NR 546
Week 6 Addiction Medication Table
Dwayne Ford 8/23
Drug Name Indication Half-life (T1/2), Notable Side Effects Initial Dosing Considerations
Neurotransmitter(s) Metabolism (CYP (link to NT or Specific lifespan
Affected 450 enzyme) affected brain circuit) considerations (age,
Target Symptoms pregnancy, breastfeeding)
Buprenorphine Indication: Treatment Subutex half-life Activates opioid - use for 16 years and older
(Subutex) of opioid addiction and 38 hours, receptors, primarily
opioid dependence the mu-opioid -safe for both pregnant and
Target Symptoms: Pain Cytochrome P450 receptor, which can breastfeeding women.
relief, reduced cravings, 3A4/3A5- lead to constipation,
and improved quality of mediated N- nausea, drowsiness,
life. dealkylation dizziness, itching,
Affected and vomiting.
Neurotransmitters:
Activates opioid
receptors, primarily the
mu-opioid
receptor.
Buprenorphine/Naloxone Indication: Treatment Suboxone, Activates opioid -use for 16 years and older
(Suboxone, Zubsolv, of opioid addiction and Zubsolv, 24 to 42 receptors, primarily
[Bunavail-no longer opioid dependence. hours the mu-opioid -safe for both pregnant and
available as of March 2020]) Target Symptoms: Pain receptor, which can breastfeeding women.
relief, reduced cravings, Bunavail, 16.4 to lead to constipation,
and improved quality of 27.5 hours. nausea, drowsiness,
life. dizziness, itching,
Affected Cytochrome P450 and vomiting.
Neurotransmitters: 3A4 (CYP3A4)
Activates opioid enzyme
receptors, primarily the
mu-opioid receptor.
,Methadone Indication: Methadone half- Activates opioid -different dosages for
(Delphine, Methadose) Treatment of life 8 to 59 hours, receptors, primarily different ages, including
opioid addiction Cytochrome P450 the mu-opioid pediatric
and opioid (CYP) receptor, which can -safe for both pregnant and
dependence. lead to breastfeeding women.
Target Symptoms: constipation,
Pain relief, reduced nausea, drowsiness,
cravings, and dizziness, itching,
improved quality of vomiting, and
life. sweating
Affected
Neurotransmitters:
Activates opioid
receptors, primarily
the mu-opioid
receptor.
Naltrexone Indication: Naltrexone Blocks opioid -use for 18 years and above
(Revia, Vivitrol) Treatment of 50mg half-life receptors, primarily
opioid addiction is about 4 to 13 the mu-opioid - contraindicated in
and opioid hours, receptor, can lead pregnancy
dependence Liver (non- to nausea,
Target Symptoms: CYP450) vomiting, - safe for
Prevention of dizziness, breastfeeding
relapse, reduced headache, and women
cravings, and fatigue.
improved quality
of life.
Affected
Neurotransmitters:
Blocks opioid
receptors, primarily
the mu-opioid
receptor.
,Acamprosate Indication: Acamprosate Modulates the -not recommended for
(Campral) Treatment of half-life is about activity of gamma- children and the elderly
alcohol addiction 32 hours, aminobutyric acid
and alcohol (GABA), - contraindicated for
dependence. CYP450 glutamate, and breastfeeding and pregnant
Target Symptoms: enzymes do not glycine, which can women
Reduced cravings metabolize it. lead to diarrhea,
for alcohol and nausea, vomiting,
improved quality -gamma- and dizziness.
of life. aminobutyric
Affected acid (GABA)
Neurotransmitters: and glutamate
Modulates the neurotransmitter
activity of gamma- systems
aminobutyric acid
(GABA),
glutamate,
and glycine
Disulfiram Indication: Used to Disulfiram half- It inhibits the - for 18 years and above,
(Antabuse) treat alcohol life 60-120 hours enzyme only contraindicated for
addiction. acetaldehyde breastfeeding
Target Symptoms: hepatic P450 2E1 dehydrogenase,
Cravings, metabolized in leading to nausea, -taken during pregnancy
withdrawal the liver vomiting, only if the benefits
symptoms, and headache, outweigh the risks
alcohol use. dizziness, metallic
Affected taste, skin rash,
Neurotransmitters: and acne.
Disulfiram is
thought to act on
the acetylcholine
and dopamine
, NR546 Final Exam Questions with correct
answers
Pharmacologic Treatment of Bipolar Disorder - ANSWER-Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression - ANSWER-major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence
highest (13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms.
Bipolar disorder (BD) - ANSWER-Chronic condition characterized by extreme
fluctuations in mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood
or psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle
rapidly
-diagnosed when a client has one or more episodes of mania or hypomania with
a history of one or more major depressive episodes
-high risk for suicide
Week 6 Addiction Medication Table
Dwayne Ford 8/23
Drug Name Indication Half-life (T1/2), Notable Side Effects Initial Dosing Considerations
Neurotransmitter(s) Metabolism (CYP (link to NT or Specific lifespan
Affected 450 enzyme) affected brain circuit) considerations (age,
Target Symptoms pregnancy, breastfeeding)
Buprenorphine Indication: Treatment Subutex half-life Activates opioid - use for 16 years and older
(Subutex) of opioid addiction and 38 hours, receptors, primarily
opioid dependence the mu-opioid -safe for both pregnant and
Target Symptoms: Pain Cytochrome P450 receptor, which can breastfeeding women.
relief, reduced cravings, 3A4/3A5- lead to constipation,
and improved quality of mediated N- nausea, drowsiness,
life. dealkylation dizziness, itching,
Affected and vomiting.
