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NURS 572 37,38,39
Pharm Ch 37,38,39 drugs of abuse
Question | Answer |
---|---|
what ntran ant of brain affected in addiction | dopa major transmitter --- remodeling in synapse leads to addictive behavior. Reward circuit affected and remodeled changes remain after drug stop |
drug classes to facilitate acute withdrawal | Beta blockers, A-2 agonist combats SNS response to withdrawal (minimizes increases in BP, tachy, sweating, etc) |
Drug for aversion | disulfiram - MUST avoid all alcohol sources |
MOA disulfiram | stops ETOH metab mid-way by irreversible inhibition of ALDEHYDE DEHYDROGENASE --> accumulation of acetylaldehydes (hangover sxs even fatal) |
mixed opioid agonist/antagonist (2) used to decrease craving, blocks the high from drinking ETOH | naltrexone, buprinorphine |
what is the drug used to maintain abstinence (decrease the frequency of ETOH consumption) | acamprosate - which is best choice in this class |
what long acting opioid agonist might be useful in detox | methadone |
what opioid antagonist MIGHT be used in conjunction with buprinorphine | naloxone |
OTC forms of nicotine replacement | gum, lozenge, transdermal |
RX forms of nicotine replacement | inhaler, nasal spray (this admin most closely increases serum nicotine to equal cigs) |
what are 2 antidepressants that have off-label uses for smoking cessation | buproprion (atypical) and nortripyline (TCA) |
New drug for smoking cessation - | varenicline |
varenicline MOA | nicotine agonist binds where tobacco nicotine binds. also prevents tobacco nicotine from binding here. |
SEs of varenicline | GI - n/flat/c/xerstomia 1% suicidal idealations, sleep dist. psychosis |
Dosing for varenicline | start low and taper up to minimize SEs |