Medications for treating addiction

Question 1

Mechanism of action of varenicline

Answer 1

Selective nicotine receptor partial agonist with higher affinity but lower efficacy than nicotine

Question 2

Receptor which varenicline has the highest affinity for

Answer 2

Alpha 4 beta 2 nicotinic receptor

Question 3

Effects of varenicline which make it useful for smoking cessation

Answer 3

Reduces cravings for cigarettes

Reduces pleasure from smoking

Question 4

Safety of varenicline in hepatic dysfunction

Answer 4

Safe to use

Question 5

Initial course length of varenicline

Answer 5

12 weeks

Question 6

Impact of varenicline on psychiatric illness

Answer 6

Can exacerbate underlying psychiatric illness

Associated with low mood, anxiety, psychosis, aggression, and suicidal ideation

Question 7

Safety of varenicline in patients with cardiac disease

Answer 7

Associated with increased risk of cardiac events

Question 8

Very common side effects of varenicline

Answer 8

Nasopharyngitis
Abnormal dreams
Insomnia
Headache
Nausea

Question 9

Brand name of varenicline

Answer 9

Champix

Question 10

Drugs used for smoking cessation

Answer 10

Nicotine replacement therapy
Bupropion
Varenicline

Question 11

Usual course length of bupropion for smoking cessation

Answer 11

7-9 weeks

Question 12

Medications contained in suboxone

Answer 12

Four parts buprenorphine

One part naloxone

Question 13

Active ingredients contained in suboxone

Answer 13

Four parts buprenorphine

One part naloxone

Question 14

Reason suboxone contains naloxone

Answer 14

To prevent it being injected - causes withdrawal symptoms when injected but not when taken orally as naloxone is not absorbed by the gut

Question 15

Active ingredient in subutex

Answer 15

Buprenorphine

Question 16

Mechanism of action of buprenorphine

Answer 16

Partial agonist at mu receptor

Question 17

Use for lofexidine in patients with addictions

Answer 17

Reduces symptoms of opioid withdrawal without causing dependence

Question 18

Benzodiazepines used to treat withdrawal in patients with liver disease

Answer 18

Lorazepam

Oxazepam

Question 19

Side effects of disulfiram in the absence of alcohol consumption

Answer 19

Headache
Halitosis
Metallic taste
Dermatitis
Sedation

Question 20

Alpha 2 agonist medications used to prevent withdrawals when stopping opiates

Answer 20

Clonidine

Lofexidine

Question 21

Alpha 2 agonist used in preventing withdrawal when stopping opiates which causes significant hypotension

Answer 21

Clonidine

Question 22

Initial potential complication on starting naltrexone for aiding in abstinence from opiates

Answer 22

Can precipitate opiate withdrawal

Question 23

Test dose which may be given prior to starting naltrexone

Answer 23

Test dose of naloxone may be given

Question 24

Possible side effect of naltrexone discontinuation

Answer 24

Increased risk of inadvertent overdose from recreational opioids

Question 25

Common side effects of naltrexone

Answer 25

Dysphoria Depression Insomnia

Question 26

Drug newly marketed in 2013 for treatment of alcohol misuse, especially for where abstinence is not realistic

Answer 26

Nalmefene

Question 27

Medication which can be used to reduce alcohol consumption in patients who are still drinking

Answer 27

Nalmefene

Question 28

Medication used for the treatment of alcohol dependence which is best known for reducing cravings

Answer 28

Acamprosate