Term
| for substance abuse must have _ criteria met for how long? |
|
Definition
|
|
Term
| what are 4 criteria for susbtance abuse? |
|
Definition
craving
continued use despite social/interpersonal problems bc of use
devlopment of tolerance
withdrawal occurs if stop using |
|
|
Term
| early remission of subst abuse is no criteria met for >_ but < _ |
|
Definition
|
|
Term
| for both early and sustained remission what is the only cirteria the pt cna have? |
|
Definition
|
|
Term
| to have sustained remission of substance pt cant meet criteria for how long? |
|
Definition
|
|
Term
| what is the scale most used for alcohol use disorder |
|
Definition
|
|
Term
alcohol withdrawal peaks how long after last drin?
how long can it last? |
|
Definition
|
|
Term
| is stage 1 or 4 hgiher for severity of alcohol withdrwal? |
|
Definition
|
|
Term
alcohol withdrwal what stage?
-anxious, sweating, hyperthermia |
|
Definition
|
|
Term
| stage 1 of alcohl withdrwal begins? and lasts? |
|
Definition
6 hrs after last drink
5 dyas |
|
|
Term
alcohol withdrawal what stage?
-begin to have hallucinations (visual, auditry) |
|
Definition
|
|
Term
when does stage 2 of alcohol withdrawal begin?
how long last? |
|
Definition
24 hrs after last dirnk
1-3 days |
|
|
Term
alcohol withdrawal, what stage?
-begin to have seizures |
|
Definition
|
|
Term
| when can stage 3 of alcohl withdrawal occur? |
|
Definition
|
|
Term
which alcohol wtihdrawal stage has delirium tremens ?
when does this occur? |
|
Definition
stage 4
3-5 dyass after alst dirnk |
|
|
Term
| what is delirium tremens?-3 |
|
Definition
| mydriasis, hgih fever, arrythmia |
|
|
Term
| what test is used to assess alcohol withdrawal symtpoms? |
|
Definition
|
|
Term
for CIWA, what score is mild?
what is mode?
what is severe? |
|
Definition
|
|
Term
preferred method for alcohol withdrawal symptoms?
how are they dosed? |
|
Definition
BDZs
symtpom triggered dosing |
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
|
Definition
|
|
Term
CIWA usually done for first _ days
if still > 8 after this what happens? |
|
Definition
3
continue protocol longer |
|
|
Term
| if pt has history of seizures or delirium tremens what should be given for alcohol withdrawal? |
|
Definition
| BDZs for 24 hrs pre-symptom triggered dosing |
|
|
Term
| DBZs cant be given until pt's blood alclhol is below? |
|
Definition
|
|
Term
| fixed dosing not reccomedned for BDZ why? |
|
Definition
| pt getting more than they need |
|
|
Term
| fixed dosing of BDZ works how? |
|
Definition
| have dose and titirate down in 3-7 dyas |
|
|
Term
| what are the 5 BDZs used? |
|
Definition
clonazepam
diazepam
chlordiazepoxide
lorazepam
oxazepam |
|
|
Term
| which 2 BDZ are longer acting and may provide better coverage to reduce seizures? |
|
Definition
|
|
Term
| what two BDZ are preferred if pt has permament liver damage? |
|
Definition
|
|
Term
| what drug can be used for outpt management of alcohol withdrawal? |
|
Definition
| gabapentin (only use for mild ) |
|
|
Term
| dosing for gabapentin genralized- |
|
Definition
| 400 mg x3 days and then decrease by 100 |
|
|
Term
when is psychosocial therapy strongly enocurage?
