BH: Substance Use

what are the opioid antagonists (2)

naloxone and naltrexone

what is the difference between naloxone and naltrexone

naloxone is used for emergency overdose, naltrexone is used for maintenance after detox

what is special about naloxone

Reverses respiratory depression, may require repeat doses

what is special about naltrexone

must be opioid free before starting or will cause withdrawal

what is the partial opioid agonist (1)

buprenorphine-naloxone

what is special about buprenorphine-naloxone

start only after withdrawal begins, use for maintenance, respiratory depression, constipation

what is a full opioid agonist

methadone

what is special about methadone

respiratory depression, QT prolongation, torstades de pointes, EKG

what is an alcohol deterrent

disulfiram

what is special about disulfiram

severe reaction if alcohol consumed: flushing, vomiting, hypotension, hepatotoxicity, makes drinking very unpleasant, no alcohol 12 hrs prior to admin

what benzodiazepine is used

lorazepam

what is special about lorazepam

prevents seizures and delirium tremens (symptoms of withdrawal) can cause respiratory depression, sedation, dependence

what is the GABA Agonist/Glutamate Antagonist med (1)

acamprosate calcium

what is special about acamprosate calcium

helps maintain abstinence not withdrawal. diarrhea, depression. continue even if cravings improve

what is the electrolyte replenishment

banana bag

what is special about the banana bag

give thiamine before glucose to prevent Wernicke encephalopathy. IV site reactions, electrolyte abnormalities. eat foods rich in thiamine after discharge

what is the first class alcohol withdrawal med

lorazepam to treat acute withdrawal

what is made for maintenance after detox

acamprosate

what is a NDRI med (1)

bupropion HCL

what is special about bupropion HCL

Avoid in seizure disorders and eating disorders. seizures, insomnia, agitation

what is special about nicotine replacement

do not smoke while using NRT. skin irritation, tachycardia, insomnia. rotate patch sites; remove old patch before new one

what is a nicotinic receptor partial agonist

varenicline

what us special about varenicline

most effective when combined with counseling. nausea, vivid dreams, insomnia, SI

what is the preferred med for nicotine use

varenicline