PS268 Study Guide - Final Guide: Nicotine Gum, Nicotine Lozenge, Varenicline
Alcohol
-withdrawal characterized by tremors, tachycardia (rapid heartbeat), hypertension, sweating,
insomnia, hallucinations and seizures and usually require treatment in inpatient medical setting
-symptoms present within 6-24 hours and peak by 72 hours
-2 central tasks during detox is to prevent development of seizures and reduce autonomic
hyperactivity
-benzodiazepines are standard treatment because there is high degree of cross tolerance between
alcohol and benzodiazepines, but benzos have longer half lives and allow safe withdrawal
-benzodiazepines potentiate inhibitory actions of GABA, decrease risk of seizures, and reduce
stress
-hoever high doses of benzos required cloud sensorium, interfere w formation/consolidation of new
memories, anterograde amnesia negatively affects dr-patient relationship, benzos are liable to
abuse
3 meds approved by Health Canada for treatment of alcohol dependence are (1)
disulfiram/Antabuse, (2) naltrexone/Revia, and (3) acamprostate/Campral
-all these meds are used during the maintenance phase for weeks or months
-disulfiram has not been shown effective in delaying relapse as individuals simply do not take the
meds
-naltrexone was developed as opioid antagonist and blocks alcohol-dopamine reinforcement but
has not proved very successful
-acamprosate has structural resemblance to GABA, normalizes basal GABA concentrations
(proposed to be disrupted in alcohol dependent people), and blocks glutamate increases observed
Document Summary
Withdrawal characterized by tremors, tachycardia (rapid heartbeat), hypertension, sweating, insomnia, hallucinations and seizures and usually require treatment in inpatient medical setting. Symptoms present within 6-24 hours and peak by 72 hours. 2 central tasks during detox is to prevent development of seizures and reduce autonomic hyperactivity. Benzodiazepines are standard treatment because there is high degree of cross tolerance between alcohol and benzodiazepines, but benzos have longer half lives and allow safe withdrawal. Benzodiazepines potentiate inhibitory actions of gaba, decrease risk of seizures, and reduce stress. Hoever high doses of benzos required cloud sensorium, interfere w formation/consolidation of new memories, anterograde amnesia negatively affects dr-patient relationship, benzos are liable to abuse. 3 meds approved by health canada for treatment of alcohol dependence are (1) disulfiram/antabuse, (2) naltrexone/revia, and (3) acamprostate/campral. All these meds are used during the maintenance phase for weeks or months. Disulfiram has not been shown effective in delaying relapse as individuals simply do not take the meds.
