SUD + Glucocorticoids Flashcards
route for prednisone
oral
route for methylprednisone (Solumedrol)
IV
which class of drugs provides the greatest anti-inflammatory action, NSAIDs or glucocorticoids?
glucocorticoids
MOA for glucocorticoids
suppresses immune system + inflammatory response
re: the MOA for glucocorticoids, what is the implication for clinical practice?
people might present with fewer or no inflammatory response to injuries - we are not cued in as much as we would be with patient with normal functioning immune system
re: MOA of glucocorticoids, these patients are at an increased risk of what?
infection
explain precautions with glucocorticoid therapy and vaccinations
these patients should avoid live vaccines, as well as any people they live with.
they will have a decreased response and need boosters!
8 SE of glucocorticoids
- hyperglycemia
- fluid retention –> weight gain
- Cushing’s Syndrome
- hyperactivity –> insomnia
- psychological reactions
- thinned skin
- capillary fragility
- increased GI bleeding risk
what should you monitor in patients with DM taking glucocorticoids?
blood glucose levels
what causes fluid retention with glucocorticoid use?
mineralcorticoid activity
–> Na retention + K loss
what should we monitor for with patients taking glucocorticoids and furosemide?
HYPOkalemia (it’s a K+ losing diuretic)
Cushing’s syndrome causes which 3 conditions? and which 3 hall mark signs can we observe?
- hyperglycemia
- f+e imbalances
- osteoporosis
- buffalo hump
- moonface
- potbelly
knowing some SE of glucocorticoids, when should we administer these meds?
9am, or as early as possible
how can we decrease PUD risk with glucocorticoids?
take with food or milk + caution when taking with ASA
what are things to know about stopping glucocorticoid treatment?
WEAN slowly to avoid adrenal insufficiency
S+S of adrenal insufficiency (4)
hypoglycemia, hypotension, myalgia, fatigue
S+S of MILD AUD withdrawal (5 things)
- disturbed sleep
- weakness
- nausea
- anxiety
- mild tremors
when can SEVERE S+S occur with AUD withdrawal
12-72 hours after last drink
S+S of SEVERE AUD withdrawal
cramping, vomiting, hallucinations, tremors, seizures, increased VS
(think neuro issues +VS)
what is delirium tremens
severe hallucinations, CV collapse, death
what is CIWA’s purpose
tool to assess severity of alcohol withdrawal; keep person from severe stages of withdrawal (medication management)
3 classes of drugs for ACUTE alcohol withdrawal (name example of each)
- benzos (Ativan)
- BP meds (atenolol, clonidine)
- anti-eleptic drugs (carbamepazine - Tegretol)
which is the MOST EFFECTIVE class of drugs for acute alcohol withdrawal? how does it work?
benzodiazepines (Ativan)
CNS depression - calms down gaba
how do BP meds help with alcohol withdrawal
reduce cravings + improve VS
what are the 2 drugs to maintain alcohol abstinence
- disulfram (Antabuse)
2. naltrexone (Re Via)
which drug is the MOST EFFECTIVE for alcohol abstinence?
naltrexone (Re Via)
MOA for disulfram (Antabuse)
unpleasant rx when ETOH consume - N/V, flushing, palpations, HA, hypotension
a person can have disulfram effects how long after last dose?
up to 2 weeks
MOA for naltrexone (Re Via)
blocks dopamine release
blocks pleasure effects + decreases cravings
nicotine withdrawal symptoms
HA, irritability, nervousness, increased appetite, weight gain, insomnia
name some nicotine agents for smoking cessation
gum, lozenge, patch, nasal spray, inhaler
what is the MOST EFFECTIVE non-nicotine drug for smoking cessation
varenicline (Chantix)
what combination of drug do they recommend with smoking cessation?
patch WITH short acting product (gum)
what are the two non-nicotine agents for smoking cessation?
varenicline (Chantix) + buproprion (Zyban)
MOA for buproprion
CNS stimulation
early S+S of Opioid use disorder withdrawal
yawning, runny nose, sweating (parasympathetic nervous system)
later S+S of opioid use disorder withdrawal
anorexia, irritability, tremor, goose bumps (SNS)
worse S+S of opioid use disorder withdrawal
violent sneezing, weakness, N/V/D, muscle spasms
between opioid use withdrawal and ETOH withdrawal, which is dangerous and life-threatening?
ETOH withdrawal
COWS scale measures what?
clinical opioid withdrawal scale
3 drugs to manage opioid addiction + their class
- methadone (agonist)
- buprenorphine - Suboxone (agonist-antagonist)
- naltrexone (antagonist)
which drug is used AFTER opioid detox b/c it’s an antagonist?
naltrexone (Re Via)
