S65(1) - Alcohol Cessation

Question 1

About 50% of Americans > 12 years old have consumed alcohol.

Answer 1

true

Question 2

Heavy drinking reported about 6.2% - defined as > 5 drinks on the same occasion on > 5 days / month.

Answer 2

true

Question 3

DSM-V classifies Alcohol-Related Disorders where two categories exist: Alcohol Use Disorders (AUD) and Alcohol-Induced Disorders.

Answer 3

true

Question 4

AUD: two groups: Dependence and Abuse.
Alcohol Dependence: tolerance and withdrawal.
Alcohol Abuse: impaired performance (e.g. job).

Answer 4

true

Question 5

Alcohol non-pharm approaches - Mild:

Answer 5

Set goals for decresed drinking (include non-drinking days).
Record daily log (smartphone).
Arrive and leave events at predetermined times.
Eat before and while drinking.
Switch to a less alcoholic drink.
Sip drinks slowly.
Alternate non-alcoholic and alcoholic drinks.
Have a 20 min. time-out between drinks.

Question 6

Non-Pharm Summary – person must stay connected with their treatment.

Answer 6

Counselors.
Support Groups.
Day and residential treatment programs.
Medication.
Addictive medicine training for professionals.
Support services – skills training (if needed).

Question 7

Three main medications FDA approved.

Answer 7

true

Question 8

Initial treatment 6 months and can be indefinite.

Insurance covers these drugs.

Answer 8

true

Question 9

Disulfiram (DSF, Antabuse®): used since the 1950’s.

Aversive therapy method: dose 250-500 mg/day.

Answer 9

Metabolites inhibit aldehyde dehydrogenase (ALDH).

Alcohol is metabolized to acetylaldehyde and then to acetic acid by ALDH.

Question 10

Disulfiram (DSF, Antabuse®)

Answer 10

Use very cautiously in persons with mild-moderate hepatic impairment. Avoid in severe cases.

Question 11

Acamprosate (Campral®) is approved for alcohol dependence AFTER detoxification and a focus on abstinence maintenance. decreases Craving.

Answer 11

Acetyl-homotaurine (ACH) is the chemical agent that is measured.

Question 12

Acamprosate (Campral®)
Pharmacodynamics: MOA.
Antagonism of NMDA receptors main focus.

Answer 12

true

Question 13

Naltrexone (NTX, ReVia®) – FDA approved oral form 1994 and Long Acting Injection in 2006. decreases Craving.

Answer 13

true

Question 14

Should a person with severe Alcohol Use Disorder avoid bars or other drinking places?

Answer 14

Yes… see Tips

Question 15

What two drugs reduce the “craving” for alcohol?

Answer 15

Acamprosate and Naltrexone

Question 16

Should disulfiram be used a person with AUD with “severe” hepatic impairment?

Answer 16

Not likely, why not acamprosate?