Ahmad is a 22 year-old male who has been taking oxycodone and morphine for over 10 years for his chronic back pain. He decided to stop oxycodone and morphine. He states, ‘I would like to use only ibuprofen from now onwards’. However, first he would like to take buprenorphine to taper off his dependence on oxycodone and morphine. His physician started him on buprenorphine-naloxone 8/2 mg. Within a few hours, Ahmad developed nausea, vomiting, diarrhea, muscleaches, rhinorrhea, sweating and insomnia. In the physical examination, he was found to have pupillary dilation, piloerection and yawing. What is the next best step in management?
Ruth is a 42 year-old female who arrives in the emergency room with headache, dizziness, confusion, depression, nausea, and vomiting. Physical examination shows miosis and reduced breath sounds and respiratory rate. Her boyfriend attended a suboxone clinic and shared some pills with her this morning. She took some acetaminophen for headaches but it is not helping. Which of the following medications would help her to recover?
Anand is a 34 year-old male who presents in the emergency room because he decided to ‘do something about my pill problem before they destroy my life’. He feels guilty that he had to starve this children to buy his ‘goodies’.He reports using hydrocodone and morphine and ‘whatever I can get my hands on’ pills almost on a daily basis, ‘I go bonkers if I don’t feed my habit one way or another’. His last use of morphine was around two hours ago. What is the best way to treat his opioid use disorder?
Andrew is a 24 year-old male who reports chronic dependence on opioids. He would like to stop using opioids and start taking buprenorphine for the management of his opioid dependence. Which of the following statements is true about buprenorphine?
Laura is a 24 year-old female who came to the emergency room this evening with severe nausea, vomiting, diarrhea, tremors, hot and cold flushes, sweating, and goosebumps. In the physical examination, you found an anxious, watery eyed patient, who was yawning and restless. She reports that she has been using oxycodone, methadone regularly and marijuana occasionally. Last night she had two beers, her regular daily intake. Today she went to an outpatient clinic for the treatment of her opioid disorder and was started on naloxone 50 mg once daily. Which of the following medications is the reason for her emergency room visit this evening?
Theresa is a 34 year-old female who joined in a medication assisted treatment for her opioid use disorder. She has a history of hepatitis C for over 7 years. She is a mother of two young children. Her physician started her on buprenorphine-naloxone combination sublingual tablet 8/2 mg twice daily. What is the purpose of combining naloxone with buprenorphine?
Most commonly abused drugs increase extracellular dopamine levels in the reward pathway. Which of the following regions of the brain consists of the neurons of the reward pathway?
Devi is a 26 year-old female who is brought to the emergency room because she is feeling difficulty breathing and chest pain. She reports she took over 260 pills of loperamide she bought on Amazon to achieve a sense of euphoria. Her routine urine drug screen is negative for oxycodone, hydrocodone, benzodiazepines and amphetamines. Loperamide can be used because it is a/an
Ayaan is a 24 year-old female who has been diagnosed with alcohol dependence. She would like to get started on an opioid antagonist to treat her alcoholism. Of the following, which is an opioid antagonist approved for adjunctive treatment of alcohol dependence?
