-Anxiety, restlessness, GI upset, tremor, sleep disturbance
Notes: Works best with patch (long acting ‘basal’ nicotine level) together with gum or lozenge for break through cravings.
-Partial mu opioid agonist and kappa opioid antagonist
-Opioid detoxification after opioid withdrawal has commenced and long term maintenance.
-Less chance of respiratory depression. Less euphoria and cravings. Provides some pain control. “24 hour reprieve”: will not get high on other opiates. High binding affinity: will precipitate withdrawal; if a full agonist is on board, wait to administer until pt is in withdrawal. Rapid clearance by liver so administer sublingually.
-Full, short-acting opioid antagonist
-opioid use medication
-clinical use: Opioid overdose (displaces bound opioid agonist from the receptor, which precipitated withdrawal but improves alertness and breathing)
-Short-acting, may need to redose several times. Not orally absorbed (IV, IM, and intranasal formulations available).
-Full, long-acting opioid antagonist
--opioid use medication and for alcohol relapse prevention
-Relapse prevention after opioid detoxification. Alcohol use disorder: relapse prevention.
-Blocks euphoria and pain relieving effect. Does not suppress withdrawal or cravings for opioids. Patient must be fully detoxified for opioids prior to starting naltrexone (or it will precipitate withdrawal)
- Blocks endogenous opioids released by Alcohol thus blunts the rewarding effects of drinking. Cuts back craving and ‘reward’ of use
-Nausea, vomiting, decreased appetite, dizziness; injection site reaction (if using depot formulation)