NURS 660 EXAM 4 questions with complete solutions

NURS 660 EXAM 4 questions with complete solutions Methadone is a _____ mu opioid receptor agonist. Side effects include _____ and _____ - answerFull. Constipation, sedation. Buprenorphine (suboxone) is a _____ at the opioid receptor. Often combined with naltrexone to prevent abuse -answerPartial agonist Naloxone (Narcan) is a mu receptor _____ . it has little effect compared to buprenorphine (usually 1:4 ratio). -answerAntagonist When buprenorphine/naloxone is injected or inhaled the ANTAGONIST effects of _____ dominate and w/d symptoms are precipitated -answerNaloxone Overdose is much more likely with ____ than _____ -answerMethadone (full agonist) buprenorphine (partial agonist) Extended-release buprenorphine can be dosed ____ -answerSubcutaneous once per month after demonstrating tolerability for 1-week oral dosing Naltrexone (ReVia) is a Mu receptor antagonist. Consideration before starting _____ - answerOpiate free 7-10d or w/d symptoms Naltrexone (ReVia) is available as once-monthly injection. How does it work? ____ - answerBlocks Mu receptors to prevent euphoric effects if patient relapses. Helps with abstinence to eliminate reward 3 meds FDA approved for AUD -answerDisufiram, Acamprosate, Naltrexone. Off-label = Gabapentin and topiramate NIAAA defines 'At risk' for men _____. Women _____. Above age 65 _____ -answerMen= 4/day, 14/week. Women= 3/day, 7/week. 65= same as for women Binge drinking for men _____, for women=_____ -answerMen= 5 in 2 hrs. Women= 4 in 2 hrs Describe transmitters involved in etOH withdrawal -answerOver time alcoholics up-regulate Glutamate to match the excess GABA. When there's a withdrawal there is a relative excess Timeline of alcohol withdrawal -answerMinor- within 36 hrs. Seizures- 1-2d. Hallucinosis- 1-2d. DT's- 1-4d Disulfiram (Antabuse) adverse effects -answerMetallic taste, hepatotoxicity, optic neuritis, peripheral neuropathy. (causes physically ill from buildup of acetaldehyde) Acamprosate (Camral), how does it work? -answerDosed 3x's/day. Cleared renally. Glutamate receptor modulator. How does naltrexone (ReVia) work in alcohol cessation. -answerBlocks opioid Mu receptors and secondary dopamine (reduce pleasure and cravings) Naltrexone extended release (Vivitrol) adverse effects -answerNausea, vomiting, precipitated opioid withdrawal, depression, elevated LFT's Mild withdrawal starts within ____ hours and resolve in _____. These include: -answer6-24. resolve 1-2 days. Tremor, anxiety, headache, insomnia, GI upset Hallucinations start within _____ and resolve in _____ -answer12-24 hrs, resolve 1-2days Moderate and Severe withdrawal starts within _____ and lasts _____ -answer1-3 days, can last 5-7 DT's start _____ and can last _____ -answer3-4 days and