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Pharmacology for Advanced Practice Nurses > Substance Use Disorder > Flashcards

Substance Use Disorder Flashcards

1
Q

Most important element

A

Build a trusting relationship with the

patient

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2
Q

Assessment for SUD

A 
Obtain a thorough medical history
• Know s/s of substance use,
withdrawal symptoms specific to each
substance
• Build a trusting relationship with the
patient
• Non-judgmental, empathetic attitude
• Be aware of resources in the community
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3
Q

ETOH Intoxication S/S

A

Slurred speech, Dizziness,
Incoordination, Unsteady gait,
Nystagmus, Impaired attention/memory,
Coma or double vision

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4
Q

ETOH Withdrawal 8 to 12 hours

A 
Autonomic hyperactivity (hight BP, increased heart rate etc);
Perceptual disturbances and hallucinations
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5
Q

ETOH Withdrawal 12-24 hours

A

Generalized/tonic-clonic seizures

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6
Q

ETOH Withdrawal other

A

Nausea, vomiting; can be life-threatening

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7
Q

CIWA Categories

A 
Agitation (0–7)
Anxiety (0–7)
Auditory Disturbances (0–7)
Clouding of Sensorium (0–4)
Headache (0–7)
Nausea/Vomiting (0–7)
Paroxysmal Sweats (0–7)
Tactile disturbances (0–7)
Tremor (0–7)
Visual disturbances (0–7)
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8
Q

CIWA <10

A

supportive, n on-pharmacologic therapy and close monitoring are indicated )unless patient has hx of alchol withdrawl seizures or co-morbid cardiovascular conditions

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9
Q

CIWA 10 - 15

A

Lorazepam is indcated to reduce symptoms and the risk of major complications

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10
Q

CIWA >15

A

Strong consideration should be given to hospitalizing inmates who exhibit severe symptoms, as they are at increased risk for serious complications

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11
Q

ETOH WD treatment drugs

A

Benzodiazepines, anticonvulsants
(carbamazepine, gabapentin), clonidine,
propranolol

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12
Q

ETOH treament supplement

A

Thiamine

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13
Q

Why do we use thiamine

A

B1 deficiency can occur with chronic ETOH use. This results in wernkeis encephalopathy. Confusion CNS effects

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14
Q

Naltrexone

A

mu opioid receptor antagonist - used in ETOH disorder

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15
Q

Acamprosate used in ETOH MOA

A

binds to and blocks glutamate

receptors

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16
Q

Disulfiram

A

irreversibly inhibits aldehyde

dehydrogenase preventing metabolism of alcohol

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17
Q

Opioid Intoxication S/S

A 
Pinpoint pupils; Psychomotor
retardation, “nodding off;” Drowsiness,
slurred speech; Impaired memory and
attention; Reduced respirations, respiratory
depression or distress
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18
Q

Opioid Withdrawal

A

Dilated pupils, yawning, runny
nose/tearing; Piloerection; Restlessness,
muscle aches; Stomach cramps, diarrhea,
tachycardia; tremors (less common), hot/cold
sweats, insomnia; feels life threatening to the
person

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19
Q

COWS categories.

A 
Resting heart rate (0–4)
Gastrointestinal upset in past
30 minutes (0–5)
Sweating (0–4)
Tremor of hands (0–4)
Restlessness (0–5)
Yawning during assessment (0–4)
Pupil size (0–5)
Anxiety or irritability (0–4)
Bone or joint aches associated with
withdrawal (0–4)
Gooseflesh skin (0–5)
Runny nose or tearing (0–4)
20
Q

COWS mild

A

5-12

21
Q

COWS Moderate

A

13-24

22
Q

COWS moderately severe

A

21-36

23
Q

COWS severe

A

36

24
Q

Treatment of opoids includes

A

alpha-2 adrenergic

agonists

25
Q

Drugs used to treat OUD

A

Buprenophine, Methadone, Nextrexone, Naloxone

26
Q

Bupreophine class

A

mu receptor partial agonist

27
Q

Methadone class

A

Full opoid agonist

28
Q

Naltrexone class

A

mu opoid receptor atnagonist

29
Q

Benzo withdrawal symptoms

A

sx similar to alcohol

withdrawal

30
Q

Benzo withdrawal starts

A

starts 2-3 days after cessation
or up to 5 with long acting; can be life
threatening

31
Q

Do not prescribe ____ on a long term basis

A

benzos

32
Q

Cannabis Intoxication S/S

A

Red eyes (dilation of conjunctival
blood vessels, mild tachycardia, dry mouth;
Heightened sensitivity to environmental stimuli,
Slowing perception of time; Depersonalization,
Derealization; Impaired memory, increased
appetite; Delirium, paranoia, or psychosis;
Impaired motor skills and attention

(up to 8 to
12 hours after use)

33
Q

Cannabis Withdrawal starts

A

1-2 weeks of cessation

34
Q

Cannabis S/S

A

Irritability, cravings, headaches;
Anxiety/restlessness, tremors; Insomnia, vivid
dreams; Decreased appetite, wt loss, stomach
pain; Hyperemesis syndrome

35
Q

Nicotinic acetylcholine receptor agonist - half life

A

2 hour

36
Q

Nicotine activates

A

dopamine vTa pathway,
increases endogenous epinephrine and
norepinephrine

37
Q

nicotine has

A

stimulant effects on the body

38
Q

Nicotine intoxication

A

skeletal muscle relaxation, improved

attention, learning, reaction time and probelm- solving (short term); decreased appetite

39
Q

Nicotine withdrawal begins

A

within 2 hours and peaks 24 to 48 hours

40
Q

Nicotine withdral S/S

A

Insomnia; Increased coughing (short- term); Irritability, cravings, tension; Increased
appetite, weight gain; Poor focus

41
Q

Nicotine Replacement therapy

A

Relieve nicotine withdrawal symptoms by providing nicotine

without the use of tobacco

42
Q

NRT Side Effects

A

common to all NRT: GI symptoms, HA, local irritation

43
Q

NRT forms

A

Patch, gum, lozenges, inhalers, nasal spray, mouth spray, SL

tablets

44
Q

Varenicline (Chantix)

A

partial nicotine agonist

45
Q

Varenicline (Chantix) MOA and use

A

Reduces the symptoms of nicotine withdrawal
• Blocks nicotine from binding to the receptor that mediates the
reinforcing effects of nicotine that leads to nicotine dependence.
• Reduces rewarding aspects of cigarette smoking.

46
Q

Bupropion (Zyban)

A

antidepressant,

47
Q

Bupropion (Zyban) MOA and use

A

dopamine/norepinephrine-reuptake inhibitor

• Enhances CNS noradrenergic and dopaminergic release

Pharmacology for Advanced Practice Nurses (50 decks)

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