With Well Elaborated Solutions
A 57-year-old man with a longstanding history of alcohol use presents with
confusion, disorientation, and gait imbalance. Other than disorientation, bilateral
paresis of conjugate gaze is noted. CT head is negative. Which vitamin deficiency
is most likely? - ANSWER -Thiamine (B1)
What medication used in AUD inhibits ALDH? - ANSWER -Disulfiram
Disulfiram action causes an excess of what enzyme?
This enzyme has a vasodilatory effect that causes: - ANSWER -Acetaldehyde
tachycardia and hypotension.
4 NTs associated with drinking are - ANSWER -Glutamate
GABA
Dopamine
Endogenous opioids
When alcohol is consumed there is a release of
___________ ________, then _______ ,which makes the drinker feel good.
AT THE SAME TIME
alcohol has an effect on ______ receptors; they are are increased (sedation effect)
OVERTIME
the brain responds to an excess and increase of alcohol by upregulating ________
receptors to compensate for the increase in GABA - ANSWER -endogenous
opioids
dopamine
GABA
glutamate
Alcohol withdrawal symptoms will occur when there is excess ________ activity
in relevance to GABA - ANSWER -glutamate
, Minor alcohol withdrawal occurs within _______ after their last drink - ANSWER
-36
Disulfiram has a _____ half life; reaction could occur 1-2 weeks after last dose -
ANSWER -long
Acamprosate is a _______ receptor modulator
Dosage: 2x333mg PO tab TID
Indication: - ANSWER -glutamate
Those individuals who are abstinent from alcohol at initiation of treatment
Naltrexone is an opioid receptor _______ - ANSWER -antagonist
_____ is the most suitable drug for patients with mild opioid use disorder. -
ANSWER -Naltrexone
Naltrexone is the most suitable drug for patients with _____ opioid use disorder. -
ANSWER -mild
Which AUD drug will cause opioid withdrawal symptoms in patients who are
physically dependent on opioids?
Person must not had taken long acting opioids how many days prior to starting?
Person must not had taken short acting opioids how many days prior to starting?
Confirm abstinence with what 2 things?: - ANSWER -Naltrexone
10-14 day
atleast7
Urine drug test & Naltrexone Challenge
_________-based treatment is not recommended for patients with moderate to
severe opioid use disorder. - ANSWER -Abstinence
Abstinence from Alcohol is a requirement prior to starting Naltrexone
T or F - ANSWER -False
, ER dose of Naltrexone is called what?
How often is it administered? - ANSWER -Vivitrol
q month
Larger doses of high dose opioids may be needed to override Naltrexone blockade
T or F - ANSWER -True
Gabapentin shows to help with post acute withdrawal symptoms like _______ and
_______
Shown improvement when added with _______in the first __ weeks - ANSWER -
anxiety, insomnia
naltrexone
6
Topiramate is traditionally used for what?
In clinical trials its use has been associated with an improvement in what 2 things?
- ANSWER -anticonvulsant and migraine prophylaxis
Binge drinking
Which MAT for AUD should the clinician be mindful of when the patient has
elevated LFTs? - ANSWER -Naltrexone
Individuals with mild liver impairment can still use Naltrexone T or F - ANSWER
-True
someone who can go several days w/o drinking MAT for AUD is indicated
T or F - ANSWER -false
Laura, if encountering an AUD pt, ask how long in the past few months have you
gone without drinking?
have you gone more than 3 days without drinking?
if so do you have withdrawal symptoms? - ANSWER -
Opioid withdrawal