NURS 663 Test 4 Questions With Correct Answers

NURS 663 Test 4 Questions With Correct Answers substance use disorder specifier criteria - ANSWER- Mild: 2-3 symptoms Moderate: 4-5 symtpoms Severe: 6 symptoms DSM for substance use disorder - ANSWER- over 12 months use increase amount persistant desire or can't cut down lots of time spent on substance craving failure to fill roles social/personal problems activities given up/reduced use when physically hazardous continue despite problem tolerence withdrawal abuse - ANSWER- use of any drug in a manner that deviates from approved social or medial patterns cross tolerence - ANSWER- the ability of one drug to be substituted for another each usually producing the same effects ex: diazepam and barbituates misuse - ANSWER- similar to abuse, but usually applies to drugs prescribed by physicians that are not used properly tolerence - ANSWER- after repeated administration, a given dose of a drug produces a decreased effect or larger doses must be administered to obtain the effect observed with the original dose withdrawal - ANSWER- a substance specific syndrome that occurs after stopping or reducing the amount of drug or substance that has been used regularly over a prolonged period acamprosate; what, side effects, dose - ANSWER- what: alcohol relapse prevention; "artificial alcohol" decreases glutamate and increases GABA side effects: anxiety, depression, diarrhea, decreased libido, flu like dose: 666mg TID must be abstinent from etoh first buprenorphine; moa, who can use - ANSWER- MOA: partial opioid agonist, prevents pleasurable effects, is a opiate analgesic who: pregnant okay, must be in mild withdrawal to start buprenorphine dosing - ANSWER- must be in withdrawal to start SL 8-32mg/d which medications are in Suboxone - ANSWER- buprenorphine and naloxone buproprion; dosing - ANSWER- for smoking cessation: begin 7-14d before stop date; 150mg SR in am x6 days then increase to 150mg SR BID tx for 7-9 weeks chlordiazepoxide; MOA, what for, dosing - ANSWER- MOA: enhances GABA for acute alcohol withdrawal 50-100mg injectable every 2hrs clonidine; MOA - ANSWER- alpha 2 receptors clonidine for opiate withdrawal - ANSWER- blocks autonomic symptoms; palpitations, sweating clonidine for etoh withdrawal - ANSWER- decrease bp, decrease HR, tremors disulfiram; MOA - ANSWER- inhibits acetalhydine and leads to buildup of acetaldehyde and causes immediate hangover effect after alcohol consumption disulfiram dosing - ANSWER- 250-500mg/d flumazenil; MOA, use, dosing, se - ANSWER- MOA: blocks benzo receptors at GABA use: benzo antidote dosing: 0.4mg-3mg se: dizzy, sweating, seizures, death disulfiram side effects - ANSWER- hepatitis, metallic taste, dermatitis lorazepam is used for - ANSWER- alcohol detox to control seizures, DTs, withdrawal psychosis methadone; MOA, dosing, for who - ANSWER- MOA: full opioid agonist dosing: 20-30mg/d, initiate immediately to avoid withdrawal standard of care for pregnant patients injectable treatment for alcohol abuse - ANSWER- naltrexone naloxone; what, for who - ANSWER- what: opiate antidote (heroin) blocks effects of buprenorphine when injected not for pregnancy naloxone and pregnancy - ANSWER- can cause spontaneous abortion, preterm labor, intrauterine fetal demise Naltrexone forms and dosing - ANSWER- pill and injection available must take 50mg x7d before getting shot; no opioids in last 7d before starting naltrexone MOA and side effects - ANSWER- MOA: opioid antagonoist; blocks euphoric effects of alcohol and prevents craving SE: withdrawal, nausea, dizzy, anxiety, fatigue paroxetine; use - ANSWER- tx of choice in PTSD veterans, sexual trauma