Thera Psych Intro / Substance use Disorders Intro

What is defined as health conditions involving changes in emotion, thinking or behavior

Mental Illness

Mental illness is focused more on what

Suffering

What is associated with distress and/or difficulty functioning in social, work, or family activities

Mental Illness

What is defined as the branch of medicine focused on the diagnosis, treatment, and prevention of mental emotional and behavioral disorders

Psychiatry

T/F

Mental illness is treatable

True

What is the most common/polymorphic genome in Psych drugs

CYP2D6

What is termed as how tightly the ligand binds to the receptor

Affinity

What is termed as the capability of the bound ligand to activate the receptor

Intrinsic Efficacy

What is termed as the duration the ligand stays bound to the receptor, affecting the duration of the biological response

Residence Time

What is termed as a primary chronic neurobiologic disease characterized by the inability to consistently abstain, impairment in behavioral control, craving, dysfunctional emotional problems with behaviors and interpersonal relationships

Addiction

What is termed as development of a substance-specific syndrome after recent ingestion and presence in the body of a substance; it' is associated with maladaptive behavior during the central nervous system (CNS)

Intoxication

What is termed as a state of adaptation manifested by as drug-class-specific, withdrawal syndrome that can be produced by abrupt cessation, rapid dose reduction, decreasing blood antagonist

Physical Dependence

What is termed as the continued use of the substance despite adverse substance-related problems

Substance dependence

What is termed as a state of adaptation in which exposure to a drug induces changes that result in a diminution of one or more of the drug’s effects over time

Tolerance

What is termed as a substance-specific syndrome occurring after cessation of or reduction in take of a substance that was used regularly

Withdrawal

What is the t1/2 of Naloxone

30-90 Minutes

What is the onset of action for Naloxone

2-5 minutes

What is the dosage for Naloxone (Opvee)

4-8mg / dose

What’s a big side effect for Nalmefene (Opvee)

Withdrawal

What is the onset of action for Nalmefene (Opvee)

2-5 minutes

What is the t1/2 for Nalmefene (Opvee)

~11 Hours

What is the brand name for Nalmefene

Opvee

What is the generic name for Opvee

Nalmefene

What protects persons that administer Naloxone in good faith

Good Samaritan Laws

What is the first step when in an overdose emergency

Call 911

What is the second step in an overdose emergency

Administer Naloxone

What is the third step in an overdose emergency

Give a second dose of Naloxone in 2-3 minutes if no response to the first dose

What is the fourth step in an overdose emergency

Follow 911 dispatcher’s instructions or perform rescue breathing

What does A represent

Axon (aka: Pre-Synapse)

What does B represent

Reuptake Transporter

What does C represent

Synaptic cleft (aka: Synapse)

What does D represent

Post Synaptic Receptor

What does E represent

Dendrite (aka: Post-Synapse)

What does F represent

Nearotransmitters

What does G represent

Vesicles

T/F

BOTH decreased and increased neurotransmission can lead to a pathological outcome

True

What depends on the level of neurotransmission as well as the neurotransmitter involved

Biological Outcome

Low levels of ____ can lead to a depressed mood

Serotonin

Low levels of ____ can lead to psychosis

Dopamine

T/F

Overdose is Deadly

True

T/F

Withdrawal is Deadly

False

What is the brand name for Naloxone Intranasal Spray

-Narcan (4mg)
-Kloxxado (8mg)

What is the brand name for Naloxone Intramuscular injection

-Evizo (4mg)
-Zimhi (5mg)

What is the MOA for Methadone

Full Mu-Opioid Agonist

What is the MOA for Buprenorphine

Partial Mu-Opioid Agonist

What is the MOA for Naltrexone

Mu-Opioid Antagonist

What drug:

-In safe in pregnancy
-Has the Highest Efficacy in OUD treatment
-Has the Highest RISK of overdose in relapse
-Can be acquired as a one-time dose in the clinic
-Can cause QTc Prolongation

Methadone

What drug is:

-Offered to most patient due to safety profile and accessibility
-Safe in pregnancy
-Offers some pain control, with ceiling effect
-NO LONGER REQUIRES DEA number to prescribe
-Is Less efficacious than methadone

Buprenorphine

What drug is:

-Equally efficacious to buprenorphine
-Can only be given to patients that are opioid-free for 7-10 days prior to initiation
-ONLY AVAILABLE for patients that CAN TOLERATE WITHDRAWAL PERIODS
-Has a REMS program for the intramuscular injection form, but can cause severe injection site reactions
-Has Opioid Antagonistic effects, will cause difficulties in pain management

Naltrexone

What does REMS stand for

Risk Evaluation and Mitigation Strategies

What is defined as a drug safety program that the FDA can require for certain medications with serious safety concerns to help ensure the benefits of the medication outweigh the risks

Risk Evaluation and Mitigation Strategies (REMS)

What is the Max dose for OUD when treating with Buprenorphine

16mg/day

What is the Max dose for analgesic effects when using Buprenorphine

24mg/day

How much is defined as “one drink”

20-25mg/dL

How much for the lethal dose of alcohol? (Variable)

400-500mg/dL

What characteristic of a chemical compound causes it to penetrate the blood brain barrier and distribute to the central nervous system

Lipophilicity

Chronic alcohol use leads to constant flooding of what

Inhibitory neurotransmitter GABA

Acute cessation leads to abrupt surge of what

Excitation via Glutamate

What type of neurotransmitter is GABA

Inhibitory

What type of neurotransmitter is Glutamate

Excitatory

What other type of withdrawal is nearly identical to alcohol withdrawal due to the same mechanism

Benzodiazepine