Opioid Use Disorder Flashcards

1
Q

What is tolerance to opiods, physical dependence

A

Decrease in opioid potency with repeated administration, physiological adaptions that are responsible for the emergence of withdrawal symptoms upon abrupt discontinuation of opiods

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2
Q

T/F: It is easy to predict tolerance and physical dependency associated with opiods but not who will develop opiod use disorder

A

True

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3
Q

What are side effects of OUD

A

increased risk of suicides, sclerosed veins, infections, tuberculosis

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4
Q

Why is buprenorphine (agonist) given with naloxone (antagonist)

A

Prevents getting a high from burpenorphine if it is abused through a needle since naloxone has 100 percent bioavailability

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5
Q

T/F: the Probuphine (buprenorphin implant) is only allowed to be used for 12 months

A

True

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6
Q

What is the indication for buprenorphine depot

A

Patients who have achieved and sustained prolonged clinical stability on low to moderate doses of transmucosal burpenorphine products for 3 months or longer

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7
Q

How is the burpenorphine depot administered

A

An abdominal subcutaneous injection, patiens recieve 300 mg monthly injection for the first 2 months and then a 100 mg monthly maintenance injection threafter

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8
Q

How does the redone ER formulation of oxycontin prevent abuse

A

Upon crushing, turns into a pasty sawdust

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9
Q

What occurs in the black market that causes heroin to be more dangerous

A

Synthetic fentanyl is made be causes it is much cheaper than heroin while also being more potent

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10
Q

What are the medication related risk factors for opioid-induced death

A

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

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11
Q

What are the patient-related risk factors for opiod-induced death

A

Greater than 65 years old, sleep disordered breathing, renal or hepatic impairment, depression, substance use disorder, history of overdose

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12
Q

What are signs and symptoms a patient has an opiod overdose

A

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

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13
Q

Why do patients usually die hours after being naloxone

A

Nalonxe’s short half life allows the long half life of opiods to cause overdose again

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14
Q

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

A

True

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15
Q

T/F: The naloxone auto injector has slower onset than the nalsal naloxone

A

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

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16
Q

What is an advantage that nasal narcan has over auto injection of nalaxone

A

Nasal narcan has two doses while the nalaxone auto-injector only has one dose

17
Q

T/F: When using nasal narcan use only one nostril

A

False: Use both one nostril per dose for nasal narcan

18
Q

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

A

Carfentanil, 2mg

19
Q

T/F: Carefentanil overdose cannot be stopped by narcan doses

A

True

20
Q

What are the steps for treating a baby with opiod use disorder

A

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)

21
Q

What are non-pharmacologic approaches for baby with opiod abuse disorder

A

Swaddling, keep them in a dark quiet room, breast feed frequently and small doses