12 - Alcohol-Related Disorders Flashcards Preview

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Flashcards in 12 - Alcohol-Related Disorders Deck (21):
1

Alcoholism can lead to ____ deficiency

thiamine

*which puts patients at risk of Wernicke-Korsakoff Syndrome

2

What dose of thiamine is recommended for all alcoholics?

200mg/day

3

For alcohol withdrawal:
Most patients respond well to ____

BZD

4

For alcohol withdrawal:
How to BZD work?

to reduce hyperactivity of GABA receptors that occurs during alcohol withdrawal

5

For alcohol withdrawal:
If you give BZD, what do you need to counsel on?

The risk of respiratory depression if alcohol relapse occurs during (or shortly after) BZD treatment due to it's synergistic CNS depressant effect

6

For alcohol withdrawal:
What is another option?

phenobarbital

7

For alcohol use disorder:
List the 4 drugs that can be used

-Naltrexone
-Acamprosate
-Disulfiram
-Anticonvulsants

8

For alcohol use disorder:
What is naltrexone? How does it work for alcohol use disorder?

-it is an opioid antagonist
-thought to decrease euphoria and make alcohol drinking less pleasurable
-also reduces cravings for alcohol

9

For alcohol use disorder:
Naltrexone is CI for those on ____ therapy

opioid

10

For alcohol use disorder:
How long do patients have to be opioid-free for before having naltrexone?

greater than or equal to 7 days

11

For alcohol use disorder:
Caution naltrexone in those with _____ dysfunction

hepatic

12

For alcohol use disorder:
What is acamprosate? How does it work for alcohol use disorder?

-it is a glutamate and GABA modulator
-relieve alcohol withdrawal symptoms and reduce euphoric effects of alcohol

13

For alcohol use disorder:
What is the drug of choice in hepatic insufficiency?

acamprosate as it is metabolized renally

14

For alcohol use disorder:
What is disulfiram ?

irreversible inhibitor of aldehyde dehydrogenase, an enzyme involved in metabolism of alcohol

15

For alcohol use disorder:
Why is disulfiram use controversial?

Because disulfiram + alcohol can result in death

This is used as a scare tactic to stop patients from drinking

16

For alcohol use disorder:
Which anticonvulsants have been studied? Why are they thought to work?

-topiramate or gabapentin
-thought to work as they modulate glutamate receptors

17

What do we use for pregnancy?

None of these agents have been studied but alcohol is not good for baby either. Prescriber must weigh risks vs benefits of each agent.

18

What do we use for breastfeeding?

limited data for naltrexone and acamprosate

*again, prescriber must weigh risks of benefits

19

What should we choose in elderly?

-avoid diazepam bc it is renally excreted and may accumulate in this population

-choose lorazepam

20

What do we choose if the goal is reduction of alcohol consumption?

naltrexone

21

What do we choose if the goal is abstinence of alcohol consumption?

acamprosate

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