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Behav Med CC

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Question
Answer
who should detox as inpatients   h/o seizure/delirium, medically unstable, psychosis, unstable environment, no support/transportation  
who should detox as outpatients   no seizure/delerium hx, med/psych stable, can return daily, has social support  
CIWA stands for   Clinical Institute Withdrawal Assessment  
Easily administered, standardized rating scale to score withdrawal severity.   CIWA  
basing benzodiazepine dose on __ score allows more precise dosing, avoiding under and over medication   CIWA  
medical complications of cocaine   coronary vasospasm, myocardial infarction, cardiomyopathy, arrhythmia, hypertension, stroke, seizures, delirium, placental abruption, fetal growth retardation, trauma, HIV/HCV/HBV, abscess, endocarditis, trauma  
psychiatric complications of cocaine   depression, mania/hypomania, anxiety, insomnia, irritability, sexual dysfunction, agitation, aggression, suicidal ideation, paranoia, psychosis, cognitive impairment  
verbal consent is required for drug testing except __   in a medical emergency  
__ is more useful than __ for drug testing except in acute overdose   urine, blood  
what must be followed to allow results of drug testing to be legally admissible   chain of custody  
use of drug testing in medical context   initial evaluation for suspected use and to monitor ongoing treatment  
what is in the standard "drugs of abuse panel"   amphetamine, barbituates, cannabinoids, cocaine metabolite (benzoylecgonine), opiates(does not detect methadone or buprenorphine, +/- oxycodone), phencyclidine (PCP)  
positive drug screen after __ is highly unlikely   passive exposure  
__ often triggers cocaine relapse   alcohol use  
supplanting crack as leading stimulant of abuse in rurual NC counties, especially in mountain regions   methamphetamine  
opioid dependence is infrequent with __   medical use for analgesia in patients without history of addictive behavior  
characteristics of opioid overdose   CNS depression progressing to coma, pinpoint pupils, resp depression, cardiovascular collapse, pulmonary edema (heroin), often lethal, rapidly reversible with IV naloxone  
opioid withdrawal is __ but rarely __ in otherwise healthy individuals   profoundly unpleasant, dangerous  
symptoms of opioid withdrawal   ab pain, N/V, diarrhea, piloerection, myoclonic jerks, lacrimation, rhinorrhea, anxiety, agitation, insomnia, irritability  
severity of opioid withdrawal is scored using __   COWS (Clinical Opiate Withdrawal Scale)  
treatment of opioid withdrawal   clonidine (reduces adrenergic hyperactivity, sedating), NSAIDS, Loperamide (diarrhea), benzodiazepines (insomnia, irritability, agitation)  
long acting synthetic opioid used as an opioid substitute   methadone  
how to administer methadone   taper over several days in hospital, taper over several weeks for outpatient  
__ blocks effect of self-administered opiates, but compliance is poor unless closely supervised   oral naltrexone  
most effective treatment for preventing relapse in opioid dependence   methadone maintenance, buprenorphine maintenance  
duration ranges of methadone maintenance   months to decades  
requires daily clinic visits for med administration   methadone maintenance  
opioid replacement that is initiated while patient is in withdrawal, safer than methadone during overdose, prescriptions are filled by pharmacies (no daily clinic visits after initial 2-day induction)   buprenorphine maintenance  
__ can trigger relapse of alcohol dependance and other addictions   opioids  


   


 

 

 
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Created by: Abarnard on 2010-04-10




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