substance use disorder

amphetamines nickname

speed, uppers

phencyclidine nickname

PCP, angel dust

methamphetamine nickname

crank, ice, crystal

heroine nickname

blow

mdma nickname

molly, ecstasy

synthetic anabolic steroids

similar to testosterone

can cause mood disorders, HTN, serious cardiac damage and liver cancer

impact sexual function

effects of substance abuse on pregnancy

lack of prenatal care

fetal alchohol syndrome

cigarette: decrease in blood flow to baby

cocaine and barbiturates: addiction in baby

cardiovascular complications of substance abuse

irregular heartbeats, increased BP, MI, stroke, heart failure

infection complications of substance abuse

hepatitis B, HIV due to shared needles

neurologic complications of substance abuse

fear, panic, depression, risk of suicide, impaired memory

cirrhosis

caused by alcohol

metabolic changes in liver cells w eventual irreversible damage of liver

korsakoff psychosis

alcohol

altered personality and amnesia

wernicke syndrome

alcohol

confusion, disorientation, loss of motor func

AUD drug treatments

dislfiram

acomprosate

naltrexone

antabuse

disulfiram

makes you very sick if you take with alcohol

best for newly abstinate

excreted in breastmilk

acamprosate

reduces cravings and distress associated with withdrawl

alcohol

adjust dose for kidney disease

side effects: pain, loss of appetite, depression

assess for suicidal ideation prior

unknown if harms fetus

naltrexone

reduces cravings for both alcohol and opioids

pt must be opioid free for 7 days before starting bc it will cause withdrawal

adverse reactions: suicidality, depression, hepatotoxicity, rash

is excreted in breast milk

drug treatment for opioid use disorder

naloxone

naltrexone

methadone

buprenorphine

naloxone

narcan

for overdose

give low dose every 2-3 min until pt responds

pt may go into immediate withdrawal

methadone

can only be prescribed by certified programs

also for heroin treatment

blocks sense of euphoria and prevents withdrawal and cravings

side effects: lightheadedness, constipation, dizzinessm sedation, nvd

crosses into breastmilk

what should not mix with methadone

rifampin, phenytoin, st johns wort, phenobarital, carbamazepine

buprenorphine

OUD

decreases withdrawal symptoms and cravings

mixed w naloxone to further deter misuse: if crushed or injected, naloxone will cause withdrawal

crosses into breastmilk

bupropion

for nicotine

antidepressant; increases dopamine and norepinephrine in brain, mimicking effects of nicotine

when starting, pt continues to smoke for first week and stops week 2

contraindicated in seizure disorder, eating disorder

must be tapered

can cause false positive urine drug test

does cross in breastmilk

varenicline

reduced cravings and withdrawal

black box warning: serious neuropsych symptoms: agitation, depression, suicidality