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37 Cards in this Set
- Front
- Back
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treatment of alcohol withdrawal
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-BZDs
-thiamine |
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treatment of alcohol dependence
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-disulfiram
-naltrexone -acamprosate |
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disulfiram MOA
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antagonizes acetylaldehyde dehydrogenase
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disulfiram adverse effects
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-metallic after taste
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disulfiram patient counseling (4)
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1)don't take for at least 12hr after EtOH
2)avoid EtOH in all forms 3)may cause drowsiness 4)EtOH-disulfiram rxn may have serious consequences |
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Naltrexone place in therapy
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-may be effective in reducing number of drinks consumed & craving for alcohol
-may be effective in binge drinkers |
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naltrexone MOA
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long-acting opiod antagonist
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naltrexone major adverse effect
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hepatotoxicity (check LFTs)
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Acamprosate MOA
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interacts w/ GABA & glutamate systems
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acamprosate adverse effects
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depression, anxiety
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treatment of opiod intoxication
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naloxone
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naloxone MOA
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opiod antagonist
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treatment of opiod withdrawal
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-clonidine
-methadone -buprenorphine |
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role of clonidine in opiod withdrawal
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reduces autonomic symptoms of withdrawal
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clonidine MOA
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central alpha-2 agonist, which affects the locus ceruleus & spinal cord
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clonidine adverse effects
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-orthostasis
-hypotension -dry mouth -depression -dizziness |
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treatment of opiod dependence
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-methadone
-buprenorphine -buprenorphine/naloxone -naltrexone |
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methadone MOA
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substitution of long-acting opiod
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buprenorphine MOA
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partial opiod agonist/antagonist
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buprenorphine place in therapy
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-less abuse potential--acts as an antagonist at high doses & induces withdrawal
-intended for beginning of opiod dependence treatment |
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this agent is indicated for maintenance treatment of opiod dependence
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buprenorphine/naloxone
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treatment of cocaine withdrawal
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-no meds have been shown effective in reducing severity
-antipsychotics or BZDs may be helpful if dulusions/paranoia present |
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treatment of cocaine abuse and dependence
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medications are not recommended as first-line therapy
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comorbidity with alcohol use:
-females -males |
FM=mood and anxiety d/o
M=personality d/o |
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laboratory findings in alcohol use
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-elevated MCV
-elevated AST,ALT,LDH -decreased B12, folic acid -elevated uric acid, amylase -evidence of bone marrow suppression |
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treatment of alcohol intoxication
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-time
-protective environment |
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clinical features of alcohol withdrawal
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-HA
-NV -tremor -insomnia -hypertension -tachycardia, sweating -possible szrs |
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clinical features of alcohol withdrawal delirium (delirium tremens)
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-abnormal perceptions
-agitation -tremor -insomnia -hyperthermia -autonomic instability |
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Wernicke's encephalopathy triad of clinical features
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-confusion
-ataxia -nystagamus |
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disulfiram reaction with alcohol
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-tachycardia
-facial flushing -palpitations -NV |
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clinical features of opiod intoxication
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-miosis
-decreased GI motility -sedation -slurred speech -memory impairment |
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clinical features of opiod withdrawal
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-mydriasis
-flu-like syndrome -anxiety -dysphoria -disrupted sleep |
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this agent blunts the euphoric response to heroin
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methadone
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suboxone indication
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-not recommended for use during induction period
-initial treatment should begin w/ buprenorphine -patients whould be switched to this product for maintenance therapy or unsupervised therapy |
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cocaine intoxication clinical features
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-tachycarda
-mydriasis -increased BP -sweating/chills -NV -visual/tactile hallucinations |
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abstinence symptoms of cocaine
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phase 1 "crash"=dysphoria, anhedonia, irritability, anxiety, craving, suicidal ideation
phase 2=low level craving, decreased capacity to experience pleasure, irritability, anxiety phase 3=mild craving |
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treatment of cocaine use
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psychotherapy
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