Substance Abuse and Medications

Flashcards covering key vocabulary and concepts related to substance abuse, medications, and clinical assessments.

Naltrexone

A medication used to decrease cravings in patients with alcohol use disorder.

Antabuse (Disulfiram)

A medication that causes unpleasant effects when alcohol is consumed, intended to deter drinking.

Thiamine (Vitamin B1)

A vitamin essential for preventing Wernicke's encephalopathy in chronic alcohol users. and Korsikofs - irreversible brain damage

BUprenorphine

A preferred medication for treating opioid use disorder, can be combined with naloxone in Suboxone.

Chlordiazepoxide

Also known as Librium, it is used for alcohol withdrawal management.

Buprenorphine microdosing

A method allowing patients to start buprenorphine while still using opioids, easing transition.

Cognitive decline

Potential early sign of dementia that requires further assessment for diagnosis.

Beers Criteria

Guidelines for avoiding potentially inappropriate medications in older adults.

Chantix (Varenicline)

A smoking cessation medication that can cause suicidal thoughts as a side effect.

SERD/SEWA,

Standardized assessment tools for evaluating the severity of alcohol withdrawal.

Acamprosate

A medication that helps people who have recently stopped drinking alcohol to stay sober by balancing chemicals in the brain.

Varenicline

A drug that reduces withdrawal symptoms and cravings related to quitting smoking.

Acamprosate class and s/e

• Modulates glutamatergic neurotransmission; NMDA receptor antagonist and positive allosteric modulator at GABA_A receptors. Helps restore neurotransmitter balance in alcohol dependence.

• Neurotransmitters: Glutamate and GABA.

• Major Side Effects: Diarrhea (most common), flatulence, nausea, pruritus.

Amphetamine class and s/e

• Mechanism of Action: Increases synaptic concentration of dopamine and norepinephrine by promoting release and inhibiting reuptake.

• Neurotransmitters: Dopamine, Norepinephrine.

• Major Side Effects: Insomnia, decreased appetite, weight loss, dry mouth.

Atomoxetine (strattera) class and s/e

• Mechanism of Action: Selective norepinephrine reuptake inhibitor (NRI).

• Neurotransmitters: Norepinephrine.

• Major Side Effects: GI upset, insomnia, dry mouth, decreased appetite.

Clonidine class and s/e

• Mechanism of Action: Alpha-2 adrenergic receptor agonist → reduces sympathetic outflow.

• Neurotransmitters: Norepinephrine (indirectly).

• Major Side Effects: Drowsiness, dry mouth, dizziness, constipation.

Donepezil class and s/e

• Mechanism of Action: Reversible acetylcholinesterase inhibitor → increases acetylcholine in synaptic cleft.

• Neurotransmitters: Acetylcholine.

• Major Side Effects: Nausea, diarrhea, insomnia, muscle cramps.

Disulfiram class and s/e

• Mechanism of Action: Inhibits aldehyde dehydrogenase → causes acetaldehyde accumulation if alcohol is consumed, leading to aversive symptoms.

• Neurotransmitters: Indirect effect (not acting directly on neurotransmitter systems).

• Major Side Effects: Drowsiness, metallic taste, headache.

Galantamine class and s/e

• Mechanism of Action: Reversible acetylcholinesterase inhibitor; also modulates nicotinic receptors to enhance acetylcholine release.

• Neurotransmitters: Acetylcholine.

• Major Side Effects: Nausea, vomiting, diarrhea, weight loss.

Lisdexamfetamine (Vyvanse) class and s/e

• Mechanism of Action: Prodrug of dextroamphetamine → increases release of dopamine and norepinephrine from presynaptic neurons.

• Neurotransmitters: Dopamine, Norepinephrine.

• Major Side Effects: Decreased appetite, insomnia, dry mouth, irritability.

Memantine class and s/e

• Mechanism of Action: NMDA receptor antagonist → regulates glutamate activity to protect against excitotoxicity.

• Neurotransmitters: Glutamate.

• Major Side Effects: Dizziness, headache, confusion, constipation.

Methylphenidate class and s/e

• Mechanism of Action: Blocks reuptake of dopamine and norepinephrine, increasing synaptic concentrations.

• Neurotransmitters: Dopamine, Norepinephrine.

• Major Side Effects: Insomnia, appetite suppression, weight loss.

Naloxone class and s/e

• Mechanism of Action: Opioid antagonist at mu, kappa, and delta receptors. Displaces opioids from receptors to reverse opioid overdose.

• Neurotransmitters: Opioid system (endorphins, enkephalins).

• Major Side Effects: Nausea, vomiting, tremors, sweating.

Naltrexone class and s/e

• Mechanism of Action: Opioid receptor antagonist, blocks effects of opioids and reduces cravings in alcohol dependence.

• Neurotransmitters: Opioid system.

• Major Side Effects: Nausea, headache, dizziness, fatigue.

Rivastigmine class and s/e

• Mechanism of Action: Reversible cholinesterase inhibitor (AChE and BuChE), increases acetylcholine in CNS.

• Neurotransmitters: Acetylcholine.

• Major Side Effects: Nausea, vomiting, anorexia, dizziness.

Viloxazine (qelbree)class and s/e

• Mechanism of Action: Selective norepinephrine reuptake inhibitor (SNRI); also modulates serotonergic activity.

• Neurotransmitters: Norepinephrine, with secondary serotonergic modulation.

• Major Side Effects: Somnolence, decreased appetite, fatigue, irritability.

Stimulant s/e

headache, stomach ache, hallucinations, insomnia, tachycardia, Increased BP 2-4mmHg, decreased appetite

Non stimulants

clonidine, guanfacine

stimulants contraindicated w/

cardiomyopathy, heart murmurs

before prescribing a stimulant, do this

chech BP, listen to HR, refer to cardiologist if abnormal

Elderly patient suddenly depressed with no mood history, think

Dementia

smoking cessation and depression medication

buproprion

Men metabolize alcohol _______ than women

faster

drinks per week

14 for men, 7 for women

Guanfacine

treats childhood trauma, anxiety, and is a non-stimulant ADHD med

opioid dependence give

Suboxone (naloxone w/ bupronorphine)

Brexalti indicated for

agitation, dementia

ADHD children should ___ before taking stimulants

eat

most commonly abused substance besides alcohol

cannabis

alcohol withdrawal can begin

4-6 hours after last drink

signs of alcohol OD:

pinpoint pupils(miosis), low HR, low BP

Give naloxone, IV narcan

street drug that interferes with dopamine

cocaine

Morphine OD

decreased LOC, hypotension, miosis, shallow breathing

Order intubation