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Guest muzafar

ISQs Addiction

15 posts in this topic

1. Disulfiram reduces the number of drinking days

2. Acamprosate reduces inhibitory action of GABA

3. The MATCH trial found that, CBT was not superiour to other psychological therapies in treating opiate dependence

4. Naltrexone can only be used following abstinence from all opioids.

5. The advantage of Lofexidine is that, it suppresses craving and muscle aches.

6. Disulfiram prevents breakdown of alcohol by Acetaldehyde.

7. Prominent maxillary area is a feature of foetal alcohol syndrom

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QUES 4) Naltrexone can only be used after abstinence from all opiods.

ANS: TRUE. If it is administered along with opioids it will precipitate an  opiod withdwawal syndrome.

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QUES :---Acamprosate reduces inhibitory action of GABA.

ANS :---FALSE

Acamprosate is GABA agonist and Glutamate(NMDA receptor) antagonist.It reduces the supersensitivity induced by alcohol.

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4- I think it is false , naltrexone can be used for opiate rapid detoxification ( detox 5 ) . The idea is the naltexone displace ( abort) the heroin from opiates receptors , therefore the patient suffers from severe withdrawal symptoms usually treated with lofixadine+ high doses of benzodiazepines

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4. Naltrexone can only be used following abstinence from all opioids.

it is true.

[ Naltrexone completely blocks the effects of opiates and acts as an 'insurance policy' against opiate use. It can precipitate acute withdrawal and should only be used following abstinence from all opioids]

From:

What works in drug addiction- Jason Luty- Advances in Psychiatry Treatment 280-288/ 2003

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You are right when you prescrib it as a relapse prevention ( maintenance) , but as i mentioned above naltrexone can be used for rapid opiates detox, well known in detox units .

exam notes , Buckley page 143

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4. Naltrexone can only be used following abstinence from all opioids.

I agree with Paul12.

It is usually used as in maintenance phase,however can be used for rapid detoxification(detox5).

So would go for false.

Confirmed by one of our associate specialist in addiction.

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7 false -

micrognathia

6 false

inhibits aldehyde dehydrogenase

no 1- true

ref

1: Addiction. 1997 Apr;92(4):381-95. Related Articles, Links

 

The efficacy of disulfiram: a review of outcome studies.

Hughes JC, Cook CC.

no 3 false

the match trial is alcohol related not opiates

see pubmed

no 5 false

easy peezy google searches

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MATCH TRIAL matching alcohol treatments to client hetrogeneity

it was a mulitcentre trial in usa in 2 groups of pateints.project MATCH. , 1997

THIS trial was hugely expensive and the largest trial of any form of psychotehrapy in history.

it compared three treatments ...MET/TSF /CBT...4SESSIONS/12/12 SESSIONS EACH

TREATMENT TOOK PLACE OVER 12 WEEKS, f/u at 1 yr and at 3yrs.

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1. Disulfiram reduces the number of drinking days TRUE

2. Acamprosate reduces inhibitory action of GABA FALSE

3. The MATCH trial found that, CBT was not superiour to other psychological therapies in treating opiate dependence TRUE

4. Naltrexone can only be used following abstinence from all opioids. FALSE

5. The advantage of Lofexidine is that, it suppresses craving and muscle aches. FALSE

6. Disulfiram prevents breakdown of alcohol by Acetaldehyde. FALSE

7. Prominent maxillary area is a feature of foetal alcohol synd FALSE

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Naltrexone is used afer abstinence from all opiods - I think it is true. That's what is done in prctice at least, for relapse prevention. Of course Naltrexone has been used to precipitate withdrawals and then start a detox, so it might be false as well

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I think the answer to the naltrexone question is False. Although currently in the UK it is almost exclusively used after detox for relapse prevention, it can also be used to precipitate withdrawals from opiates. These are Rapid- and Ultra-rapid methods of detox. Ultra-Rapid detox is done under GA using naltrexone and is currently under review by the GMC due to a high profile fatality.

A useful article is from the APT (dunno exactly when, but within the last year) title 'what works in drug addiction'.

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Disulfiram reduces the number of drinking days

true

the side effects are extremely unpleasant

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Disulfiram prevents breakdown of alcohol by Acetaldehyde. false

disulfiram blocks the aldehyde dehydrogenase that normally metabolizes acetaldehyde.

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