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NURS 252 > substance misuse: chapter 18 > Flashcards

substance misuse: chapter 18 Flashcards

1
Q

what are 8 drugs that fall under the class of opioids

A

heroin, codeine, hydrocodone, hydromorphone, meperidine, morphine, fentayl, oxycodone

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2
Q

mechanism of action of opioids

A

block receptors in the cns

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3
Q

effect of opioids (4)

A

analgesia, drowsiness, euphoria, reduced sensory response

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4
Q

indication for methadone. why

A

opioid dependence. long acting drug to reduce cravings, suppress euphoria, and prevent withdrawal

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5
Q

3 contraindications for opioids

A

high doses or prolonged use with pregnancy, respiratory depression, severe asthma

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6
Q

4 cns adverse effects of opioids

A

diuresis, miosis, convulsions, respiratory depression

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7
Q

4 non cns adverse effects of opioids

A

hypotension, decreased urinary retention, flushing, sweating

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8
Q

what is the peak period for opioid withdrawal

A

1-3 days

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9
Q

how long do opioid withdrawal symptoms last for

A

5-7 days

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10
Q

7 signs of opioid withdrawal

A

drug seeking, dilated pupils, goosebumps, sweating, rhinorrhea, lacrimation, elevated bp and pulse

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11
Q

4 symptoms of opioid withdrawl

A

desire for drugs, muscle cramps, arthralgia, anxiety

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12
Q

why is naltrexone used. why

A

to prevent euphoria that is produced by opioids because it blocks opioid receptors

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13
Q

what is methylnatrexone

A

the injectable form of naltrexone

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14
Q

what is naloxone used for. what two drugs is it commonly combined with

A

used for opioid overdose and respiratory depression. commonly combined with buprenorphine or hydromorphone

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15
Q

what are 3 classes of amphetamines

A

salts of racemic amphetamine, dextroamphetamine, methamphetamine

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16
Q

effects of cocaine

A

creates the temporary illusion of limitless power and energy but leaves the user feeling depressed, edgy, and craving more

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17
Q

what 4 things does dextroamphetamine effect

A

mood, behaviour, cognition, mental status

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18
Q

which amphetamine has the strongest effect on the body

A

methamphetamine

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19
Q

what is another name for methylenedioxymethamphetamine

A

ectasy

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20
Q

how do the effects of ecstasy differ from other amphetamines

A

it has a more calming effect but can also be energizing

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21
Q

mechanism of action of amphetamines

A

stimulate the release of norephinephrine which stimulates the cns and cardiovascular systems

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22
Q

what are the general effect of amphetamines (4)

A

elevate mood, reduce fatigue, increase alertness, increase aggression

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23
Q

7 cns adverse effects of amphetamines

A

fainting, hypoactive reflexes, fever, aggression, delirium, hallucinations, suicidal or homocidal tendencies

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24
Q

5 cardiovascular adverse effects of amphetamines

A

chilliness, pallor/flushing, tachycardia, hyper or hypotension, cardiac arrest

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25
Q

2 gi adverse effects of amphetamines

A

metallic taste, abdominal cramps

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26
Q

what is a potentially fatal adverse effect of amphetamines

A

hyperthermia

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27
Q

what is the peak period for withdrawal from amphetamines

A

1-3 days

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28
Q

how long do withdrawal symptoms last from amphetamines

A

5-7 days

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29
Q

3 signs of amphetamine withdrawal

A

social withdrawal, psychomotor retardation, hypersomnia

30
Q

3 symptoms of amphetamine withdrawl

A

depression, suicidal thoughts/behaviours, delusions

31
Q

treatment for amphetamine withdrawal/overdose

A

no pharmacological treatments or antidotes. treatment is supportive and the patient is usually sedated

32
Q

how does death from amphetamine overdose usually occur (3)

A

convulsions, coma, cerebral hemorrhage

33
Q

what are the two main classes of depressants

A

benzodiazepines, barbiturates

34
Q

which drug is a benzodiazepam

A

flunitrazepam

35
Q

mechanism of action of depressants (marihuana)

A

THC binds to cannabinoid receptors in the cns which stimulates the sympathetic system and inhibits the parasympathetic system

36
Q

4 effects of marihuana

A

euphoria, memory lapses, enhanced appetite, distortion of time and space

37
Q

4 cns adverse effects while on depressants

A

sedation, loss of coordination, dizziness, hallucinations

38
Q

what can long term use of marihuana during childhood lead to

A

cognitive and psychomotor problems

39
Q

what chronic syndrome has been seen in adolescents who regularly use marihuana

A

chronic, depressive “amotivational” syndrome

40
Q

peak period of depressant withdrawal (short acting and long acting)

