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37 Cards in this Set

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