STUDY GUIDE FALL 2024
First Line Treatments for alcohol use disorder (according to Study Guide &
Dynamed) - ANSWER-naltrexone and acamprosate
Second Line Treatments for alcohol use disorder (according to study guide but not
dynamed) - ANSWER-Disulfuram and Bupropion (not FDA approved for ETOH but
second line according to study guide)
Second Line Treatment for alcohol use disorder (according to Dynamed) - ANSWER-
Disulfuram
Other off label medications for alcohol use disorder according to Dynamed -
ANSWER-Topiramate, gabapentin, baclofen
Other off label medications for alcohol use disorder according to Stahl's - ANSWER-
Topiramate, ondansetron
MOA of Naltrexone - ANSWER-Opioid Receptor Antagonist
MOA of Acamprosate - ANSWER-- weak GABAa agonist
- weak NMDA antagonist
(does not prevent withdrawal symptoms)
, MOA of Disulfuram - ANSWER-inhibits enzyme (aldehyde dehydrogenase) in the
liver
Bupropions role in alcohol use disorder - ANSWER-Can diminish cravings for etoh,
treat underlying anxiety/depression
Safety Risk associated with bupropion and etoh - ANSWER-bupropion increases the
risk of seizures in those going through etoh withdrawal
s/s ETOH intoxication - ANSWER-impaired fine motor control, impaired judgement
and coordination, ataxic gait, poor balance, lethargy, difficulty sitting upright,
difficulty with memory and sitting upright, N/V, coma in levels 300mg/dL and over
with respiratory depression and death possible
S/S of etoh withdrawal - ANSWER-Mild: insomnia, irritability, hand tremor
Moderate: autonomic hyperactivity (diaphoresis, tachycardia, HTN), fever
Severe: seizures (12-48 hours post consumption), hallucinations, Delirium Tremens
Delirium Tremens - ANSWER-48-96 hours after last etoh consumption includes
anxiety, anorexia, nausea/vomiting, psychomotor agitation
Scale used to measure etoh withdrawal - ANSWER-CIWA
CIWA assesses: - ANSWER-n/v, tremor, paroxysmall sweats, anxiety, agitation, tactile
disturbances, auditory disturbances, visual disturbances, headaches, orientation
CIWA scoring - ANSWER-<10=mild
10-15=moderate