Alcohol Cessation Flashcards
Definition of heavy drinking?
> 5 drinks on the same occasion on > 5 days/month
Tolerance and withdrawal are associated with alcohol ___
dependence or abuse?
dependence
Alcohol ___ is associated with impaired performance.
dependence or abuse?
abuse
3 techniques for coping with cravings and urges for alcohol?
- delay technique
- distract technique
- urge surfing technique
Counseling should be done every __ weeks.
2
Initial treatment is __ months and can be indefinite
6
3 FDA approved drugs for alcohol cessation?
- disulfiram
- acamprosate
- naltrexone
Metabolites of disulfiram inhibit what enzyme?
aldehyde dehydrogenase
Avoid what cessation drug in persons with severe hepatic impairment?
disulfiram
Disulfiram enzyme inhibitions ___
reversible or irreversible?
irreversible
Which cessation drug decreases cravings?
acamprosate
which cessation drug is approved for alcohol dependence after detoxification and a focus on abstinence maintenance?
acamprosate
Which cessation drug has no hepatic metabolism?
acamprosate
renal elimination
Should acamprosate dose be decreased with renal impairment?
yes
linear PK
Avoid acamprosate use with clearance of ___ L/hr
1.1
What is main MOA of acamprosate?
antagonism of NMDA receptors
2nd is antagonism of opiate and noradrenergic receptors
How many assessments for acamprosate?
10
every 4 weeks for first 12 weeks, then every 12 weeks
Duration of acamprosate treatment?
96 weeks
Which cessation med decreases cravings, and has an oral form and long acting injection form?
naltrexone
There are no naltrexone dose adjustments with mild to moderate hepatic impairment.
a. true
b. false
a. true
What two drugs reduce the craving for alcohol?
- acamprosate
- naltrexone
