Addictions

Question 1

Biological markers of alcohol use disorder

Answer 1

CDT/GGT/ elevated MCV
AST/ALT >2:1
Elevated TG,LDL

Question 2

Wernicke’s triad (or acronym)

Answer 2

Classic triad only present in 30% of cases

WACO- wernicke’s ataxia (wide based gait)confusion/ophthalmoplegia (aka 6th nerve palsy-horizontal nystagmus most common, but vertical possible, as well as lateral rectus palsy)

Question 3

Treatment Wernicke’s as per nul

Answer 3

Thiamine 100mg IM/IV daily x3 days then PO

Question 4

Korsakoffs symptoms

Answer 4

Anterograde amnesia, poor recall, confabulation, disorientation, poor insight

Question 5

Think about increasing dose of what Med in third trimester?

Answer 5

Methadone

Question 6

Cannabis intox (other non specific symptoms)

Answer 6

Uncoordinated, euphoria, HTN, constipation, dilated pupils

Question 7

Tx of cocaine intox as per nul

Answer 7

Diazepam
Phentolamine (alpha blocker)
Nitro

AVOID B BLOCKERS

Question 8

Liver enzyme for caffeine

Other interactions?

Answer 8

1A2- So be careful with clozapine!

Decreases lithium levels by increased excretion from the kidneys

Question 9

If you wanted to use meds for stimulant addiction

Answer 9

Light-moderate: Disulfiram/modafinil/bupropion

Severe d amphetamines
————-
Severe cocaine: Amantadine/propranolol/modsfinil

Question 10

Naltrexone in alcohol does what

Answer 10

Targets cravings and limits euphoria

Question 11

Acamprosate des what in alcohol

Answer 11

May modulate acute and protracted withdrawal states plus or minus cravings

Can caused diarrhea, Renally cleated

Question 12

Methanol affects what part of the brain

CO?

Answer 12

Putamen

—-
Globus pallid is

Question 13

Second line treatments for smoking cessation

Answer 13

Nortriptyline and clonidine