Pharmacology of Addiction

Question 1

What medications are used for alcohol withdrawl (abstinence) (4)?

Answer 1

• Acamprosate
• Disulfiram
• Naltrexone
• Nalmefene

Question 2

What is the mechanism of action of acamprosate?

Answer 2

• An NMDA antagonist that increases GABA
  
  • Possible neuro protective role in withdrawl / detox

Question 3

What is the dose of acamprosate?

Answer 3

• 333-666mg TDS (3 time a day)

Question 4

What is the mechanism of action of disulfiram (antabuse)?

Answer 4

• Inhibits acetaldehyde dehydrogensae, leading to feeling nauseous / flushes if mixed with alcohol

Question 5

What is the dose of disulfiram (antabuse)?

Answer 5

• 200 - 500mg daily

Question 6

What is the dose of naltrexone?

Answer 6

• 50mg daily

Question 7

What is the mechanism of action of nalmefene?

Answer 7

• Opioid inverse agonist

Question 8

What is the dose of nalmefene?

Answer 8

• 18mg PRN (single daily dose)

Question 9

What medication is used for alcohol withdrawl (detox regimes)?

Answer 9

• Chlordiazepoxide, used both for inpatient and community settings

Question 10

How is chlordiazepoxide administered?

Answer 10

• 20 - 40mg QDS (4 times a day), reducing over 7 -10 days + give supplements of Thiamine (B12) & Folate

Question 11

What medication is used for opioids withdrawl (abstinence)?

Answer 11

• Buprenorphine

Question 12

What is the dose of methadone?

Answer 12

• 60 - 120mg daily

Question 13

What is the dose of buprenorphine?

Answer 13

• 12 - 24mg daily

Question 14

What medication is used for opioid withdrawl (detox regimes)?

Answer 14

Methadone

Question 15

What medication is used for benzodiazepine / G drugs withdrawl (abstinence)?

Answer 15

• Maintenance on Diazepam with a reducing regime of 1mg per week

Question 16

What medication is used for benzodiazepine / G drugs withdrawl (detox regimes)?

Answer 16

• Balcofen (GABA agonist)
• Benzodiazepine (Diazepam)