Pharm, Alcohol part II Flashcards
alcohol and cancer
chronic alcohol use increases risk for cancer of mouth, pharynx, larynx esophagus and liver
maybe breast
chronic alcohol consumption increases what enzyme
CYP450s
DDI with ethanol
may inhibit drug metabolis: phenothizines, TCA, sedative-hypnotics
additive CNS depression to CNS depressants
inhibit ALDH and cause disulfiram like reaction: metronidazole, cefotetan, trimethoprim
management acute alcohol intoxication
prevent severe respiratory depression and aspiration of vomitus
glucose to Tx metabolic alterations
thiamine to protect wernicke korsakoff
K if severe vomiting and renal function okay
moderate alcohol withdrawal syndrome
tremor, anxiety, insomina
major pharm objective in alcohol withdrawal syndrome
prevent seizures, delirium, arrhythmias and include electrolyte rebalancing and thiamine therapy
Drug therapy for detox alcohol
long acting sedativ hypnotic and tapering
like benzos: chlordiazepoxide, clorazepate, diazepam
pros and cons to benzos for drug therapy of withrawal
pro: less frequent dosing, built in tapering effect
con: active metabolites may accumulate
short acting benzos used in withdrawal
lorazepam and oxazepam
Primary Tx for alcohol dependence
psychosocial therapy
MOA naltrexone
mu opioid R antagonist
CI naltrexone
acute hepatitis or liver failure
do not use with disulfiram
if on opioids too, must be opioid free before initiating therapy because precipitates acute withdrawal syndrome
MOA acamprosate
weak NMDA R antagonist and GABA a R agonist
reduces shor tand long term relapse rates
use caution in what patients with acamprosate
kidney disease
adverse effect acamprosate
nausea comiting, diarrhea, rash
