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Y3 Psychiatry > Opioid Dependence > Flashcards

Opioid Dependence Flashcards

1
Q

what are the three different types of opiates?

A

natural
semi synthetic
fully synthetic

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2
Q

name two natural opiates

A

morphine

codeine

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3
Q

name two semi synthetic opiates

A

hydrocodone

hydromorphone

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4
Q

name two fully synthetic opiates

A

methadone

tramadol

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5
Q

what rating scale is used to asses symptoms of an opioid withdrawal?

A

COWS

clinical opiate withdrawal scale

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6
Q

what is ORT?

A

opioid replacement therapy

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7
Q

what is the main management for opioid dependence?

A

ORT

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8
Q

what are the four phases of ORT?

A

induction
optimisation
maintenance
reduction

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9
Q

what is involved in the induction phase of ORT?

A

identifying need for treatment

starting

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10
Q

what is involved in the optimisation phase of ORT?

A

finding the right dose for the patient that eliminates opioid use

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11
Q

what is involved in the maintenance phase of ORT?

A

keep the dose stable til they feel ready to reduce

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12
Q

what is involved in the reduction phase of ORT?

A

reducing dose of ORT when the patient is ready and stable on maintenance

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13
Q

how long can the maintenance phase of ORT last?

A

months - years if stable

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14
Q

what are the two main ORT drugs used?

A

methadone

buprenorphine

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15
Q

what type of drug is methadone?

A

Mu receptor agonist

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16
Q

when does methadone reach peak plasma concentration?

A

4 hours

17
Q

when does methadone reach a steady state?

A

5 days

18
Q

how is methadone metabolised?

A

hepatic

via CY3P4 pathway

19
Q

how is methadone administered?

A

liquid preparation

20
Q

what dose of methadone are patients started on?

A

30ml

increase by 10ml until reaching 60ml then optimise from there

21
Q

what type of drug is buprenorphine?

A

Mu receptor partial agonist

22
Q

when does buprenorphine reach peak plasma levels?

A

1.5-2.5 hours

23
Q

how long does buprenorphine have an effect for?

A

depends on the dose

24
Q

what are the effective doses of buprenorphine?

A

12-24 mg

25
Q

how is buprenorphine administered?

A

sublingual tablets

Y3 Psychiatry (24 decks)

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