.gif)
HOW to withdraw from alcoholism (ULEVI WA POMBE) through medication
TODAY in gammaTHERAPY. we will see alcoholism, effect of it and how to stop it b through medication. Dear, honestly if is not u it might be your close relative who is victim of alcoholism. As usual gammaLOVE we never leave u alone, then we love humanity. TOday we have bring a package so as to make your life better.
.
ALCOHOLISM is alcohol use disorder (AUD). is a broad term for any drinking of alcohol that result in mental or physical health.
Alcoholic Beverages
ALCOHOL DEPENDENT Is a previous psychiatric diagnosis in which and individual is physically dependent upon alcohol.
Alcohol may be Malted Liquors: Fermentation
of germinating cereals (malts) – mostly Barley – Beers (3-6%) Wines: fermentation of Natural Sugars – grapes, apples and other fruits pNo distillation, Fortified (port) – up to 22% pChampagne – 12-16% (effervescent wine) o Spirits – Rum, Whisky, Brandy and Gin. Whiskey - distilled grain pRum - distilled molasses pGin – any sugar source; pBrandy – Distilled wine (Grapes);pVodka – fermentation of any of grain, rye, wheat, potatoes, grapes, sugar beet or molasses
Pharmacological actions of alcohol -
Local
1. Rubefacient and counterirritant to skin
2. Irritant – soft skin and mucus membrane (A rubefacient is a substance for topical application that produces redness of the skin e.g. by causing dilation of the capillaries and an increase in blood circulation).
3. Pain, inflammation and necrosis – injection 4. Astringent: Antiseptic (20 – 90%)
n 100% is dehydrating 5. No action on spores
Effects of alcohol consumption -Acute
CENTRAL NEVER SYSTEM CNS
depressant – dose dependent manner
Plasma concentration
Expected effects
30 – 100 mg/dl
Anxiolytic, euphoria and excitation Hesitation, restraint, caution are lost
Impaired coordination – mood and feelings are altered
100 -150 mg/dl;Mental clouding, ataxia, disorganization of thought and impairment of memory and drowsiness
150 – 200 mg/dl;Sloppy, ataxia and drunkenness
- Slurring of speech, loss of judgment and inhibition
200 – 300 mg/dl ;Stupor and unconsciousness
CARDIOVASCULAR SYSTEM (CVS)
pSmall doses – cutaneous vasodilatation, flushing pMedium dose – tachycardia and mild rise in BP
pLarge dose - Vasodilatation due to direct vascular smooth muscle dilatation and vasomotor centre depression (clinical implication)
RESPIRATORY SYSTEM
pStimulation of Respiration – by irritation of pharyngeal and buccal mucosa
pCentral action – depression Blood:
pModerate drinking increases HDL-cholesterol level pDecrease in LDL oxidation
GASTROINTESTINAL TRACT (GIT)
pDilute alcohol at low doses - stimulate GI secretion – flavour, aroma or direct action on gastrin secretion
pHigher doses inhibit GI secretion
pAcute consumption – pylorospasm, gastritis, vomiting, reflux etc
pMallory-Weiss lesion
UROGENITAL SYSTEM
oKidney: Diuresis – increased water ingestion and inhibition of ADH
oUterus: Relaxation of uterine muscles oEndocrine:
pLow dose – Adrenaline release and hyperglycemia pHigh dose – Hypoglycemia
oSex - Aphrodisiac
Acute Effects
1.Nausea, Vomiting, hangover and traffic accidents CNS Depressant
2.Depression of inhibitory control Vasodilatation, warm, flushed, reddish skin Emotional outbursts
3.Decreased memory & concentration Poor judgment
4.Decreased reflexes Decreased sexual response
ADVERSE EFFECT
Gastritis and damage to the mucosa – anaemia Intestinal damage: Lack of absorption - Deficiency of water soluble vitamins and amino acids (protein deficiency)Less or no food intake (enough calorie) - Vitamin and Protein deficiency Neurological: Polyneuritis, pellagra, tremors, seizures, loss of brain mass, Korsakoff`s psychosis and Warnicke`s encephalopathy. CVS: Hypertension, cardiomyopathy, CHF arrhythmias and stroke. Hormonal: Impotence, gynaecomastia and infertility.Acute pancreatitis
Reproduction
Alcohol is a teratogen, it causes birth defects. Fetal Alcohol Syndrome (FAS) or Fetal Alcohol Effects (FAE), or Alcohol-Related Birth Defects (ARBD) Symptoms include retardation, poor coordination, loss of muscle tone, low birth weight, slow growth, malformation of internal organs and peculiar facial characteristics
Fetal Alcohol Syndrome
Chronic Alcoholism - features
• Craving: A strong need, or compulsion, to drink
• Loss of control: The inability to limit one’s drinking on any given occasion
• Tolerance: The need to drink greater amounts of alcohol in order to “get high” – pharmacokinetic or cellular tolerance
• Physical dependence: Withdrawal symptoms, such as nausea, sweating, shakiness, sleep impairment, hallucinations, delirium tremens and anxiety, occur when alcohol use is stopped after a period of heavy drinking
HONESTLY gammaTHERAPY HERE IS WHERE WE WERE FOCUS TO SEE MEDICATION ON HOW TO WITHDRAW
altrexone (Vivitrol)
Naltrexone is one of the first line treatments, and you may start it while you are still drinking without the need for a detox program first.
