Third Year Flashcards

1
Q

What drug class is chlordiazepoxide?

A

Benzodiazepine

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2
Q

When would we use chlordiazepoxide?

A

Acute moderate and severe alcohol dependency withdrawal

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3
Q

What is the dose of chlordiazepoxide?

A

Moderate 10-30mg TD PO. Titrate down for 5-7 days.

Severe 10-50mg QDS PO and PRN for 2 days. Titrate down for 7-10 days.

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4
Q

What is the maximum daily dose of chlordiazepoxide?

A

250mg

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5
Q

What are important contraindications for chlordiazepoxide?

A

Respiratory depression/insufficiency
Psychosis
Myasthenia gravis

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6
Q

What are the side effects of chlordiazepoxide?

A
Movement disorder
Drowsy
Confusion
Dizziness
Hypotension
Nausea
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7
Q

What advice should you give patients on benzodiazepines?

A

Don’t drive or use heavy machinery as drowsiness can persist the next day

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8
Q

What do we use in acute alcohol withdrawal?

A

Chlordiazepoxide or diazepam
Carbamazepine as an alternative
Clomethiazole if in patient as a third alternative

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9
Q

What is the drug treatment for delirium tremens?

A

Oral lorazepam

Parenteral lorazepam or haloperidol as second line

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10
Q

What is carbamazepine?

A

Anti convulsant/anti epileptic

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11
Q

What is carbamazepine used for?

A
Epilepsy
Alcohol withdrawal
Mania
Neuropathic pain
Diabetic neuropathy
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12
Q

What is the dose for carbamazepine in alcohol withdrawal?

A

800mg divided over the day

Titrate to 200mg over 5 days

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13
Q

When should you be cautious with carbamazepine?

A

Blood, hepatic or skin disorders

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14
Q

What are the side effects of carbamazepine?

A

Drowsiness
Dizziness
N/V
Diplopia

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15
Q

Which drugs do we use for helping with alcohol cessation?

A

Acamprosate - prevents relapse by reducing insomnia, anxiety and craving
Disulfiram - causes bad things when drink alcohol
Naltrexone - opioid receptor antag, stops alc effects
Nalmefene - opioid receptor antag, stops craving

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16
Q

What dose of thiamine do we give before WE and in WE?

A

25-100mcg OD

200-300mcg daily

17
Q

What is pabrinex?

A

Mix of vit B and vit C: thiamine, riboflavin, pyridoxine, nicotinamide and ascorbic acid

18
Q

How do we give pabrinex?

A

IV

19
Q

What are the SEs of pabrinex?

A

Tight chest and wheeze indicates sensitivity reaction.

Anaphylactic shock

20
Q

Which drug do we need to be aware of if someone is about to be prescribed pabrinex?

A

Levodopa

21
Q

What are the contraindications to acamprosate?

A

Pregnancy
Severe liver failure
Cr above 120

22
Q

What are the side effects of acamprosate?

A

D/V

reduced libido

23
Q

What is the dose of acamprosate?

A

666mg TD PO if over 60kg and under 65y/o

666mg OD PO and 333mgx2 BD PO if under 60kg or over 65

Continue for 1 year

24
Q

How does disulfiram work?

A
Causes acetaldehyde build up causing asian flush:
flushing
throbbing
headache
palpitations
25
Q

Why can’t you drink on metronidizole?

A

It give you asian flush bc acetaldehyde build up