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PHRM 845 > Ott Substance Use Disorder > Flashcards

Ott Substance Use Disorder Flashcards

1
Q

substance use criteria

A

two of the following in 12 months:
- larger amount /longer period than intended
- desire or no success trying to cut out
- lots time spent obtaining and recovering
- craving, desire, urge to use
- failure to fulfill major role obligations
- use despite it causing problems
- important activities given up/ reduced
- use when it is hazardous (driving)
- using while knowing you have a problem
- tolerance
- withdrawal sx

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2
Q

does a person with a SUD recover?

A

always recovering

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3
Q

what is the legal limit for alcohol in most states

A

80 mg/dL
0.08mg%

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4
Q

0.05% presentation

A

motor function impairment observable

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5
Q

0.08% presentation

A

moderate impairment

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6
Q

450 mg/dL presentation

A

respiratory depression

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7
Q

500 mg/dL presentation

A

LD 50 for alcohol

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8
Q

stage 4 of alcohol withdrawal time of onset

A

3-5 days

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9
Q

stage 4 of alcohol withdrawal clinical features

A

DTs in 5% of pts, confusion, hallucinations, illusions, agitation, tachycardia, hyperthermia

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10
Q

risk factor for DTs

A

prior DTs
number of detoxifications
early withdrawal sx
hepatic dysfunction
consuming 1 pint of whiskey for 10 of 14 days prior to admission

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11
Q

consuming what puts you at higher risk for DTs

A

equivalent of 1 pint of whiskey for 10 of 14 days leading up to admission

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12
Q

prophylaxis/fixed dosing advantage and disadvantage

A

advantage: prevent withdrawal
disadvantage: unnecessary benzo dosing

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13
Q

individualized dosing uses what

A

CIWA-Ar scale

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14
Q

when to use non-pharm

A

CIWA < 8

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15
Q

when to medicate

A

CIWA 8+

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16
Q

when do we have risk if we don’t treat

A

CIWA >15

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17
Q

benefits of individual dosing

A

reduce treatment duration
decreased benzo dosing

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18
Q

alcohol withdrawal treatmen

A

good liver: diazepam/chlordiazepoxide
bad liver: lorazepam/oxazepam

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19
Q

lorazepam use in alcohol withdrawl

A

PRN

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20
Q

what drug is recommended with alchol use

A

thiamine

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21
Q

which drug does not work for pts with seizures in alcohol disorder?

A

phenytoin

22
Q

what is Wenicke’s encephalopathy a result of

A

thiamine deficiency
high glucose loads

23
Q

when do we give thiamine?

A

before dextrose containing fluids

24
Q

thiamaine is a cofactor in what

A

glucose metabolism

25
Q

disulfiram

A

aversive therapy
unpleasant effects if used
highly motivated person

26
Q

disulfiram reaction for how many days after discontinuation

A

14 days

27
Q

disulfuram dosing

A

250 mg daily

28
Q

acamprosate considerations

A

avoid in severe renal impairment
suicidality warning

29
Q

acamprosate side effects

A

diarrhea
constipation
depression
anxiety

30
Q

naltrexone does what

A

decreases binge drinking
increase time between drinking days

31
Q

side effects with naltrexone

A

elevated LFTs
injection site reactions

32
Q

what happens if you take opioids with naltrexone

A

opioids wont work

33
Q

opioid withdrawl sx

A

like the flu
muscle aches
abdominal cramping
diarrhea
sweating

34
Q

treatment of anxiety or agitation with withdrawal

A

hydroxizine

35
Q

alpha 2 agonists used in opioid withdrawal sx

A

clonidine
lofexidine

36
Q

clonidine side effect

A

hypotension

37
Q

lofexidine benefit

A

less CV hypotension side effects

38
Q

whats FDA approved for withdrawal FDA approved

A

lofexidine

39
Q

pregnant recomendations for OUD

A

buprenorphine
methadone

40
Q

what drug must be given in a licensed treatment program?

A

methadone

41
Q

buprenorphine must be given how

A

sublingually with naloxone

42
Q

methadone CYPs

A

2B6
3A4
2C19
2D6

43
Q

qtc med

A

methadone

44
Q

when to initiate buprenorphine

A

clear signs of withdrawal
divided doses on day 1

45
Q

buprenorphine CYP

A

3A4 substrate

46
Q

buprenorphine concern

A

LFTs
serotonin syndrome

47
Q

buprenorphine injection can be given to who?

A

patients on sublingual for at least 7days prior to administration

48
Q

abstinenece treatment of opioid use disorder

A

naltrexone

49
Q

risk of overdose if they discontinue treatment

A

naltrexone

50
Q
A

PHRM 845 (38 decks)

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