Psychosocial aspects of care and experiences of using pharmacies Flashcards
What is the main-stay of treatment for drugs that don’t have physical withdrawal syndromes?
Psychosocial therapy
This could be simple (MI) to complex (CBT) interventions
What is Intersectional Stigma?
When stigmas come together and become compounded…such as stigmas from pharmacy staff, themselves and the media all coming together
In terms of Brief Advice, what does the acronym ‘FRAMES’ stand for?
Feedback –> On the patients risk
Responsibility –> Explain that the patient is responsible for their health
Advice –> About reduction and the harms
Menu –> Give options
Empathy –> Don’t stigmatise
Self Efficacy –> Encourage optimism
What is the major issue with non-opitate addicitons in terms of drug treatment?
There often isnt a pharmacological option!
When there is it is often very risky…like using benzos….so not worth the risk:benefit –> Only really used in alcohol detox
What is Acamprosate?
A drug that reduces the urge to drink
Used in alcohol relapse prevention…..although it isn’t very effective
Can Cannabis cause a withdrawal syndrome?
No!
There is no physical dependence…only psychological
Why is adjunct therapy useful in the treatment of non-opitate addiction?
As often there is an underlying cause to the drug use, like insomnia or depression, so treating this with short course benzos, or antidepressents, may reduce the illicit drug use
What is Dual Diagnosis?
The term that is used when a patient has diagnosed mental health issues whilst also being being an addict
Ideally therefore, you want to treat both together…..but can cause some issues as mental health teams may think that the drugs are causing the mental health problems so don’t think it’s their problem
Can be a bit of a ‘chicken or the egg’ scenario
Explain the properties of Buprenorphine
Mu opioid partial agonist
Kappa antagonist
ORL-1/NOP agonist
Long duration of effect
What is the role of the kappa receptor in terms of anti-depressing effects?
Stress upregultes CREB, causing dynorphin (a kappa agonist) release
Kappa agonist binding prevents dopamine release…therefore causing a depressing effect
Therefore kappa antagonists have anti-depressing effects
What is Kappa System Overdrive?
Due to mu and kappa levels normally being in equalibrium, if a addict takes heroin consistently there will be a surge in mu activation
If this is stopped then it will cause a drop in mu activation and thus a sruge in kappa activation (which is depressing)
A kappa antagonist would prevent this from occuring
What is the ORL-1/NOP Receptor?
A member of the opioid receptor family, but opioids don’t bind or activate them
Their endogenous ligands are Noiciceptin and Orphanin FQ….but these still don’t active them!
Buprenorphine appears to bind to it
Activation of ORL-1/NOP appears to decrease analgesia, but is helpful in alcohol addiction
What is the biggest problem with the combination of buprenorphine/naltrexone?
Buprenorphine isnt orally active
Naltrexone isnt active sublingually
What is BU10119?
Kappa antagonist
Mu antagonist
NOP partial agonist
Has shown to give anti-depressing effects and inhibit drug/stress related relapse to drug taking
