module 4 opioid tolerance and dependence

Question 1

tolerance

Answer 1

reduction in AE
shorter duration
lower efficacy
- inc. dose
- switch to another opioid/methadone

Question 2

physical dependence

Answer 2

physical dependence: withdrawal s/s

- slinically significant

Question 3

addiction

Answer 3

psychological dependence

biologic and social factors

Question 4

naloxone MOA

Answer 4

pure competitive opioid antagonist

- no opioid activity at therapeutic dose

Question 5

naloxone use

Answer 5

reversal of opioid overdose associated with resp. depression 
sedatin 
coma
hypotension
psychotomimetic effects

Question 6

naloxone administration

Answer 6

parenteral only, not absorbed orally

half-life: 30-90min

Question 7

naloxone AE

Answer 7

precipitates withdrawal in opioid dependent subjects

Question 8

naltrexone MOA

Answer 8

pure competitive opioid antagonist

Question 9

naltrexone administration

Answer 9

half-life 4 hours with active metabolite

effective PO

Question 10

naltrexone use

Answer 10

maintenance of opioid free state in detoxified, formerly opioid dependent pts
alcoholism

Question 11

nalmephene

Answer 11

pure opioid antagonist

half-life 10 hours

Question 12

nalmephene use

Answer 12

post op reversal of opioids and tx of opioid overdose

Question 13

tx of opioid withdrawal somatic s/s

Answer 13

clonidine
benzodizepines
antiemetics
antidiarrheals
analgesics

Question 14

tx of opioid wthdrawal maintenance tx

Answer 14

methadone
buprenorphine
buprenorphine/naloxone