Opioid Use Disorder Flashcards
What is tolerance to opiods, physical dependence
Decrease in opioid potency with repeated administration, physiological adaptions that are responsible for the emergence of withdrawal symptoms upon abrupt discontinuation of opiods
T/F: It is easy to predict tolerance and physical dependency associated with opiods but not who will develop opiod use disorder
True
What are side effects of OUD
increased risk of suicides, sclerosed veins, infections, tuberculosis
Why is buprenorphine (agonist) given with naloxone (antagonist)
Prevents getting a high from burpenorphine if it is abused through a needle since naloxone has 100 percent bioavailability
T/F: the Probuphine (buprenorphin implant) is only allowed to be used for 12 months
True
What is the indication for buprenorphine depot
Patients who have achieved and sustained prolonged clinical stability on low to moderate doses of transmucosal burpenorphine products for 3 months or longer
How is the burpenorphine depot administered
An abdominal subcutaneous injection, patiens recieve 300 mg monthly injection for the first 2 months and then a 100 mg monthly maintenance injection threafter
How does the redone ER formulation of oxycontin prevent abuse
Upon crushing, turns into a pasty sawdust
What occurs in the black market that causes heroin to be more dangerous
Synthetic fentanyl is made be causes it is much cheaper than heroin while also being more potent
What are the medication related risk factors for opioid-induced death
Daily dose greater than 20 morphine miligram equivalents, long-acting or extended-release formulations, combination of opiods with BZDs, opiod use greater than 3 months, less than 2 weeks after initiation of long acting/extended release formulations
What are the patient-related risk factors for opiod-induced death
Greater than 65 years old, sleep disordered breathing, renal or hepatic impairment, depression, substance use disorder, history of overdose
What are signs and symptoms a patient has an opiod overdose
breathing will be slow or absent, lips and nails are blue, person is not moving, person may be choking, gurgling sounds or snoring, person can’t be woken up, skin feels cold, PUPILS ARE TINY
Why do patients usually die hours after being naloxone
Nalonxe’s short half life allows the long half life of opiods to cause overdose again
T/F: Patients who received naloxone in the out of hospital setting should seek immediate emergency medical assistance after the first dose due to the likelihood the respiratory and/or central nervous system depression will return
True
T/F: The naloxone auto injector has slower onset than the nalsal naloxone
False:The naloxone auto injector has an onset of 2 to 5 minutes while the naloxone nasal spray has an onset of 8 to 13 minutes
What is an advantage that nasal narcan has over auto injection of nalaxone
Nasal narcan has two doses while the nalaxone auto-injector only has one dose
T/F: When using nasal narcan use only one nostril
False: Use both one nostril per dose for nasal narcan
What is the most potent fentanyl analog that can kill a patient with a much as a grain of salt, how much fentanyl can kill a patient
Carfentanil, 2mg
T/F: Carefentanil overdose cannot be stopped by narcan doses
True
What are the steps for treating a baby with opiod use disorder
Initiation (2 consecutive NAS score of greater than 8 or 1 score greater than 12), Escalation (increase dose every 3 hours until average NAS score is less than 8 in 24 hours), Stabilization (Maintain dose for 48 hours), Wean ( 10% stabilization dose daily then discharge 48 hours off the drug)
What are non-pharmacologic approaches for baby with opiod abuse disorder
Swaddling, keep them in a dark quiet room, breast feed frequently and small doses
