Management of opioid misuse Flashcards

1
Q

define problem drug use

A

problematic use of opiates +/or the illicit use of BZDs

implies routine and prolonged use as opposed to recreational and occasional use

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2
Q

effects of heroin

A
euphoria
analgesia 
respiratory depression 
constipation 
reduced conscious level 
hypotension + bradycardia 
pupillary constriction - miosis
tolerance
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3
Q

why is heroin addictive

A

rapid onset of action
short half life
available

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4
Q

withdrawal symptoms

A
dysphoria 
cravings
agitation 
tachycardia + hypertension 
piloerection 
dilated pupils
diarrhoea, N+V
joint pains 
yawning 
rhinorrhoea + lacrimation
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5
Q

when do withdrawal symptoms usually occur

A

within 6-8 hours

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6
Q

methods of administrating drugs

A
IV
smoking 
suppository 
insufflation 
ingestion
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7
Q

complications of IV drug use

A
infection: cellulitis, infective endocarditis
abscess
DVT, PE
thrombophlebitis
necrotising fasciitis
ischaemic limb 
viral hepatitis B+C
HIV
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8
Q

heroin causes psychosis, true or false

A

false

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9
Q

what are the aims of treatment

A

reducing harm
promoting recovery
maintaining abstinence

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10
Q

what test is used in drug testing

A

urine sample

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11
Q

in terms of goal setting what does SMART stand for

A
specific 
measurable 
achievable 
realistic 
time limited
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12
Q

what are the prescribing options for pharmacological management of problem drug use

A

Opioid replacement therapy ORT
Opioid detox
Opioid antagonists

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13
Q

examples of opioid replacement therapy

A

methadone

buprenorphine

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14
Q

examples of opioid detox and which is most commonly used

A

methadone - most common
buprenorphine
lofexidine

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15
Q

examples of opioid antagonists

A

naltrexone

naloxone

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16
Q

what is ORT

A

replacement of a short acting opioid with a long acting one that is safer, well tolerated and stops withdrawal symptoms

17
Q

ORT administration

A

daily visits to pharmacy

taken under supervision

18
Q

what is opioid detox

A

aims to achieve complete abstinence from all opioids

19
Q

indication for opioid antagonists

A

used in acute opioid intoxication

20
Q

methadone is a full/partial agonist and is short/long lasting

A

full agonist

long lasting

21
Q

administration of methadone

A

PO tablet

liquid

22
Q

does methadone have a maximum dose

A

no

23
Q

what is the mechanism of action of buprenorphine

A

partial agonist and antagonist

24
Q

buprenorphine is short/long lasting

A

long lasting with very high affinity

25
Q

administration of buprenorphine

A

subllingual

depot injection

26
Q

methadone/buprenorphine is used in high dose heroin addiction

A

methadone

27
Q

which drug is safer and less sedative, methadone or buprenorphine

A

buprenorphine

28
Q

max dose of buprenorphine

A

32mg/day

29
Q

what is ECG monitoring for

A

look for prolonged QT interval

30
Q

if medication is not collected for __ consecutive days, medication cannot be given

A

3