Substance Use Meds Flashcards
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
Mechanism of alcohol?
Inhibits ________ action on NMDA receptors –> CNS depression
glutamate
Mechanism of alcohol?
Inhibits Glutamate action on NMDA receptors –> CNS depression
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
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
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
In chronic alcohol abuse, the GABA receptors become [less or more] sensitive?
less
In chronic alcohol abuse, the GABA receptors become less sensitive (tolerance!)
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).
_________ 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
brand name for Acamprosate
Campral
acamprosate Campral
ACAM
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
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
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
Most frequent side effect of acamprosate/Campral?
diarrhea
CAM goes poopy
brand name for disulfiram
Antabuse
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
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
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
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