why? |
|
Definition
treatment for relapse prevention
meds wont be useful without this |
|
|
Term
| disulfuram isnt used a lot bc?-2 |
|
Definition
|
|
Term
|
Definition
| inhibits aldehyde dehydrogenase |
|
|
Term
| when can you starts disulfuram-2 |
|
Definition
after blolod alc 0
12 hrs after last drink |
|
|
Term
|
Definition
| headache, metallic tase, smell diustrubed |
|
|
Term
| monitoring for disulfuram if pt drinks again? |
|
Definition
|
|
Term
| drug interacitons with disulfuram-2 |
|
Definition
3A4
metronidazole (increase psychosis) |
|
|
Term
| counseling with disulfuram-2 |
|
Definition
avoid all alcohol
avoid this until 14 days after disct med |
|
|
Term
| what drug redeuces heavy drinking? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| how cna naltrexone be admin?-2 |
|
Definition
|
|
Term
ADEs for naltrexone:
oral? -2
IM? -2 |
|
Definition
GI, cause opioid withdrawl syndrome
inject rxn, joint pain |
|
|
Term
| naltrexone is able to reduce what 2 htings? |
|
Definition
|
|
Term
| naltrexone interacts with what drugs? |
|
Definition
|
|
Term
| counseling for naltrexone-1 |
|
Definition
| carry wallet card that says on naltrexone ICE |
|
|
Term
|
Definition
|
|
Term
dosing fro acamprosate if cr cl 30-50
if less than 30? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| whcih med doesnt have emd interactions? |
|
Definition
|
|
Term
| counseling fro acamprosate |
|
Definition
|
|
Term
withdrawal for opiod symtpoms start _
they have peak of _ and can last _ |
|
Definition
8 hrs after alst dose
36 hrs
5 days |
|
|
Term
| what drug cna only be used in opiate treatment programs? |
|
Definition
|
|
Term
|
Definition
|
|
Term
| once get withdrawal suppresion how do you titrate methadone? |
|
Definition
| reduce by 5 mg daily over 7-21 days |
|
|
Term
|
Definition
|
|
Term
| _ mg of buprenorphine = 60 of methadone |
|
Definition
|
|
Term
| if pt needs burpenorphine dose higher than 16 mg what needs ot be done? |
|
Definition
| switch to methdone bc it doesnt have this celing dose |
|
|
Term
| pros about using buprenorphine-2 |
|
Definition
| less resp depression and prolonged QTC compared ot methadone |
|
|
Term
which med for opiod withdrawal can be used in outpatient?
if this is done what should be added? |
|
Definition
|
|
Term
for buprenorphine dosing, when do you give first dose?
what is formulation? |
|
Definition
after in mild-mod withdrawal
sub lungual tab |
|
|
Term
| hwo do you taper burpenorphone? |
|
Definition
| go to 16 mg then decrease over 7 days |
|
|
Term
opiod withdrawl:
what can be used for diarrhea? |
|
Definition
|
|
Term
opiod withdrawl:
what can be used to reduce autonomic activity |
|
Definition
|
|
Term
opiod withdrawl:
what can be used for N?V |
|
Definition
|
|
Term
opiod withdrawl:
what can be used for insomnia |
|
Definition
|
|
Term
opiod withdrawl:
what can be used for muscle aches? |
|
Definition
|
|
Term
opiod withdrawl:
what can be used for anxiety |
|
Definition
|
|
Term
| what drug is more useful for maintenacne therapy to prevent opiod withdrawal |
|
Definition
|
|
Term
| what are benefits of maintenace methadone?-3 |
|
Definition
| imrpove social, decrease criminal, decrease mortality |
|
|
Term
| pts that shoudl get opiod withdrawal main therapy-4 |
|
Definition
depedent> 1 yr
preggo, just released fro jail, those treated fro depeedn in past yr |
|
|
Term
| how long cna maintenance of opiodi withdrawal be used for? |
|
Definition
|
|
Term
| what med is combined with buprenorphine to reduce damage if it is crushed or injected |
|
Definition
|
|
Term
| what are the 2 meds for prevention of nicotine releapse? |
|
Definition
|
|
Term
formulation of buproion
when do you start taking the med?
how long do you take it for? |
|
Definition
sustained release
1-2 weeks before quite nicotine
take for 3-6 mo |
|
|
Term
| which nicotine prevention drug has highest absitience rate? |
|
Definition
|
|
Term
|
Definition
inhibits DA reuptake
anatag of nicotine recpt |
|
|
Term
|
Definition
| nicotine partial recpt agonist |
|
|
Term
when do you start chantix?
by day 8 taking? |
|
Definition
1 week before quit
1 mg BID |
|
|
Term
|
Definition
nauseua (majoprity)
insomnia
vivid dreams |
|
|
Term
| Black box warning for varenicline |
|
Definition
| increase depression/suicide |
|
|