How does it work? Naltrexone works to suppress alcohol cravings by blocking the mu-opioid receptor. Blocking the effects of naturally occurring opioids will help block the reinforcing effects of alcohol.
How is it taken? In two ways: a tablet daily, or a once monthly injection. Vivitrol(the brand name of the injection) and naltrexone pills have never been compared in head to head studies so we don’t know which one works better, or if they are the same. Naltrexone cannot be used by people taking opioid medications.
Does naltrexone work? Sort of. Studies show that naltrexone reduced the risk of heavy drinking to 83 percent of the risk in the placebo group (those taking no medications), and decreased drinking days by about 4 percent. It does cause some nausea and headache—though the longer you take it, the fewer symptoms you will have. It is a first line treatment (meaning it is tried before other medications), though as you will see below, it works the same compared to topiramate.
2. Disulfiram (Antabuse)
Disulfiram cannot be started while you are still drinking. In fact, it will make you quite sick if you take it with alcohol, which is sort of the point of it.
How does it work? Disulfiram inhibits aldehyde dehydrogenase so it prevents the metabolism of alcohol’s primary metabolite, acetaldehyde. Nausea, vomiting headache and flushing will occur if you drink alcohol while taking this medication.
How is it taken? Disulfiram is a pill taken at a dose of 500 mg per day for one to two weeks, then lowered to 125 mg a day.
Does it work? Not so well. A 2014 meta-analysis did not find that it was any better than placebo. It may work in a small subset of people who are given it under supervised conditions.
3. Acamprosate (Campral)
Acamprosate should also be used once you’ve stopped drinking.
How does it work? Acamprosate works to dampen desire for alcohol by modulation of glutamate receptors in the brain.
How is it taken? Acamprosate is a pill, and you’ll take two pills, three times a day.
Does it work? Acamprosate has had mixed results and does not appear to have a significant effect on heavy drinking. Some studies show it does work in others. In those cases, it reduces the rate of return to any drinking, and increases abstinence rates by 11 percent. It is generally well tolerated, though diarrhea is the most common side effect reported.
4. Topiramate (Topamax)
Topiramate is used for migraine prevention, seizure disorder, and to suppress appetite—and now for alcohol dependence. It can be used if you are still drinking.
How does it work? Topiramate works by altering the balance of chemicals in the brain, which reduces the “rewarding” effect of consuming alcohol.
How is it taken? You’ll increase your dose of topiramate gradually over several weeks, starting at 25 mg per day and increasing to a maximum of 75 mg a day.
Does it work? Yes, a review of several studies found that topiramate reduced the percentage of heavy drinking days compared to placebo when taken over 14 weeks. Three trials comparing naltrexoneto topiramate found no difference in outcome, so both appear to work the same.
Baclofen is a muscle relaxant that has been found in small studies to be effective in the treatment of alcohol dependence.
How does it work? Baclofen also reduces the “reward” you feel from consuming alcohol.
How is it taken? Baclofen is available as 10 mg tablets, and in studies the effective dose was 10 mg three times daily (30 mg).
Does it work? People taking baclofen for 12 weeks were more likely to be abstinent from alcohol (71% vs 29%). Taken at a day it may be effective for alcohol dependence. Baclofen is well tolerated and has been around forever, so it is a tempting option.
How long will you take any of these medications?
Most research suggests two to six months, with at least six months being the preference of most experts.
No comments
Post a Comment