Pharmacotherapy of SUD Flashcards
There is serious concern for which adverse effect with methadone?
QTc prolongation
Which drugs used for the treatment of SUD should you monitor LFTs? (3)
Naltrexone
Buprenorphine
Disulfiram
Onset to stage 1 of alcohol withdrawal
6-8 hours
Onset to stage 2 of alcohol withdrawal
24 hours
Onset to stage 3 of alcohol withdrawal
1-2 days
Onset to stage 4 on alcohol withdrawal
3-5 days
What can occur in stage 4 alcohol withdrawal that happens in about 5% of patients?
Delirium tremens
What are 5 risk factors for delirium tremens?
- Prior history of DTs (#1 predictor)
- Number of detoxifications
- Consuming the equivalent of 1 pint of whiskey for 10-14 days prior to admission
- Early symptoms of withdrawal
- Hepatic dysfunction
What benzodiazepines may be used for alcohol withdrawal if there is NO liver dysfunction?
Diazepam
Chlordiazepoxide
(can also use lorazepam and oxazepam)
What benzodiazepines may be used for alcohol withdrawal if there IS liver dysfunction?
Lorazepam
Oxazepam
What anticonvulsant medication is NOT effective in treating withdrawal seizures?
Phenytoin
What supplement should be recommended if any suspicion of alcohol use?
Thiamine - 100mg daily
Wernicke’s encephalopathy is a result of what?
Thiamine deficiency
Acamprosate has a warning for what?
suicidality
Acamprosate should be avoided in severe ______ impairment
renal
A patient can have a disulfiram reaction for up to ___ days after discontinuation of Antabuse
14
T/F: incarcerated people should NOT be required to switch medications if entering incarceration on medication
TRUE
For which drug is risk of respiratory depression in overdose much less than with other opioids due to its partial agonist effect?
Buprenorphine
Buprenorphine ER injection brand names
Sublocade
Brixadi
If taking buprenorphine, monitor for use with ___________ drugs due to risk of what?
serotonergic drugs
risk of serotonin syndrome
T/F: naltrexone is given in the same dose for OUD as that used for alcohol use disorder
TRUE
There is a high risk for what if a patient stops taking naltrexone and “relapses”?
OVERDOSE