A

2-4 days for short acting, 4-7 days for long acting

41
Q

duration of depressant withdrawal symptoms

A

4-7 days for short acting, 7-12 days for long acting

42
Q

5 signs of depressant withdrawal

A

increased psychomotor activity, hyperthermia, delirium, increased bp and pulse, muscle weakness

43
Q

treatment for benzodiazepine withdrawl

A

7-10 day taper or 10-14 day taper for long acting

44
Q

which drug is used for the tapering of benzodiazepines

A

diazepam

45
Q

treatment for barbiturate withdrawal

A

7-10 day taper or 10-14 day taper

46
Q

what is a benzodiazepine reversal drug

A

flumazenil

47
Q

mechanism of action of alcohol (2)

A

cause cns depression by dissolving lipid membranes in the cns, enhance gaba

48
Q

effects of alcohol (5)

A

vasodilation, sweating, diuretic effect, respiratory stimulation or depression

49
Q

what are systemic uses of alcohol (what can it treat)

A

methyl alcohol and ethylene glycol intoxication (drinking automotive antifreeze)

50
Q

what are 5 adverse effects of long term excessive ingestion

A

neurological and mental health disorders, seizures, alcoholic hepatitis, cardiomyopathy, vitamin b deficiency

51
Q

what 4 things can vitamin b deficiency lead to

A

wernicke’s encephalopathy, korsakoff’s psychosis, polyneuritis, nicotinic acid deficiency encephalopathy

52
Q

what is fetal alcohol syndrome characterized by (3)

A

craniofacial abnormalities, cns depression, prenatal and postnatal growth restriction

53
Q

when can alcohol withdrawal begin

A

6-12hrs after the last drink

54
Q

peak period of alcohol withdrawal

A

2-3 days

55
Q

how long can alcohol withdrawal symptoms last for

A

7 days

56
Q

mild signs and symptoms of alcohol withdrawal (bp, hr, temp)

A

systolic bp greater than 150mmhg, diastolic bp higher than 90mmgh, hr greater than 110, temp above 37.7

57
Q

moderate signs and symptoms of alcohol withdrawal (bp, hr, temp)

A

systolic bp 150-200mmhg, diastolic bp 90-140mmhg, hr 110-140, temp 37.7-38.3

58
Q

severe signs and symptoms of alcohol withdrawal (bp, hr, temp)

A

systolic bp above 200mmhg, diastolic bp above 140mmhg, hr above 140, temp above 38.3

59
Q

treatment for alcohol withdrawal

A

supportive to stabilize the patient and maintain airway. can use benzodiazepines

60
Q

what does disulfiram do

A

alter metabolism of alcohol so that severe effects are seen which much lower amounts of alcohol

61
Q

what happens if a patient drank alcohol within 3-4 days of taking disulfiram. what 6 specific signs and symptoms are seen

A

acetaldehyde syndrome. signs and symptoms include whole body vasodilation, hypotension, chest pain, intense headache, vertigo, difficulty breathing

62
Q

why is acamprosate used for alcoholics/overdose

A

prevents relapse, restores balance between glutamate and gaba

63
Q

3 mechanisms of action of nicotine

A

stimulate autonomic ganglia followed by depression of ganglia, stimulate cns and respiratory system, cause the release of epinephrine

64
Q

3 effects of nicotine

A

increased heart rate and bp, increase activity in the bowels, increased stress

65
Q

what can large doses of nicotine lead to. why

A

death due to respiratory failure

66
Q

3 manifestations of nicotine withdrawal

A

cigarette craving, irritability, decrease in hr and bp

67
Q

what 3 things can be used to help with nicotine withdrawal. how do these things help

A

nicotine transdermal patch, nicotine polacrilex (gum), inhalers. provide a lower dose of nicotine to gradually decrease dose

68
Q

what drug is used as first line therapy for smoking cessation

A

bupropion

69
Q

mechanism of action of varenicline

A

activate and antagonize nicotinic receptors in the brain

70
Q

3 effects of varenicline

A

reduce the pleasurable effects of smoking, drowsiness, psychiatric symptoms such as depression and suicidality

71
Q

is varenicline safe to use during pregnancy

A

no

NURS 252 (18 decks)

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