Brainscape's Knowledge GenomeTM

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


See full index

Therapeutics 3 - Spring 2018 > Final - Ott > Flashcards

Final - Ott Flashcards

1
Q

Alcohol Withdrawal: Time of Onsets

Stage 1: ______ hours

A

6 - 8

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

Alcohol Withdrawal: Time of Onsets

Stage 2: ______ hours

A

~24 hours

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

`Alcohol Withdrawal: Time of Onsets

Stage 3: ______ hours

A

~1 - 2 days

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

Alcohol Withdrawal: Time of Onsets

Stage 4: ______ hours

A

3 - 5 days

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

what are the clinical features of alcohol withdrawal during stage 1

A

autonomic hyperactivity (tachycardia, insomnia, N/V,diaphoresis)

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

what are the clinical features of alcohol withdrawal during stage 2

A

still autonomic hyperactivity but w/ auditory and visual hallucinations

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

what are the clinical features of alcohol withdrawal during stage 3

A

~4% of pts that go untreated develop GRAND MAL seizures after the drop in BAC

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

what are the clinical features of alcohol withdrawal during stage 4

A

~5% of pts: delirium tremens!

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

People are more likely to develop delirium tremens if they have ______ dysfunction

A

hepatic

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

what things make a pt more likely to have DTs when alcohol withdrawal

A 
prior hx of DTs
# of detoxs
early symptoms during withdrawal
hepatic dysfunction
consuming 1 pint of whiskey per day for 10 - 14 days prior to admission
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

what is CIWA/how do we use it

A

validated scale —- known as Clinical Institute withdrawal assessment
ranks diff. symptom types from 0 - 7
(symptoms include N/V, tremors, sweats, anxiety, agitation, tactile disturbances, auditory/visual hallucinations)

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

Main tx option for alcohol withdrawal?

A

BZDs

Diazepam, Chlordiazepoxide, Lorazepam

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

BZDs for Alcohol Withdrawal:
Use _______ if no liver dysfunction

Use _______ if pt has liver dysfunction

A

Diazepam, Chlordiazepoxide

Lorazepam

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

Using CIWA scores for Alcohol Withdrawal:

What to do it CIWA < 8 - 10

A

nonpharm tx

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

Using CIWA scores for Alcohol Withdrawal:

What to do it CIWA 8 - 15

A

medicate

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

Using CIWA scores for Alcohol Withdrawal:

What to do it CIWA > 15

A

risk of complications if not treated

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

what other drugs can be used for alcohol withdrawal rather than BZDs

A

Thiamine!!

Anticonvulsants - Valproic acid 1st; CBZ 2nd

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

what is wernicke korsakoff syndrome

A

when there is low thiamine — give thiamine before you give ppl dextrose containing fluids because this could cause encephalopathy

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

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
is known as aversive therapy

A

disulfiram

20
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
is best for binge drinking

A

naltrexone

21
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
need to monitor renal function

A

acamprosate

remember prosate —prostate— urination…

22
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
monitor LVTs

A

disulfiram and naltrexone

23
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
has a suicidality warning

A

acamprosate

24
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
has to take 6 tabs daily (TID dosing)

A

acamprosate

25
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
which one has IM dosing option

A

naltrexone

26
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
which one is problematic if pt has pain management needs/gets in accident and needs pain meds

A

naltrexone (opioid antagggggg)

27
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
is for maintenance of abstinence

A

acamprosate

28
Q

Disulfiram, Acamprosate, or Naltrexone for alcohol use disorders?
lasts in body for 14 days after last dose

A

disulfiram (aka pt counseling pt if they want a glass of wine for a special occasion, they have to stop it 2 weeks in advance)

29
Q

what drugs can be used to help with opioid withdrawal

A

clonidine (new drug of lofexidine is just like clonidine)
antidiarrheals
analgesics
antiemetics

30
Q

maintenance tx options for opioid use disorders

A

methadone and buprenorphine

31
Q

which drug needs DATA 2000 certified physicians

A

buprenorphine (X_______ DEA)

32
Q

Methadone Tx Pearls:

_____ half life

A

long

33
Q

Methadone Tx Pearls:

______ dosing — pts earn ______

A

witnessed

earn TAKE home bottles

34
Q

Methadone Tx Pearls:

Urine tox screen results?

A

+ for methadone

  • for everything else
35
Q

Methadone Tx Pearls:

CYP_____ substrate

A

3A4

36
Q

Methadone Tx Pearls:

Most serious concern?/Monitoring to go with this concern?

A

QT prolongation

EKG monitoring

37
Q

Buprenorphine Tx Pearls:

it is commonly given with ______ to decrease abuse

A

naloxone

38
Q

Buprenorphine Tx Pearls:
for initial dosing you should wait _____ hours since last opioid use so that the pt does not have early withdrawal to prevent buprenorphine induced withdrawal

A

4 hours

39
Q

Buprenorphine Tx Pearls:

can keep titrating the buprenorphine/naloxone dosing til you achieve what?

A

achieve minimizing withdrawal but also not providing euphoric effects

40
Q

what are the buprenohrpone ER forms?

A

implant and injection

41
Q

issue with the buprenorphine impalnt?

A

pt must be stable on a low dose of buprenorphine

aka most pts starting off - this is NOT a good option

42
Q

Buprenorphine ER Injection:

Dosed every _____?

A

month

43
Q

why does buprenorphine ER injection have a REMS program

A

has a REMS program to prevent ppl taking the drug and giving it IV— giving IV can cause thromboembolism

44
Q

if someone comes in to hospital with psychosis from K2/spice of bathsalts — should you give antipsychotics or not?

A

No! psychosis induced by those drugs is not typically responsive to antipsychotics

45
Q

if a pt comes in with HTN due to cocaine intoxication— do we give them a beta blocker to chill?

A

don’t think so — it is controversial – worried about cardiovascular collapse

Therapeutics 3 - Spring 2018 (20 decks)

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