NURS660-EXAM4 -Verified
Questions and Answers
Methadone is a _____ mu opioid receptor agonist. Side effects include
_____ and _____ - -Full. Constipation, sedation.
-Buprenorphine (suboxone) is a _____ at the opioid receptor. Often
combined with naltrexone to prevent abuse - -Partial agonist
-Naloxone (Narcan) is a mu receptor _____ . it has little effect compared
to buprenorphine (usually 1:4 ratio). - -Antagonist
-When buprenorphine/naloxone is injected or inhaled the ANTAGONIST
effects of _____ dominate and w/d symptoms are precipitated - -
Naloxone
-Overdose is much more likely with ____ than _____ - -Methadone (full
agonist) > buprenorphine (partial agonist)
-Extended-release buprenorphine can be dosed ____ - -Subcutaneous
once per month after demonstrating tolerability for 1-week oral dosing
-Naltrexone (ReVia) is a Mu receptor antagonist. Consideration before
starting _____ - -Opiate free 7-10d or w/d symptoms
-Naltrexone (ReVia) is available as once-monthly injection. How does it
work? ____ - -Blocks Mu receptors to prevent euphoric effects if patient
relapses. Helps with abstinence to eliminate reward
-3 meds FDA approved for AUD - -Disufiram, Acamprosate, Naltrexone.
Off-label = Gabapentin and topiramate
-NIAAA defines 'At risk' for men _____. Women _____. Above age 65 _____
- -Men= 4/day, 14/week. Women= 3/day, 7/week. >65= same as for
women
-Binge drinking for men _____, for women=_____ - -Men= 5 in 2 hrs.
Women= 4 in 2 hrs
-Describe transmitters involved in etOH withdrawal - -Over time
alcoholics up-regulate Glutamate to match the excess GABA. When
there's a withdrawal there is a relative excess
-Timeline of alcohol withdrawal - -Minor- within 36 hrs. Seizures- 1-2d.
Hallucinosis- 1-2d. DT's- 1-4d
, -Disulfiram (Antabuse) adverse effects - -Metallic taste, hepatotoxicity,
optic neuritis, peripheral neuropathy. (causes physically ill from buildup
of acetaldehyde)
-Acamprosate (Camral), how does it work? - -Dosed 3x's/day. Cleared
renally. Glutamate receptor modulator.
-How does naltrexone (ReVia) work in alcohol cessation. - -Blocks opioid
Mu receptors and secondary dopamine (reduce pleasure and cravings)
-Naltrexone extended release (Vivitrol) adverse effects - -Nausea,
vomiting, precipitated opioid withdrawal, depression, elevated LFT's
-Mild withdrawal starts within ____ hours and resolve in _____. These
include: - -6-24. resolve 1-2 days. Tremor, anxiety, headache, insomnia,
GI upset
-Hallucinations start within _____ and resolve in _____ - -12-24 hrs,
resolve 1-2days
-Moderate and Severe withdrawal starts within _____ and lasts _____ - -1-
3 days, can last 5-7
-DT's start _____ and can last _____ - -3-4 days and last 2-3 days
-Triad of Wernicke's - -Encephalopathy, oculomotor dysfunction, gait
ataxia (often progresses to Korsakoff syndrome)
-Wernicke-Korsakoff psychosis - -COAT (Wernickes) RACK (Korsakoffs).
Confusion, ophthalmoplegia, Ataxia, Thiamine def. RACK= Retrograde
and Anterograde amnesia, Confabulation, Korsakoff psychosis
-Opioid use disorder and neurotransmitter - -Lowers NE and the brain
up-regulates to make more. When the opioid is removed there is a
relative excess surge of NE
-Drug classes that help treat opioid w/d - -Alpha 2 agonists (Clonidine,
Methyldopa, Tizanidine, Guanfacine), Beta blockers, SNRI
-Impulsivity and reward= _____ striatum. Compulsivity and motor
response inhibition= _____ striatum - -Ventral, dorsal
-Reward pathway: mesolimbic from the _____ to the _____ - -VTA to the
Nucleus accumbens (specifically in regards to dopamine)
