SUD5 Flashcards

1
Q

Overactivity of what NT is responsible for mediating Etoh withdrawal symptoms?

  1. What NT is responsible for the CNS inhibitory affect of Etoh?
A
  1. Glutamate ( the main excitatory neurotransmitter of the brain.)
  2. GABA ( the main inhibitory NT)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Out of the FDA approved medications for Etoh use disorder (Acamprosate, Disulfiram, Naltrexone) which one is the only one contraindicated in severe RENAL disease?

A

Acamprosate (because completely renally excreted)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

How is Acamprosate thought to help in Etoh use disorder?

A

As a structural analog of GABA, it MODIFIES GLUTAMATE AND GABA PATHWAYS, resulting in decreased reinforcement of etoh intake and decreases cravings.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What is the MOA of Naltrexone?

A

Opioid receptor antagonist

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What are the four main advantages of Naltrexone IM vs Oral?

A
  1. Better compliance (monthly shot)
  2. More consistent steady state plasma levels
  3. Less GI side effects
  4. Bypass first pass hepatic metabolism.
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

How many days opioid free should one be in order to start Naltrexone?

A

7-10 days opioid free.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

If urine drugs is positive, what is the “gold standard” for confirmatory testing?

A

GCMS

Gas chromatography mass spectrometry

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the Utox detection window for the following drugs?

  1. Marijuana
  2. Amphetamines
  3. Barbiturates “-barbitals”
  4. BZDs
  5. Cocaine
  6. Methadone
  7. Opiates
  8. PCP
  9. Heroin
A
  1. Marijuana (3-30 days)
  2. Amphetamines (2-3 days)
  3. Barbiturates (1-3 days)
  4. BZDs (1-7 days)
  5. Cocaine (6hrs to 3 days)
  6. Methadone (7-9 days)
  7. Opiates (1-3 days)
  8. PCP (8 days)
  9. Heroin (3 days)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

What is the difference between Methadone and Buprenorphine in safety profile in pregnancy?

A

Methadone = approved in pregnancy

Buprenorphine = Category C, but MOTHER study showed that it was safe and effective in pregnancy.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What is the MOA of Buprenorphine?

A

Potent partial (Mu) opioid Antagonist

Mixed agonist/antagonist of (kappa) opioid receptors.

How well did you know this?
1
Not at all
2
3
4
5
Perfectly