Substance Use Meds Flashcards by Elsa Cee

Mechanism of alcohol?

Enhances the effects of ______ on its receptors –> CNS depression

GABA

Mechanism of alcohol?
Enhances the effects of GABA on its receptors –> CNS depression

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Mechanism of alcohol?

Inhibits ________ action on NMDA receptors –> CNS depression

glutamate

Mechanism of alcohol?
Inhibits Glutamate action on NMDA receptors –> CNS depression

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Mechanism of alcohol?

Affects ______ synapses within mesolimbic reward circuitry –> release of dopamine

opioid

Mechanism of alcohol?
Affects opioid synapses within mesolimbic reward circuitry –> release of dopamine

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Mechanism of alcohol?

Affects opioid synapses within ________ reward circuitry –> release of dopamine

mesolimbic

Mechanism of alcohol?
Affects opioid synapses within mesolimbic reward circuitry –> release of dopamine

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what are the 4 medications approved by the FDA to treat alcohol dependence?

There are 4 medications approved by the FDA to treat alcohol dependence:

Acamprosate
Disulfiram
Naltrexone
Naltrexone Long Acting Injection

ADNN

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In chronic alcohol abuse, the GABA receptors become [less or more] sensitive?

less

In chronic alcohol abuse, the GABA receptors become less sensitive (tolerance!)

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In chronic alcohol abuse, the ______ receptors become less sensitive (tolerance!). When alcohol is no longer consumed the receptors are so insensitive to XX that the normal amount of XX the body produces is ineffective. This leads to physical withdrawal and unopposed _________ neurotransmission (withdrawal).

GABA; excitatory

In chronic alcohol abuse, the GABA receptors become LESS sensitive (i.e., tolerance!). When alcohol is no longer consumed the receptors are so insensitive to GABA that the normal amount of GABA the body produces is ineffective. This leads to physical withdrawal and unopposed excitatory neurotransmission (withdrawal).

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_________ restores balance to GABA and glutamate activities which are disrupted in alcohol use disorder

acamprosate/Campral

Acamprosate restores balance to GABA and glutamate activities which are disrupted in alcohol use disorder

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brand name for Acamprosate

Campral

acamprosate Campral

ACAM

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Acamprosate is used for long term management of alcohol abstinence OR for treatment of acute alcohol withdrawal?

long term tx

Acamprosate is used for long term management of alcohol abstinence not for treatment of acute alcohol withdrawal

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acamprosate/Campral starting dose is ____mg PO TID

666 mg PO TID

acamprosate/Campral starting dose is 666mg PO TID. (Pills come in 333mg tablets so this would equate to 2 pills taken at 3 different times during the day).

CAM is 666

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acamprosate/Campral: when should tx begin?

when abstinent

acamprosate/Campral: Treatment should only begin when abstinence has already been achieved.

CAM should start CAM only when he’s already abstinent

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Most frequent side effect of acamprosate/Campral?

diarrhea

CAM goes poopy

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brand name for disulfiram

Antabuse

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which med is used as a deterrent that induces an adverse reaction when the person drinks alcohol?

disulfiram/Antabuse

used as a deterrent that induces an adverse reaction when the person drinks alcohol

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Mechanism of Action: _________ works by blocking an enzyme in the liver (acetaldehyde dehydrogenase) and causes the accumulation of acetaldehyde

disulfiram/Antabuse

Mechanism of Action: disulfiram/Antabuse works by blocking an enzyme in the liver (acetaldehyde dehydrogenase) and causes the accumulation of acetaldehyde

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Mechanism of Action: Disulfiram works by blocking an enzyme in the liver (acetaldehyde dehydrogenase) and causes the [accumulation or loss] of acetaldehyde.

The XX of this metabolite causes the “disulfiram reaction” which can be likened to a bad hang over

Accumulation

Mechanism of Action: Disulfiram works by blocking an enzyme in the liver (acetaldehyde dehydrogenase) and causes the accumulation of acetaldehyde.

