Alcohol Withdrawl

Question 0

Oxazepam

Answer 0

short acting

use instead of diazepam if liver damage

Question 1

Diazepam

Answer 1

Long acting drug, used to taper wd

dec. over time (days)

Question 2

Cholordiazepoxide

Answer 2

Long acting, - used to taper wd, dec. over several days

Question 3

Lorazepam

Answer 3

Anticonvulsant,

IV for status epilepticus, also prevents seizures, hallucinations, and DT in EtOH/barb wd

Question 4

Phenytoin

Answer 4

Tx seizures in EtOH wd

Question 5

Naltrexone

Answer 5

Blocks EtOH stimulating reward pathway- reduces the craving for EtOH (opiod receptor antagonist)
Decreases the relapse by 50%
oral or 1x/month injection
Side effects: Nausea (F>M), Liver damage (do not give to alcoholics with acute liver disease, hepatitis, liver failure), opiods will no longer work for pain (or be as effective)

Question 6

Nalmefene

Answer 6

opiod antagonist- works similarily to naltrexone except NO LIVER TOXICITY!!!!!

Question 7

Acamprosate

Answer 7

Structural analog of GABA
Restores the normal balance of GABA and glutamate transmission
(wd leads to hyperactivity, insomnia, and anxiety due to an dysregulation of receptors)
Inc. the rate of abstinence and dec. relapse
NO ABUSE POTENTIAL, and NO LIVER TOXICITY

Question 8

Fomeprizole

Answer 8

Alcohol Dehydrogenase inhibitor
Used for methanol and ethylene glycol poisoning
Other tx for poisoning: EtOH (compete with alcohol dehydrogenase and limit the aldehyde synthesis), lavage, support ABC, dialysis

Question 9

Ethanol

Answer 9

CNS depressent, diuretic effect. Absorbed from SI (faster on empty stomach). Crosses BBB and placenta easily. ADH in GI tract (higher in men). Emesis, stupor, coma, resp depression, death. OD tx: manage airway, give thiamine, phenytoin for seizures. Toxic with acetaminophen.

Question 10

Disulfuram

Answer 10

Unpleasant effect w/EtOH (flushing, HA, nausea, vomit, etc). Long duration. Blocks ADH, causes acetaldehyde to build up. Dangerous, not recommended. Interactions w/metronidazole, cephalosporins, oral hypoglycemics.

Question 11

Gabaperitin

Answer 11

anticonvulsant and tx neuropathic pain

reported better sleep and better overall feeling

Question 12

Ondansetron

Answer 12

antiemetic and prevents relapse in early onset alcoholics only!

Question 13

Topiramate

Answer 13

anticonvulsants and decreases alcohol cravings and inc abstinence in recovering alcoholics