Alcohol Dependence

Question 1

Acamprosate (Campral)

Answer 1

A) Neuromediator

B)
1. Maintenance of abstinence in alcohol depence

C)
> 60kg: 2 tabs (666 mg) TDS
< 60kg: 2 tabs MANE and 1 tab (333 mg) MIDI and NOCTE

D)
1. MOOD or BEHAVIOUR changes (association betweem alcohol dependence, depression and suicidality)
2. RENAL** (impairment increases concentration)
NO liver

E)
Labels: 2, A (swallow whole - enteric coated), B (with FOOD)
#Start taking this approximately 1 week AFTER you have stopped drinking alcohol
#Generally recommended that you take this continuously for 1 year. Do not stop taking it even if you have a short relapse, or think you don’t need it anymore
S/E
Rash, Diarrhoea, Changes in LIBIDO and Abdo pain

Question 2

Disulfiram (Antabuse)

Answer 2

A) Deterrent in Chronic Alcoholism
(irreversibly inhibits aldehyde dehydrogenase)

B)
1. Maintenance of Abstinence in Alcohol Dependence

C)
100-300 mg ONCE daily

D)

1. Intensity of Disulfiram reaction (i.e. difficulty breathing, coughing spasms and chest pains)
2. HEPATIC** (jaundice and hepatitis)
3. RENAL

E)
Labels: 2, 5
#This medicine is intended to help you avoid drinking alcohol. If you consume or come into contact with, even small amounts of alcohol while taking this medicine (even for up to 3 weeks after stopping it), you are likely to experience unpleasant effects
#Do not consume any alcohol containing products (i.e. cough syrups) or use alcohol in cooking or rub alcohol-containing products
#Best taken in the MORNING on WAKING. However, if they make you drowsy, you can take them at bedtime
#Do not start taking this medicine if you have consumed alcohol within the previous 24 hours
**DR - Yellowing of the white of your eyes, dark urine or pale bowel motions

Question 3

Naltrexone (Revia)

Answer 3

A) Opioid antagonist

B)

1. Treatment of ALCOHOL Dependence (adjunct)
2. Maintenance of Abstinence from OPIOIDS after opioid detoxification (adjunct)

C)
25-50 mg ONCE daily

D)

1. PAIN score** (reduce opioid analgesia)
2. LIVER function *** (especially total BILIRUBIN) - can exacerbate hepatitis or liver failure

E)
Labels: 12
#Tell your dentist, pharmacist, a new doctor or hospital doctor that you are taking naltrexone
#After Opioid Withdrawal - you may be more sensitive to the effects of opioids and will be at risk of fatal overdose if you stop taking naltrexone and use opioids again
#Do not try and overcome the blockade effect of naltrexone by taking higher doses of opiods
#Naltrexone continued to blocks the effects of opioids for some time after you stop taking it. People have overdosed on opioids when they used them shortly after stopping naltrexone.
**DR - yellowing of whites of your eyes, dark urine or pale bowel motions
S/E
(transient)
nausea, headache, dizziness, anxiety, fatigue, insomnia and sleepiness