12 - Alcohol-Related Disorders Flashcards
Alcoholism can lead to ____ deficiency
thiamine
*which puts patients at risk of Wernicke-Korsakoff Syndrome
What dose of thiamine is recommended for all alcoholics?
200mg/day
For alcohol withdrawal:
Most patients respond well to ____
BZD
For alcohol withdrawal:
How to BZD work?
to reduce hyperactivity of GABA receptors that occurs during alcohol withdrawal
For alcohol withdrawal:
If you give BZD, what do you need to counsel on?
The risk of respiratory depression if alcohol relapse occurs during (or shortly after) BZD treatment due to it’s synergistic CNS depressant effect
For alcohol withdrawal:
What is another option?
phenobarbital
For alcohol use disorder:
List the 4 drugs that can be used
- Naltrexone
- Acamprosate
- Disulfiram
- Anticonvulsants
For alcohol use disorder:
What is naltrexone? How does it work for alcohol use disorder?
- it is an opioid antagonist
- thought to decrease euphoria and make alcohol drinking less pleasurable
- also reduces cravings for alcohol
For alcohol use disorder:
Naltrexone is CI for those on ____ therapy
opioid
For alcohol use disorder:
How long do patients have to be opioid-free for before having naltrexone?
greater than or equal to 7 days
For alcohol use disorder:
Caution naltrexone in those with _____ dysfunction
hepatic
For alcohol use disorder:
What is acamprosate? How does it work for alcohol use disorder?
- it is a glutamate and GABA modulator
- relieve alcohol withdrawal symptoms and reduce euphoric effects of alcohol
For alcohol use disorder:
What is the drug of choice in hepatic insufficiency?
acamprosate as it is metabolized renally
For alcohol use disorder:
What is disulfiram ?
irreversible inhibitor of aldehyde dehydrogenase, an enzyme involved in metabolism of alcohol
For alcohol use disorder:
Why is disulfiram use controversial?
Because disulfiram + alcohol can result in death
This is used as a scare tactic to stop patients from drinking
