Substance dependence

Question 1

What is offered to patients going through opioid withdrawal?

Answer 1

Methadone and Buprenorphine

Question 2

A patient is withdrawing from sedative drugs, what type of opioid replacement should be offered?

Answer 2

Methadone as it had sedative properties so is the most similar to the drug of abuse.

Question 3

Why would a patient be given Lorazepam instead of diazepam in regards to an acute alcohol related seizures?

Answer 3

Lorazepam is a short acting benzodiazepam so will act quicker during a seizer. For prophylaxis of seizures during alcohol withdrawal longer acting benzodiapams (diazepam) can be used.

Question 4

What are the four drugs given to patients with alcohol dependence?

Answer 4

Acamprosate
Disulfiram
Naltrexone
Nalmefene

Question 5

What is considered first line for alcohol dependence?

Answer 5

Acamprosate with Naltrexone with psychological interventions.

Question 6

What are some of the risks of disulfiram?

Answer 6

Disulfiram alcohol reaction: this can occur when exposed to small amounts of alcohol that includes perfume, non-alcoholic beers/ wine, aerosol sprays. It leads to severe and life threatening side effects like nausea, flushing, palpitations, hypotension, respiratory depression and arrhythmia.

Question 7

A patient is going through alcohol dependence and is at high risk of relapse, what treatment should be initiated?

Answer 7

Nalmefene(18mg daily PRN) is used specifically for patients who are at high drinking risk level.

Question 8

When would Buprenorphine be preferred over methadone?

Answer 8

-Pt requires use of driving equipment (less sedating)
-Patient is on many medications (less drug-interactions)
-lower risk of overdose.

Question 9

A patient walks in the pharmacy for their methadone having not received their methadone dose for the past three days, what is the course of action you should take?

Answer 9

You cannot give them their normal dose of methadone according to the three day rule as they have built up their tolerance and there is a increased risk of overdose. So you contact the prescriber.

Question 10

what can be given to a patient who is experiencing diarrhoea linked to opioid withdrawal?

Answer 10

Loperamide and meberverine for stomach cramps

Question 11

what can be given to a patient who is experiencing nausea and vomiting linked to opioid withdrawal

Answer 11

Metoclopramide, Prochlorperazine