Alcohol and drug abuse

Question 1

What are the treatment guidelines for alcoholic ketoacidosis?

Answer 1

Vigorous volume repletion with normal saline, along with administration of thiamine and glucose. Only in the rare presence of marked acidemia (pH <7.10) is the administration of bicarbonate thought to be necessary.

Question 2

What muscle relaxant has been shown to have some addictive potential?

Answer 2

Carisoprodol (Soma) is metabolized to meprobamate, which is a class III controlled substance. It has been shown to produce both physical and psychologic dependence.

Question 3

What is the treatment for cocaine-associated chest pain?

Answer 3

Nitroglycerine and benzodiazepines. Do not give beta-blockers. Calcium channel blockers such as nifedipine have not been studied.

Question 4

What medications can cause false positive results for an opioid drug screen?

Answer 4

Dextromethorphan, diphenhydramine, ibuprofen, and even fluoroquinolones are among the many agents that can cause a false-positive urine drug screen for opioids.