LCAS MEDICATION ASSISTED TREATMENT exam study guide fully solved & verified for accuracy 2024

MAT Medication Assisted Treatment- form of pharmacotherapy/any treatment that includes pharmacologic intervention as part of a comprehensive substance abuse treatment plan with the ultimate goal of patient recovery with full social function. The ultimate goal of medication Alcohol Medication Assisted Treatment are: FDA Drugs: Disuifiram, Naltrexone, Acomposate Opioid Disorder drugs are: Methadone, Naltrexone, Buprenorphine There are currently no medication assisted Treatment for 3 drugs Cannibis, cocaine, methamphetamine Acamposate (Brand name: Campral) reduces the symptoms of alcohol withdrawl/protracted withdrawl (insomnia, anxiety, restlessness, and dysphoria). What drug is used for ETOH DO: Used for Protracted withdrawal's of alcohol PAW's in individuals with severe alcohol use disorder. Disulfiram how does it work and which DO is this MAT used for? Disulfiram (Antabuse) inhibits the enzyme in the metabolism of alcohol, causing an unpleasant reaction, inducing: flushing, nausea, heart palpitations. Naltrexone what is it used for in relationship to ETOH. ETOH DO-blocks receptors involved in the rewarding effects of drinking/craving for alcohol. Medication Assisted Treatment, Methadone, how does it work? Methadone-prevents withdraw sx and reduces cravings by "ACTIVATING" opioid receptors in the brain. In some states, may be administered to 16-18, with two documented failed treatments, and written consent for methadone by parent or legal guardian. Buprenorphine what is it used for and how does it work? Buprenorphine (Subutex® & Suboxone®) reduces or eliminates opiate withdraw symptoms, including drug cravings, without euphoria/dangerous side effects of heroin or opiates. By "activating/blocking" opioid receptors in the brain. Buprenorphine is an FDA approved opioid addiction treatment. Currently Subutex® & Suboxone® are the only Buprenorphine medications approved by the FDA. Subutex is an opioid medication. This medicine oral/sublingual (given under the tongue) is used to treat opioid addiction. Comes in a "stand-alone" treatment sublingual; and, as a "combination treatment," called, Naloxone, which cannot be shot up or causes withdraw symptoms. MD needs special certification to administer in office/detoxification. 16 years or older Naltrexone how does it work Naltrexone is for individuals who have been detoxed from opioids. Acts by "blocking" the brains opioid receptors, prevents the drug from reacting/prevents euphoria. Causes withdrawal if taken soon after opioids/without detoxification. Comes in one time a month IM or oral tablets Nalxone how does it work and what does it do? Naloxone is a medication for opioid overdose deaths. The medication binds to opioid receptors and can reverse or block opioid receptors, reversing overdose. Which type of therapy is recommended for Medication Assisted Treatment? (Name 3) Behavioral Therapies-individual, group, and family behavioral therapy. 1. CBT-recognize, avoid, cope with situations they are most likely to abuse drugs. 2. Motivational Enhancement-readiness of individuals to change behavior and enter treatment. 3. Motivational Incentives (CONTINGENCY MANAGEMENT) uses positive reinforcement to encourage abstinence from drugs. Disulfiram is also called Antabuse Disulfiram is used to treat what disorder? How? ETOH DO, central nervous system effects, inhibiting the enzyme dopamine B-hydroxylase and affecting serotonergic function. Disrupts the metabolism of alcohol-severe reaction. Motivation to remain abstinent: Reaction to alcohol consumption. Uncertain: Decreases craving/urge What it does not do-does not effect brain opiate, y-aminobutyric acid, or glutamate receptors directly. Disulfriam-alcohol- Reaction 10-30 minutes after ETOH ingested. Sx moderate to severe-proportionate to amount of ETOH:Disulfriam. Disulfriam Affects the Skin (sweating/warm/flushing), respiratory system (hyperventilation), head/neck/throat (acetaldehyde breath, odor, blurred vision, thirst), chest/heart/circulatory system (palpitations, hypotension, tachycardia, MI, ACHF (with preexisting coronary artery disease), brain/nervous system (vertigo, syncope, confusion, seizures, unconsciousness) It may take up to how many weeks for the body to adequately metabolize alcohol after disulfraim is used? It may take up to two weeks after patient dosing. Who is disulfiram not used for? Patients with severely impaired judgement/highly impulsive from SPMI/cognitive impairment-not good candidates for disulfiram. Disulfriam has been used to treat alchohol use disorder for how many years? Patients with severe.....cannot use disulfiram. What is one of things that disulfriam needs to be monitored for? 60 years. Severe Cardiac Disease. Monitor for hepatoxicity, may cause hepatitis, risk is low. Black Box Warning for Disulfriam Never administer to patients in a state of alcohol intoxication. Wait time: 12 hours before or Blood Alcohol Level is 0. Issues with diabetes, pregnancy, cardio, thyroid disease, seizure DO, CNS impairment, kidney/liver disease. Alcohol is disguised forms-aftershave, liniments, sauces. Drink safely after two weeks without drug. Interactions: Benzos, Librium, Valium, flagyl, coumadin, dilantin, tricyclics, elavil Overdose: Symtoms include: drowsiness followed by coma or persistent nausea, vomiting, aggressive or psychotic behavior, flaccid paralysis Duration of Treatment: No tolerance develops, months or years Disulfiram-alcohol reaction lasts between _____ and ____ minutes 30-60 Minutes. Patient Education on warnings including Disguised forms of alcohol, importance of informing counselor/physician if slip or relapse occurs, telling physician/dentist if taking, symptoms of potential neurologic injury report to md, report sx of liver injury to md What must be done when patient receives disulfiram Document received and understands informed and written consent. Who is appropriate for disulfram? 1. Motivated for TX and committed to total abstinence. 2. Patients capable of understanding the consequences of drinking and taking disulfram. 3. Medically appropriate 4. Who can receive supervised dosing 5. Patients who maintain abstinence during treatment 6. Patients who are codependent or also abuse cocaine. Which opioid antagonist is used to treat Alcohol Use Disorder? Oral Naltrexone hydrochloride (ReVia; Depade) for Alcohol Treatment