Substance Use Disorders

First line medication for alcohol use disorder

Naltrexone and acamprosate

what med blocks opioid receptors to reduce alcohol cravings and reward

Naltrexone

What med is used to maintain abstinence and reduce heavy drinking

Naltrexone

Side effects of Naltrexone? 3

Nausea

Headaches

Dizziness

Contraindications for Naltrexone in OUD?

Current opioid use

Hepatitis/liver failure

Important teaching before starting Naltrexone in OUD?

Patient must be opioid-free

what med restores the balance of GABA and glutamate in the brain

Acamprosate

What med is used to maintain abstinence after alcohol withdrawl

Acamprosate

Side effects of acamprosate

2

Diarrhea

Nausea

Contraindication for acamprosate

severe kidney disease

What med blocks alcohol metabolism, causing unpleasant symptoms if alcohol is consumed

Disulfiram

What medication is best used for highly motivated patients committed to abstinence

Disulfiram

Contraindications of Disulfiram for AUD

3

Heart disease

Psychosis

Active alcohol use

How long should alcohol be avoided after stopping disulfiram

14 days`

Buprenorphine, methadone, and naltrexone are all first line medications for

Opioid use disorder

Partial opioid agonist that reduces cravings and withdrawl

Buprenorphine

The advantage of this medication is lower overdose risk than full opidoid agonists

Buprenorphine

When should buprenorphine be started

when the patient is in mild to moderate withdrawl

Why wait before starting buprenorphine

Starting too early can cause precipitated withdrawl

what med is a full opioid agonist that prevents withdrawl and cravings

Methadone

Methadone serious risk

QT prolongation

How is methadone dispensed

usually through a certified opiod treatment program

When can naltrexone for OUD be started

after the patient has been opioid free for 7-10 days

Naltrexone contraindication for OUD

Current opioid use

Alcohol withdrawl sx

Tremor

Anxiety

Sweating

Seizures

First line treatment medication CLASS for alcohol withdrawl

Benzodiazepines

What do benzodiazapines used for alcohol withdrawl prevent

seizures

Opioid withdrawl sx

Muscle aches

Sweating

dialated pupils

Is opioid withdrawl usually life threatening?

no

How is naloxone usually given

intranasal or IM

How long does it take Naloxone to work

30-90 minutes

Why monitor after naloxone

Overdose can return after it wears off