NU553 Unit 3 Substance Use Disorders Advanced Pharmacology and Pharmacotherapeutics Exam 2

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Mild substance use disorder criteria count?

2 to 3

Moderate substance use disorder criteria count?

4 to 5

Severe substance use disorder criteria count?

6 or more

Reward pathway projection?

Ventral tegmental area to nucleus accumbens

Primary neurotransmitter reward pathway?

Dopamine

Inhibitory neurotransmitter on reward pathway?

Gamma aminobutyric acid

Cocaine mechanism?

Blocks monoamine reuptake

Amphetamine mechanism?

Blocks reuptake and increases release

SBIRT components?

Screening brief intervention referral

Opioid misuse screening tool?

Current Opioid Misuse Measure

Drug abuse screening tool?

DAST 10

Alcohol withdrawal onset?

6 to 12 hours

Alcohol withdrawal first line treatment?

Benzodiazepines

Delirium tremens timing?

48 to 72 hours

Delirium tremens symptoms?

Confusion hallucinations autonomic instability

AUD with liver disease best medication?

Acamprosate

Acamprosate contraindication?

Severe renal impairment

Acamprosate dose normal renal function?

666 milligrams three times daily

Acamprosate most common side effect?

Diarrhea

Disulfiram mechanism?

Blocks aldehyde dehydrogenase

Disulfiram counseling?

Avoid all alcohol sources

Naltrexone mechanism?

Opioid receptor antagonist

Naltrexone must avoid if?

Current opioid use

Naltrexone injection dose?

380 milligrams every 4 weeks

Alcohol vs opioid withdrawal risk?

Alcohol can be fatal opioid usually not

Pregnant OUD treatment?

Methadone

Opioid withdrawal scale?

Clinical Opioid Withdrawal Scale

Naloxone use?

Reverse opioid overdose

Naloxone repeat dosing?

Every 2 to 3 minutes if needed

Buprenorphine mechanism?

Partial opioid agonist

Buprenorphine start requirement?

Patient in withdrawal

Buprenorphine max dose?

24 milligrams daily

Buprenorphine metabolism?

CYP3A4

Lofexidine mechanism?

Alpha 2 agonist

Lofexidine adverse effect?

Hypotension bradycardia

Methadone starting dose?

10 to 30 milligrams

Methadone maintenance dose?

80 to 120 milligrams

Methadone major risk?

Respiratory depression QT prolongation

Preferred OUD outpatient treatment?

Buprenorphine

Why combine buprenorphine with naloxone?

Prevent injection misuse

Naltrexone challenge before start?

Naloxone challenge

Key deficiency in alcohol use disorder?

Thiamine

Give thiamine before what?

Glucose

Wernicke triad?

Confusion ataxia nystagmus

Heavy drinking male definition?

More than 4 drinks daily

Heavy drinking female definition?

More than 3 drinks daily

Standard drink alcohol grams?

14 grams

PCP mechanism?

NMDA receptor inhibition

Injectable naltrexone safety program?

Risk evaluation mitigation strategy

Oral naltrexone limitation?

Poor adherence

Lofexidine discontinuation?

Taper gradually

Lofexidine max dose?

2.88 milligrams daily

Alcohol screening quick tool?

CAGE

Monitor disulfiram labs?

Liver function tests

Lofexidine advantage?

Non opioid withdrawal treatment

If buprenorphine fails?

Switch to methadone

Opioid withdrawal onset short acting?

8 to 24 hours

Methadone withdrawal duration?

10 to 20 days

Neonatal abstinence syndrome cause?

Maternal drug use

Preferred benzo liver disease withdrawal?

Lorazepam or oxazepam

Methadone dispensing setting?

Opioid treatment program

Recovery definition?

Improved health and wellness

First line AUD maintenance?

Naltrexone or acamprosate

Key naltrexone safety point?

Must be opioid free

Methadone vs buprenorphine?

Full agonist vs partial agonist

Buprenorphine advantage?

Ceiling respiratory effect

Naloxone role?

Reverse overdose

SBIRT purpose?

Early identification intervention

DT timing?

48 to 72 hours

If liver disease benzodiazepine?

Lorazepam or oxazepam

If pregnancy OUD?

Methadone

Thiamine role?

Prevent Wernicke encephalopathy

If poor adherence AUD?

Use injectable naltrexone

Opioid vs alcohol withdrawal?

Alcohol life threatening

If still using opioids avoid?

Naltrexone