NSG552 Exam 3 |73 questions and answers.

naloxone MOA: Pure opioid antagonist that competes and displaces opioids at opioid receptor sites. methadone, buprenorphine, buprenorphine+naloxone Treatments for opioid use disorder. buprenorphine+naloxone Treatment for opioid use disorder with comorbid pain. opioids Inappropriate use of what substance may be due to uncontrolled pain? tablet, injectable, implant Naltrexone delivery methods. implant Form of naltrexone limited to inpatient use. buprenorphine Mu receptor partial agonist for opioid withdrawal. buprenorphine Taking this medication too soon after last opioid use increases the chances of intense withdrawal that comes on very quickly (precipitated withdrawal). opioid intoxication Symptoms include nausea and vomiting, respiratory depression, constipation, itching, mioisis (small pupil). Patient will experience euphoria and sedation. opioid withdrawal Symptoms include N/V/D and dehydration, irritability, restlessness, yawning, and twitching, increased HR/BP, chills, increased temperature, rhinorrhea, lacrimation, dilated pupils. naloxone Treatment for opioid intoxication during which cardiac or respiratory depression is a concern. cocaine intoxication Symptoms include dilated pupils, HA, tremor, hyper-reflexia, twitching, seizures, or coma, increased HR/BP, arrhythmias, and MI, N/V, incontinence/ARF, or rhabdomyolysis cocaine intoxication Treatment includes BZD, antipsychotics, and management of medical problems including HTN, stroke, cardiac arrhythmias, hyperthermia, and seizures. cocaine The use of beta blockers for treatment of chest pain and MI during this intoxication is to be avoided due to unopposed a adrenergic stimulation. alcohol intoxication Signs vary with blood levels, from decreased reaction time, muscle incoordination, ataxia, dysarthria, to respiratory failure and coma. severe alcohol intoxication Treatment includes cardiopulmonary function maintenance, thiamine, and haloperidol PRN agitation. thiamine Given IM/IV for 3 days to prevent Wernicke's encephalopathy, along with IV fluids and a banana bag. benzodiazepines Class of drugs to avoid for acute alcohol intoxication. uncomplicated alcohol withdrawal Treatment includes BZD in either symptom triggered or fixed dose; diazepam and chlordiazepoxide have a longer half life, and oxazepam and lorazepam are suitable for patients with hepatic dysfunction. diazepam and chlordiazepoxide BZDs with a long half-life used to treat AUD. oxazepam and lorazepam BZDs with moderate half-life used in AUD patients with liver disease. alcohol withdrawal seizures Treatment includes diazepam IV or lorazepam IV/IM, thiamine IV/IM, and addressing electrolyte imbalances. DT Treatment includes acute care management, parenteral diazepam or lorazepam, thiamine, and antipsychotics if necessary. disulfiram MOA is via negative reinforcement, where drinking is avoided due to unpleasant effects. acamprosate NMDA receptor antagonist that is renally cleared, suitable for AUD patients with hepatic dysfunction. naltrexone Treatment suitable for AUD with comorbid OUD, reducing consumption by decreasing reinforcing properties. NRT Only deals with physical dependence, does not address the psychological component of smoking. varenicline, bupropion, clonidine Oral stop-smoking aids, remember Very Bad Cancer buproprion Patients on what medication for smoking cessation treatment should be observed for neuropsychiatric symptoms including changes in behavior, hostility, agitation, depressed mood, and suicide-related events, including ideation, behavior, and attempted suicide. IV BZD How would you treat cocaine induced chest pain/myocardial infarction? atypical antipsychotics Treatment for agitation in patients with dementia. BZD Used only for short term and acute episodes of aggression, agitation, and psychosis in patients with dementia. delirium TCAs, Anticholinergics, Benzos, Non-benzos, Corticosteroids, H2 blockers, opioids cause what medical emergency in elderly patients? hypersexuality, hyperorality Klüver-Bucy syndrome, a type of frontotemporal degeneration (FTD), results from bilateral lesions of the medial temporal lobe and manifests with what 2 common symptoms? Donepezil, rivastigmine, galantamine Cholinesterase inhibitors appropriate for mild to moderate dementia, remember Damn, Grandma's Regressing memantine NMDA receptor antagonist that promotes synaptic plasticity and is used for moderate to severe dementia. nortiptyline TCA with fewest anticholinergic effects, making it the most appropriate TCA in the elderly SSRIs ARE PREFERRED mirtazapine Most appropriate medication for elderly patient with MDD, insomnia, and decreased appetite. methylphenidate In cases of severe depression or psychomotor retardation, this may be used in low doses as an adjunct to antidepressants. trazodone Best alternative to sedative-hypnotic use for insomnia in the elderly as it's less likely to cause memory impairment, paradoxical excitement, or rebound insomnia. delirium A reversible condition that may be caused by drugs, electrolyte imbalance, low O2 sat, infection, reduced sensory input, intracranial events, urinary retention, or myocardial issues. methylphenidate, amphetamine salts, dexmethylphenidate, dextroamphetamine The 4 stimulants for treating ADHD. Man, Adhd Does Damage *know long vs short acting* TCAs, clonidine, guanfacine, bupropion, atomoxetine The 5 non-stimulants for treating ADHD. Calm Teens Give Better Answers height, weight, BP, HR, EKG What baseline measurements are needed prior to starting treatment for ADHD? atomoxetine Second line treatment, non-stimulant, used in patients with history of SUD or when family prefers non-stimulant. intermediate or long acting Types of stimulants used when patient needs duration of action longer than 4 hours; also improves adherence and is less likely to be abused. dizziness, poor growth, decreased appetite, insomnia, mood lability Common adverse effects of stimulants Dizzy Patients Demand Immediate Monitoring dizziness Children exhibiting this symptom require BP and HR monitoring. If it occurs at peak, patient should be switched to a longer acting formula. insomnia Patients exhibiting this stimulant associated symptom should be switched to a shorter acting formula. cardiovascular Prior to starting a stimulant, patient history, family history, and exam should be conducted with what focus? tics This stimulant side effect may require discontinuation of medication or change to clonidine or guanfacine. intellectual disability Pharmacological treatment for what condition is only initiated after careful assessment and targets co-occurring disorders for which medication is first-line therapy? SNRIs, mood stabilizers, MAOIs, antipsychotics, TCAs Stimulants should not be combined with these 5 medication classes. Stimulants Make Me Act Tense bupropion, TCA Non-stimulant ADHD treatment most appropriate in a patient with co-occurring depression, and class considered a "reasonable choice" in a patient with co-occurring depression AND anxiety. risperidone, ariprazole Which 2 medications are approved by the FDA to treat severe behavioral issues in ASD, specifically tantrums, self-injury, and aggression? clomipramine On-demand treatment for premature ejaculation. sildenafil Combining this medication with some others, such as nitrates, can cause an unsafe drop in blood pressure as well as headaches, flushing, and dizziness. sexual dysfunction Causes of this condition may be physiological (meds), psychological (depression), or hormonal (abnormal levels). bupropion Most appropriate medication for a female with depression and hypoarousal. paroxetine SSRI most likely to cause sexual dysfunction that may also be used to treat premature ejaculation.