Alcohol dependence Flashcards
How much alcohol is safe?
No amount of alcohol is safe
no more than 2 standard drinks on any day = reduce lifetime harms from alcohol
no more than four standard drinks on a single occasion = reduce risk of injury
What are some short term effects of alcohol consumption?
relaxation, wellbeing, drowsiness, n/v, dehydration, dec cognitive performance, risk taking behaviour
What does it mean to be dependent or to have a tolerance to alcohol?
Dependent = Person must use it regularly, mild degree of dependence on alcohol is common
Tolerance = body becomes increasingly resistant to the substance
Discuss the effect of alcohol on pregnancy
Developing fetus does not have ability to process alcohol –> has BAC lvls same or high for longer –> impact brain and other major organs –> alcohol spectrum disorder
Discuss the effect of alcohol in breast feeding
alcohol enters breast milk, avoid in first month of breastfeeding
nor more than2 standard drinks a day, avoid immediately before breastfeeding or pump before alcohol
Discuss the effect of alcohol an increased age
lowered alcohol tolerance, reduce ability to metabolise
Generally, what are some alcohol-drug interactions?
Inhibit metabolism
Activate drug-metabolising enzymes
enzymes are activated
magnifying inhibitory effects of sedative & narcotic drugs
What is the role of the pharmacist in aiding alcohol abuse?
Provide support where necessary with their decision about alcohol
Educate on normal/safe alcohol consumption levels
Provide education about how alcohol affects health
Try and increase patient motivation to want to change
When is alcohol withdrawal symptoms likely to occur? What are they?
Occur 6-24 hours after last drink
Some e.g.: tremor, anxiety, restlessness, fomication, n/v, restlessness, seizures, hallucination, tachycardia, insomnia
What are the first line therapies of alcohol withdrawal?
Benzodiazepines = dose depends on severity of withdrawal
Thiamine (Vit B1) = alcohol related thiamine def ( can result in vernicke’s encephalopathy
How is acamprosate used to treat alcohol abuse?
mechanism unknown, structural analogue to GABA –> reduces cravings, not alter CNS effects of drinking or withdrawal
Start 7 days after last drink, preferred treatment when on opioids for pain
What are some ADRs and C/I of acamprosate?
ADRs = rash, diarrhoea, libido change, n/v, itch
C/I= sig renal impairment
Discuss the use of nalteroxone in alcohol abuse
Opioid antagonist = reversible block of opioid receptor for 14-72 hrs
Reduce craving and pleasure of alcohol
Can be used while still drinking, helps cut down drinking
What are some C/I and ADRs of naltrexone use in alcohol abuse?
ADRs = n, headache, dizziness, anxiety, fatigue, insomnia (transient and subside after 1-2 wks)
C/I = using opioid analgesics, acute hepatitis, liver failure
Discuss the use of disulfiram in alcohol abuse
Prevents metabolism of alcohol –> produces unpleasant effects if alcohol consumed (during and 7 days after treatment)
BAC should be 0 before starting, not recommended for routine use
