

safe medications for OUD in pregnancy

A

methadone or buprenorphine

32
Q

buprenorphine is usually given in combo with ______ in a ______ form due to poor bioavailability of _______ when swallowed

A

naloxone, SL, buprenorphine or naloxone

33
Q

methadone normally has the worst interactions with an ______ (inhibitor or inducer) of ________

A

inhibitor, 3A4

34
Q

common 3A4 inhibitor drugs

A

diltiazem, verapamil, alprazolam, grapefruit, and some antibiotics

35
Q

methadone most serious SE

A

QTc prolongation

36
Q

buprenorphine substrate

A

3A4

37
Q

buprenorphine use (SL or SQ inj.) with ______ drugs may cause ______ syndrome

A

serotonergic, serotonin

38
Q

buprenorphine ER injection brand names

A

Sublocade, Brixadi

39
Q

buprenorphine ER injection is used in what case (what severity? how to start it?)

A

moderate-severe OUD
-pts started on SL form and dose adjusted for 7 days prior to initiation of injection

40
Q

considerations of methadone compared to buprenorphine (OMLA)

A

-opioid so it has more effect on receptors
-medicaid covers
-effective long term
-availability or program in area? transportation?

41
Q

considerations of buprenorphine compared to methadone

A

-less misuse potential
-medicaid covers
-monthly prescription available
-less stigma

42
Q

dose of naltrexone long acting injection (for OUD and AUD)

A

380mg q4weeks

43
Q

naltrexone considered the “_________” treatment, pts must be ready to be done for good

A

abstinence

44
Q

there is an increased risk of OD if patient stops ________ and goes back to using opioids at previous doses

A

naltrexone
-must educate pts on this

45
Q

what other comorbidity may come with substance withdrawal and how do you treat it?

A

depression, treat as normal clinical depression

Therapeutics III (22 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions