Third Year Flashcards
What drug class is chlordiazepoxide?
Benzodiazepine
When would we use chlordiazepoxide?
Acute moderate and severe alcohol dependency withdrawal
What is the dose of chlordiazepoxide?
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.
What is the maximum daily dose of chlordiazepoxide?
250mg
What are important contraindications for chlordiazepoxide?
Respiratory depression/insufficiency
Psychosis
Myasthenia gravis
What are the side effects of chlordiazepoxide?
Movement disorder Drowsy Confusion Dizziness Hypotension Nausea
What advice should you give patients on benzodiazepines?
Don’t drive or use heavy machinery as drowsiness can persist the next day
What do we use in acute alcohol withdrawal?
Chlordiazepoxide or diazepam
Carbamazepine as an alternative
Clomethiazole if in patient as a third alternative
What is the drug treatment for delirium tremens?
Oral lorazepam
Parenteral lorazepam or haloperidol as second line
What is carbamazepine?
Anti convulsant/anti epileptic
What is carbamazepine used for?
Epilepsy Alcohol withdrawal Mania Neuropathic pain Diabetic neuropathy
What is the dose for carbamazepine in alcohol withdrawal?
800mg divided over the day
Titrate to 200mg over 5 days
When should you be cautious with carbamazepine?
Blood, hepatic or skin disorders
What are the side effects of carbamazepine?
Drowsiness
Dizziness
N/V
Diplopia
Which drugs do we use for helping with alcohol cessation?
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
What dose of thiamine do we give before WE and in WE?
25-100mcg OD
200-300mcg daily
What is pabrinex?
Mix of vit B and vit C: thiamine, riboflavin, pyridoxine, nicotinamide and ascorbic acid
How do we give pabrinex?
IV
What are the SEs of pabrinex?
Tight chest and wheeze indicates sensitivity reaction.
Anaphylactic shock
Which drug do we need to be aware of if someone is about to be prescribed pabrinex?
Levodopa
What are the contraindications to acamprosate?
Pregnancy
Severe liver failure
Cr above 120
What are the side effects of acamprosate?
D/V
reduced libido
What is the dose of acamprosate?
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
How does disulfiram work?
Causes acetaldehyde build up causing asian flush: flushing throbbing headache palpitations
Why can’t you drink on metronidizole?
It give you asian flush bc acetaldehyde build up
