Substance dependence Flashcards

1
Q

What 2 medications are used in opioid substitution therapy

A

Buprenorphine and Methadone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

How long does compelte withdrawal from opioids takw?

A

12 weeks in community, 4 weeks in rehab facility

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How many mised doses puts a patient at risk of overdose due to tolerance?

A

3 missed doses

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is suboxone

A

Buprenorphine and Naloxone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

Symptoms of neonatal withdrawl syndrome

A

High pitched cry, hypertonicity, convulsions, ineffective suckling, excesive wakefullness

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What drug can be used in combination with opioid substitution therapy or alone for people with mild or uncertain dependence?

A

Lofexidine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What medication precipitates opioid withdrawl in opioid dependent subjects?

A

Naltrexone

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

what medicastions are used in fixed dosing egimes for alcohol withdrawl?

A

Long acting benzo e.g. Chlordiazepoxide reducing doses over 7 to 10 days

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the risk of alcohol in combination with Clomethiazole?

A

can lead to fatal respiratory depression even with short term use

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Symptoms of Delirium tremens

A

agitation, confusion, paranoia, visual and auditory hallucinations

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

First line treatment for Delirium tremens

A

Lorazepam

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indication of use of Acamprostate calcium

A

relapse prevention in patients with moderate - severe alchol dependence

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

What drug can be used to treat patients who have alchohol dependence without physial withdrawl symptoms

A

Nalmefene

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What can be given to alcohol dependent patients who have severe alcohol related hepatitis with a discriminant function of 32 or more?

A

Corticosteroids

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the medication is used for Wernickes encepthalopathy

A

Thiamine (IV) followed by PO

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

How often should patients taking Disulfiram be monitored?

A

Every 2 weeks for first 2 months then each month follwing 4 months then every 6 months

17
Q

What should patients on disulfiram be counselled on?

A
  1. Risk of Disulfiram related reactions - may pccur when exposed to alcoho in perfume, aerol spray etc/ causes nausea, flushing, palpitations, htypotension and arrhythmias
  2. reporting signs of hepatoxicity
18
Q

How old do you have to be to have Acamprosate

19
Q

If patient has nicotine cravings on waking, what NRT patch is most appropriate?

A

24 hour patch

20
Q

Side effects of NRT patches

A

Mild local reactions due to irritant effects of nicotone, nightmares

21
Q

How long is Bupropion treatment for?

22
Q

Pharmacotherpay options ofr smoking cessastion

A

NRT, Varenicline, Bupropion

23
Q

What is an ADR associated with Nicotine replacement patches?

A

Nightmares - use the 16 hour patch if this occurs (break overnight)

24
Q

Side effects of nicotine chewing gum

A

GI disturbance, N&V, dyspepsia, hiccup

25
What are the 3 strengths of the 24 hour patches
21mg, 14mg, 7mg
26
hat are the 2 strengths of the 16 hour patches
15mg, 10mg
27
What conditions are NRT cautioned in?
Diabetes (monitor BMs initially), CVD, GI disease, uncontrolled hyperthyroidism --> although NRT is also betterthan smoking
28
What is smokings affect on theophylline
Smoking increases theophylline clearance, so if stopping, dose reduction may be needed
29
Can a patient have a can of coke before using nicotine gum?
No - acidic drinks can decrease absorption of nicotine through the buccal mucosa and should be avoided for 15 mins before use of NRT
30
What conditions is Varenicline and Bupropion contraindciated in?
<18 years and pregnant/breastfeeding
31
How long Varenicline treatment for?
12 weeks (start 1-2 weeks before stop date)
32
What conditions is Varenicline and Bupropion cautioned in?
Mental health (risk of suicial ideation), Seizures and CVD