-Drugs of abuse cause DA release in the _____ - -Mesolimbic pathway
-Pathology of Alzheimer's - -Amyloid/ Tau
-Pathology of Parkinson's / dementia w/ Lewy bodies - -Alpha-synuclein
Questions and Answers
Methadone is a _____ mu opioid receptor agonist. Side effects include
_____ and _____ - -Full. Constipation, sedation.
-Buprenorphine (suboxone) is a _____ at the opioid receptor. Often
combined with naltrexone to prevent abuse - -Partial agonist
-Naloxone (Narcan) is a mu receptor _____ . it has little effect compared
to buprenorphine (usually 1:4 ratio). - -Antagonist
-When buprenorphine/naloxone is injected or inhaled the ANTAGONIST
effects of _____ dominate and w/d symptoms are precipitated - -
Naloxone
-Overdose is much more likely with ____ than _____ - -Methadone (full
agonist) > buprenorphine (partial agonist)
-Extended-release buprenorphine can be dosed ____ - -Subcutaneous
once per month after demonstrating tolerability for 1-week oral dosing
-Naltrexone (ReVia) is a Mu receptor antagonist. Consideration before
starting _____ - -Opiate free 7-10d or w/d symptoms
-Naltrexone (ReVia) is available as once-monthly injection. How does it
work? ____ - -Blocks Mu receptors to prevent euphoric effects if patient
relapses. Helps with abstinence to eliminate reward
-3 meds FDA approved for AUD - -Disufiram, Acamprosate, Naltrexone.
Off-label = Gabapentin and topiramate
-NIAAA defines 'At risk' for men _____. Women _____. Above age 65 _____
- -Men= 4/day, 14/week. Women= 3/day, 7/week. >65= same as for
women
-Binge drinking for men _____, for women=_____ - -Men= 5 in 2 hrs.
Women= 4 in 2 hrs
-Describe transmitters involved in etOH withdrawal - -Over time
alcoholics up-regulate Glutamate to match the excess GABA. When
there's a withdrawal there is a relative excess
-Timeline of alcohol withdrawal - -Minor- within 36 hrs. Seizures- 1-2d.
Hallucinosis- 1-2d. DT's- 1-4d
, -Disulfiram (Antabuse) adverse effects - -Metallic taste, hepatotoxicity,
optic neuritis, peripheral neuropathy. (causes physically ill from buildup
of acetaldehyde)
-Acamprosate (Camral), how does it work? - -Dosed 3x's/day. Cleared
renally. Glutamate receptor modulator.
-How does naltrexone (ReVia) work in alcohol cessation. - -Blocks opioid
Mu receptors and secondary dopamine (reduce pleasure and cravings)
-Naltrexone extended release (Vivitrol) adverse effects - -Nausea,
vomiting, precipitated opioid withdrawal, depression, elevated LFT's
-Mild withdrawal starts within ____ hours and resolve in _____. These
include: - -6-24. resolve 1-2 days. Tremor, anxiety, headache, insomnia,
GI upset
-Hallucinations start within _____ and resolve in _____ - -12-24 hrs,
resolve 1-2days
-Moderate and Severe withdrawal starts within _____ and lasts _____ - -1-
3 days, can last 5-7
-DT's start _____ and can last _____ - -3-4 days and last 2-3 days
-Triad of Wernicke's - -Encephalopathy, oculomotor dysfunction, gait
ataxia (often progresses to Korsakoff syndrome)
-Wernicke-Korsakoff psychosis - -COAT (Wernickes) RACK (Korsakoffs).
Confusion, ophthalmoplegia, Ataxia, Thiamine def. RACK= Retrograde
and Anterograde amnesia, Confabulation, Korsakoff psychosis
-Opioid use disorder and neurotransmitter - -Lowers NE and the brain
up-regulates to make more. When the opioid is removed there is a
relative excess surge of NE
-Drug classes that help treat opioid w/d - -Alpha 2 agonists (Clonidine,
Methyldopa, Tizanidine, Guanfacine), Beta blockers, SNRI
-Impulsivity and reward= _____ striatum. Compulsivity and motor
response inhibition= _____ striatum - -Ventral, dorsal
-Reward pathway: mesolimbic from the _____ to the _____ - -VTA to the
Nucleus accumbens (specifically in regards to dopamine)
-Drugs of abuse cause DA release in the _____ - -Mesolimbic pathway
-Pathology of Alzheimer's - -Amyloid/ Tau
-Pathology of Parkinson's / dementia w/ Lewy bodies - -Alpha-synuclein
