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NURS 572 37,38,39

Pharm Ch 37,38,39 drugs of abuse

what ntran ant of brain affected in addiction dopa major transmitter --- remodeling in synapse leads to addictive behavior. Reward circuit affected and remodeled changes remain after drug stop
drug classes to facilitate acute withdrawal Beta blockers, A-2 agonist combats SNS response to withdrawal (minimizes increases in BP, tachy, sweating, etc)
Drug for aversion disulfiram - MUST avoid all alcohol sources
MOA disulfiram stops ETOH metab mid-way by irreversible inhibition of ALDEHYDE DEHYDROGENASE --> accumulation of acetylaldehydes (hangover sxs even fatal)
mixed opioid agonist/antagonist (2) used to decrease craving, blocks the high from drinking ETOH naltrexone, buprinorphine
what is the drug used to maintain abstinence (decrease the frequency of ETOH consumption) acamprosate - which is best choice in this class
what long acting opioid agonist might be useful in detox methadone
what opioid antagonist MIGHT be used in conjunction with buprinorphine naloxone
OTC forms of nicotine replacement gum, lozenge, transdermal
RX forms of nicotine replacement inhaler, nasal spray (this admin most closely increases serum nicotine to equal cigs)
what are 2 antidepressants that have off-label uses for smoking cessation buproprion (atypical) and nortripyline (TCA)
New drug for smoking cessation - varenicline
varenicline MOA nicotine agonist binds where tobacco nicotine binds. also prevents tobacco nicotine from binding here.
SEs of varenicline GI - n/flat/c/xerstomia 1% suicidal idealations, sleep dist. psychosis
Dosing for varenicline start low and taper up to minimize SEs
Created by: lorrelaws