Be on schedule.Score better.

EN

The reason I did not select disulfiram

Decision Number One

Naltraxone (Vivitrol) injection, 380 mg intramuscularly in gluteal region every four weeks.

Rationale: Pharmacotherapy should be used in patients with alcohol use disorder who have current, heavy use and ongoing risk for consequences from use, motivated to reduce alcohol intake and do not have medical contraindications to the individual drug choice (SAMHSA, 2016). As the 53 year-old female has acknowledged that she has a drinking problem and has tried psychosocial approach with alcoholic anonymous(AA) without success, adding medication such as naltrexone would be warranted as next step. In random clinical trials (RCTs) naltrexone medication has been shown to reduce heavy drinking and enhance the likelihood of abstinence ( Garbutt et al.,  2014)

Naltraxone is mu opioid receptor antagonist, can be in form of oral ( Revia) and injection( Vivitrol) ( Stahl, 2017). Naltraxone is FDA approved to treat alcohol dependence, blockade of effects of exogenously administered opioids (oral) and prevention of relapse to opioid dependence (Stahl, 2017).  Naltrexone reduces alcohol consumption through modulation of opioid systems, thereby reducing the reinforcing effects of alcohol and opioids (cravings, rewarding effects). Moreover, naltrexone also modifies the hypothalamic-pituitary-adrenal axis to suppress ethanol consumption.

The recommended naltrexone injectable (vivitrol) suspension is 380mg and should be administered via intramuscular (IM)injection to the gluteal area using the provided 1.5 inch 20-gauge needle(Drugs.com, 2017).  Vivitrol is extensively metabolized in humans, and elimination half-life of naltrexone via injection is 5–10 days (Drugs. com, 2017) Common side effects of naltrexone are nausea, headache, and dizziness, joint or muscle pain which subside with continued use. Special considerations include that vivitrol should not be given to patients taking opioids, and if opioids are required to treat pain, naltrexone should be discontinued. Naltrexone is contraindicated in acute hepatitis or liver failure.

The advantage usage is that naltrexone can be initiated while the individual is still drinking (Canidate et al., 2017) This allows treatment for alcohol use disorder to be provided in community-based practice at the point of maximum crisis without the need for enforced abstinence or detoxification, thus beneficial for the client. Additionally, depot preparations of naltrexone may improve adherence by reducing the frequency of medication administration from daily to monthly and by achieving a steady therapeutic level of medication, thus avoiding peak effects that can exacerbate adverse events.

The reason I did not select disulfiram (Antabuse) which by intent leads to adverse effects ( nausea, vomiting, metallic taste, tachycardia) when combined with alcohol intake, was that it  should only be used by abstinent patients in the context of treatment intended to maintain abstinence. In regards of Acamprosate, I did not select the medication because research indicates that Acamprosate should be used once abstinence is achieved (Yahn, Witterson, & Olive, 2013).

Table of Contents

[display_short_calculator]

Latest Reviews

Impressed with the sample above? Wait there is more

Related Questions

MNC Management and Operation in China

Description Main research tasks: Study the basic principles of management and operation of multinational companies, and explore the competitive advantages of Chinese multinational corporations and

Read chapter 11 https:bookshelf.vitalsource.combooks9781284158823cfi644424220:0 1. Communication may be spoken writtenformal or informal.The text describes five communication practices e.g.facetofacevoice mailetc. What

Read chapter 11 https://bookshelf.vitalsource.com/#/books/9781284158823/cfi/6/44!/4/2/4/2/2@0:01. Communication may be spoken, written,formal or informal.The text describes five communication practices (e.g.face-to-face,voice mail,etc). What are the pros and cons of

New questions

women and gender studies

Topic: women and gender studies Order code: 628115 Time remaining: 9 days 18 hours 53 minutes Pages:     5, Double spaced Sources:     4 Order

world economy

Topic: Choose a current �situation� in the world economy and evaluate the competitive environment. Order code: 6829850 Time remaining: 0 days 2 hours 58 minutes

TERM PAPER EDITING

A term paper is a long paper written within the course of a semester. One is often required to come up with a topic to

Culture attitude to banking in Malaysia

Topic: Culture attitude to banking in Malaysia Order code: 629732 Time remaining: 28 days 22 hours 48 minutes Pages: 54, Double spaced Sources: 80 Order

Don't Let Questions or Concerns Hold You Back - Make a Free Inquiry Now!