PSYCH PART 5.docx

[PSYCH PART 5] DRUGS W/ABUSE POTENTIAL - Alcohol - Naltrexone- decreases craving for alcohol - Acaprosate- reduces unpleasant feelings brough on by abstinence - Disulfiram- helps to avoid drinking by causing unpleasant effects if alcohol is ingested acetaldehyde synd...

[PSYCH PART 5] DRUGS W/ABUSE POTENTIAL - Alcohol - Naltrexone- decreases craving for alcohol - Acaprosate- reduces unpleasant feelings brough on by abstinence - Disulfiram- helps to avoid drinking by causing unpleasant effects if alcohol is ingested acetaldehyde syndrome pt must avoid all forms of alcohol - Smoking - Lozanges - Nicoderm and nicotrol patches - Nicotine inhaler: not for pts with asthma - Nicotine nasal spray - Nicotine gum - AE: mouth and throat soreness - After 3mo w/out nicotine pts should discontinue by tapering - bupropion - varenicline - cv events - cannot use if truck/bus driver, pilot or air traffic controllers - opioid - heroin, oxycodone - naloxone is tx of choice: autoinjector and nasal spray - opioid agonist (methadone) and agonist-antagonist (buprenorphine) substituted for those not ready for detox - naltrexone is used for discouragement after detox - buprenorphine - can be Rx in primary care offices and prescriber must receive 8 hours of training and register with the Substance Abuse and Mental Health Services Administration - low potential for abuse. Safer than methadone - methadone - suppressive therapy: giving addict progressively larger doses until 120mg/day. - BBW: prolong QT and respiratory depression - Rx in programs - Barbiturates - Cross dependency exists between barbs and other CNS depressants but not with opioids. - Phenobarbital can help with withdraw - Benzos - Flumazenil for OD - Methamphetamine - Tx: bupropion and modafinil