Medications for treating addiction Flashcards
Mechanism of action of varenicline
Selective nicotine receptor partial agonist with higher affinity but lower efficacy than nicotine
Receptor which varenicline has the highest affinity for
Alpha 4 beta 2 nicotinic receptor
Effects of varenicline which make it useful for smoking cessation
Reduces cravings for cigarettes
Reduces pleasure from smoking
Safety of varenicline in hepatic dysfunction
Safe to use
Initial course length of varenicline
12 weeks
Impact of varenicline on psychiatric illness
Can exacerbate underlying psychiatric illness
Associated with low mood, anxiety, psychosis, aggression, and suicidal ideation
Safety of varenicline in patients with cardiac disease
Associated with increased risk of cardiac events
Very common side effects of varenicline
Nasopharyngitis Abnormal dreams Insomnia Headache Nausea
Brand name of varenicline
Champix
Drugs used for smoking cessation
Nicotine replacement therapy
Bupropion
Varenicline
Usual course length of bupropion for smoking cessation
7-9 weeks
Medications contained in suboxone
Four parts buprenorphine
One part naloxone
Active ingredients contained in suboxone
Four parts buprenorphine
One part naloxone
Reason suboxone contains naloxone
To prevent it being injected - causes withdrawal symptoms when injected but not when taken orally as naloxone is not absorbed by the gut
Active ingredient in subutex
Buprenorphine
Mechanism of action of buprenorphine
Partial agonist at mu receptor
Use for lofexidine in patients with addictions
Reduces symptoms of opioid withdrawal without causing dependence
Benzodiazepines used to treat withdrawal in patients with liver disease
Lorazepam
Oxazepam
Side effects of disulfiram in the absence of alcohol consumption
Headache Halitosis Metallic taste Dermatitis Sedation
Alpha 2 agonist medications used to prevent withdrawals when stopping opiates
Clonidine
Lofexidine
Alpha 2 agonist used in preventing withdrawal when stopping opiates which causes significant hypotension
Clonidine
Initial potential complication on starting naltrexone for aiding in abstinence from opiates
Can precipitate opiate withdrawal
Test dose which may be given prior to starting naltrexone
Test dose of naloxone may be given
Possible side effect of naltrexone discontinuation
Increased risk of inadvertent overdose from recreational opioids
Common side effects of naltrexone
Dysphoria
Depression
Insomnia
Drug newly marketed in 2013 for treatment of alcohol misuse, especially for where abstinence is not realistic
Nalmefene
Medication which can be used to reduce alcohol consumption in patients who are still drinking
Nalmefene
Medication used for the treatment of alcohol dependence which is best known for reducing cravings
Acamprosate
