Opiate Cessation Flashcards
3 opioid cessation programs
- 12 step programs
- narcotics anonymous
- mutual help programs-health systems
What is the antidote for opioid overdose?
naloxone
opioid antagonist
Naloxone is structurally similar to ___, but has no analgesic properties.
morphine
no abuse potential
not a controlle substance
Which type of opioid receptor does naloxone bind too?
Mu
Is naloxone an agonist or antagonist?
antagonist
Naloxone has no effect in the absence of opioids.
a. true
b. false
a. true
Which route of naloxone administration has fastest onset of action?
IV
IV: 2mins
Nasal: 8-10mins
IM: 2-5mins
Does naloxone have a PO formulation?
no
The naloxone profiled syringe is what concentration?
2mg/mL
How is naloxone profiled syringe administered?
- 1mL in each nostril PRN
- inject 2mL IM in outer thigh PRN
What is the concentration of the naloxone vial?
0.4mg/mL
comes in 2 vials
How is naloxone vial administered?
inject 1mL in outer thigh PRN, repeat in 2 mins PRN
What is the concentration of the naloxone auto-injector?
2mg/0.4mL
or 0.4mg/0.4mL
comes as a two pack
How is the naloxone auto injector (Evzio) administered?
inject in outer thigh PRN, repeat in 2mins PRN
__ maintenance therapy is the cornerstone for opiate addiction.
methadone
R methadone binds to which receptor?
mu opiate
S methadone binds to which receptor?
NMDA receptor
Methadone is a substrate for efflux pump?
P-glycoprotein
Methadone is primarily metabolized by what two CYPs?
3A4
2B6
Methadone can cause what type of heart problem?
torsades de pointes
Which CYP may be genetic tested for methadone?
2B6
Which 2B6 allele is associated with higher concentrations?
2B611
What is buprenorphine MOA?
partial mu opiate receptor agonist and kappa opiate antagonist
Buprenorphine can be used alone as an alternative to methadone for opiate addiction.
a. true
b. false
a. true
Naloxone has very low bioavailability.
a. true
b. false
a. true
< 10%
half life 1.1 hrs
glucuronidation
What ratio of buprenorphine:naloxone (Suboxone) is FDA approved?
4:1
2mg: 0.5mg
8mg: 2mg
The buprenorphine implant is better than sublingual formulation over longer periods of time.
a. true
b. false
a. true
can start on sublingual and switch to implant
Which two opioids have combination formulations with naltrexone?
- morphine
- oxycodone
What is the time of onset for the therapeutic actions of naloxone given nasally?
8-10 mins