The accumulation of this metabolite causes the “disulfiram reaction” which can be likened to a bad hang over

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Signing informed consent to take [this med] is highly recommended to ensure patient understands the consequences of ingesting alcohol and assumes responsibility for avoiding alcohol intake

disulfiram/Antabuse

Signing informed consent form highly recommended to ensure patient understands the consequences of ingesting alcohol and assumes responsibility for avoiding alcohol intake

Patient should not be started on this medication until they have abstained from alcohol for at least 12 hours

disulfiram/Antabuse

Patient should not be started on the medication until they have abstained from alcohol for at least 12 hours

Patient should not be started on disulfiram/Antabusen until they have abstained from alcohol for at least ___ hours

12 hours

Patient should not be started on disulfiram/Antabusen until they have abstained from alcohol for at least 12 hours

when should disulfiram/Antabuse be started?

at least 12 hours

disulfiram/Antabuse should be started when pt has abstained from alcohol for at least 12 hours

DA 12 hours judge

T or F: for disulfiram/Antabuse, the risks far outweigh the benefits for use during pregnancy

True

for disulfiram/Antabuse, the risks far outweigh the benefits for use during pregnancy

brand name for naltrexone?

ReVia & Vivitrol (tablet, injection)

nalt revs up the car?!

naltrexone/Revia -
Mechanism of Action: _______ antagonist. Blocks the effects of XX in the CNS and prevents their euphoric effects in the opioid dependent person. How it works in regards to alcohol dependence is not clearly understood

opiate; opioids

naltrexone/Revia -
Mechanism of Action: Opiate antagonist. Blocks the effects of opioids in the CNS and prevents their euphoric effects in the opioid dependent person. How it works in regards to alcohol dependence is not clearly understood

naltrexone/Revia - when starting, | Pt should be opioid free for no fewer than ___ to ___ days

7 to 10 days, i.e., need to be opioid free for a little over a week to start naltrexone/Revia

naltrexone/Revia - for injection, | Single vial containing 380 mg powder is reconstituted and administered intramuscularly every __ weeks

4 weeks; need naltrexone injection once per month

This med is an opioid AGONIST

methadone is an opioid AGONIST

this med works to help lessen the painful symptoms of withdrawal from opiates by binding to the same receptors of opioid drugs (like heroin) but blocking the euphoric effects

methadone

this med's long half life makes it hard for other opiates to be abused and give a quick high

methadone Methadone’s long half life makes it hard for other opiates to be abused and give a quick high

this med May still be habit forming if tolerance develops

methadone

this med's side effects can cause anaphylaxis and sleep related breathing problems

methadone can cause anaphylaxis and sleep related breathing problems meth causes allergies & breathing problems

these meds ARE safe to take in pregnancy & ok for breastfeeding

methadone & buprenorphine ARE safe to take in pregnancy & ok for breastfeeding

this med requires 8 hour certification training to obtain DEA waiver to prescribe

buprenorphine

this med works as a PARTIAL agonist

buprenorphine bupARTIAL BUpartial agonist

for this med, the ceiling effect of partial agonist prevents chance for respiratory depression

buprenorphine the ceiling effect of partial agonist prevents chance for respiratory depression

brand name for buprenorphine

Suboxone bup Subox bup bup Sub

naltrexone/Revia - Mechanism of Action: opiate [agonist or antagonist]. [Allows or blocks] the effects of opioids in the CNS and prevents their euphoric effects in the opioid dependent person. How it works in regards to alcohol dependence is not clearly understood

antagonist; blocks naltrexone/Revia - Mechanism of Action: _______ antagonist. Blocks the effects of XX in the CNS and prevents their euphoric effects in the opioid dependent person. How it works in regards to alcohol dependence is not clearly understood

Methadone is an opioid [agonist or antagonist]

Methadone is an opioid agonist

brand name for naloxone

Narcan nala nala Narc

naloxone/Narcan is an opioid [agonist or antagonist]

naloxone/Narcan is an opioid antagonist

which Medication has limited bioavailability if taken by mouth

naloxone/Narcan

which med reduces the desire to drink alcohol?

naltrexone/Revia

T or F: Naltrexone does not prevent withdrawal symptoms but helps with cravings

True Naltrexone does not prevent withdrawal symptoms but helps with cravings

What are the 2 tobacco use disorder drugs?

bupropion/Zyban and varenicline/Chantix