Neurotransmitters:
Activates opioid
receptors, primarily the
mu-opioid
receptor.
Buprenorphine/Naloxone Indication: Treatment Suboxone, Activates opioid -use for 16 years and older
(Suboxone, Zubsolv, of opioid addiction and Zubsolv, 24 to 42 receptors, primarily
[Bunavail-no longer opioid dependence. hours the mu-opioid -safe for both pregnant and
available as of March 2020]) Target Symptoms: Pain receptor, which can breastfeeding women.
relief, reduced cravings, Bunavail, 16.4 to lead to constipation,
and improved quality of 27.5 hours. nausea, drowsiness,
life. dizziness, itching,
Affected Cytochrome P450 and vomiting.
Neurotransmitters: 3A4 (CYP3A4)
Activates opioid enzyme
receptors, primarily the
mu-opioid receptor.
,Methadone Indication: Methadone half- Activates opioid -different dosages for
(Delphine, Methadose) Treatment of life 8 to 59 hours, receptors, primarily different ages, including
opioid addiction Cytochrome P450 the mu-opioid pediatric
and opioid (CYP) receptor, which can -safe for both pregnant and
dependence. lead to breastfeeding women.
Target Symptoms: constipation,
Pain relief, reduced nausea, drowsiness,
cravings, and dizziness, itching,
improved quality of vomiting, and
life. sweating
Affected
Neurotransmitters:
Activates opioid
receptors, primarily
the mu-opioid
receptor.
Naltrexone Indication: Naltrexone Blocks opioid -use for 18 years and above
(Revia, Vivitrol) Treatment of 50mg half-life receptors, primarily
opioid addiction is about 4 to 13 the mu-opioid - contraindicated in
and opioid hours, receptor, can lead pregnancy
dependence Liver (non- to nausea,
Target Symptoms: CYP450) vomiting, - safe for
Prevention of dizziness, breastfeeding
relapse, reduced headache, and women
cravings, and fatigue.
improved quality
of life.
Affected
Neurotransmitters:
Blocks opioid
receptors, primarily
the mu-opioid
receptor.
,Acamprosate Indication: Acamprosate Modulates the -not recommended for
(Campral) Treatment of half-life is about activity of gamma- children and the elderly
alcohol addiction 32 hours, aminobutyric acid
and alcohol (GABA), - contraindicated for
dependence. CYP450 glutamate, and breastfeeding and pregnant
Target Symptoms: enzymes do not glycine, which can women
Reduced cravings metabolize it. lead to diarrhea,
for alcohol and nausea, vomiting,
improved quality -gamma- and dizziness.
of life. aminobutyric
Affected acid (GABA)
Neurotransmitters: and glutamate
Modulates the neurotransmitter
activity of gamma- systems
aminobutyric acid
(GABA),
glutamate,
and glycine
Disulfiram Indication: Used to Disulfiram half- It inhibits the - for 18 years and above,
(Antabuse) treat alcohol life 60-120 hours enzyme only contraindicated for
addiction. acetaldehyde breastfeeding
Target Symptoms: hepatic P450 2E1 dehydrogenase,
Cravings, metabolized in leading to nausea, -taken during pregnancy
withdrawal the liver vomiting, only if the benefits
symptoms, and headache, outweigh the risks
alcohol use. dizziness, metallic
Affected taste, skin rash,
Neurotransmitters: and acne.
Disulfiram is
thought to act on
the acetylcholine
and dopamine
, NR546 Final Exam Questions with correct
answers
Pharmacologic Treatment of Bipolar Disorder - ANSWER-Lithium
Anticonvulsants
Second generation antipsychotics
Unipolar depression - ANSWER-major depressive disorder (MDD)
one of the most common mental disorders
-Approximately 7.1% of adults in the U.S. had episode in last year, prevalence
highest (13.1%) among individuals aged 18-25
S/S
-depressed mood
-loss of interest or pleasure in daily activities
-irritability
-withdrawal
-problems with sleep, eating, energy, concentration, or self-worth
-severe depression: may experience thoughts of suicide or psychotic symptoms.
Bipolar disorder (BD) - ANSWER-Chronic condition characterized by extreme
fluctuations in mood, energy, and ability to function
-Moods may be manic, hypomanic, or depressed and may include mixed mood
or psychotic features
-many have only experienced only one manic episode in their lifetime
-Mood fluctuations may be separated by periods of high stability or may cycle
rapidly
-diagnosed when a client has one or more episodes of mania or hypomania with
a history of one or more major depressive episodes
-high risk for suicide
