ANTA ABUSE & ANTE CRAVING MEDICATION

1. ANTA ABUSE DRUG
MS.POOJASEN
NURSINGTUTOR

2. INTRODUCTION
Drug addiction is a condition characterized of
compulsiveness for drug and abuse of drug and long
lasting chemical change in the brain.
DEFINITION – Medication are used to control
withdrawal ,detoxification ,relief of symptoms,
reduce craving for drug and produce aversion.

3. CLASSIFICATION
Disulfiram
Anti craving agent
Antidepressant agent
Anti psychotic agent

4. DISULFIRAM
Disulfiram is used to ensure abstinence in the
treatment of alcohol dependence. Its main effect is
to produce a rapid and violently unpleasant reaction
in a person who ingests even a small amount of
alcohol while taking disulfiram.

5. MECHANISM OF ACTION
Disulfiram is an aldehyde dehydrogenase inhibitor that interferes
with the metabolism of alcohol and produce a marked increase in
blood acetaldehyde levels.The accumulation of acetaldehyde ( to 10
times more than what which occurs in the normal metabolism of
alcohol) produce a wide array of unpleasant reactions called the
DISULFIRAM-ETHNOL-REACTION reaction, characterized by nausea,
vomiting headache, hypotension, flushing, sweating, thirst ,
dyspnea, tachycardia, chest pain, blurred vision and severe anxiety .
The reaction occur almost immediately after the ingestion of even
one alcoholic drink and may last up to 30 min.

6. THERAPEUTIC INDICATION
The primary indication for disulfiram use is an
aversion conditioning treatment for alcohol
dependence.

7. CONTRA INDICATION
Pulmonary and cardiovascular diseases.
Disulfiram should be used with caution in patient
with nephritis, brain damage, hypothyroidism,
diabetes, hepatic disease, seizure.
First trimester of pregnancy.
Patient at high risk of alcohol ingestion.

8. DOSE
Disulfiram is supplied in tablets of 250 and 500 mg .
The usual dose initial dose is 500 mg/day orally for
the first 2 weeks ,followed by maintenance dosage of
250 mg/day.
The dose should not exceed 500 mg/day.

9. PHARMACOKINETICS
Rate of alcohol absorption from the stomach is
dependent on its concentration, presence of food
and other factors, but generally it quite slow.
Absorption from intestine is very fast.
Metabolized in liver.
Excretion of alcohol through kidney.

10. ANTI CRAVING MEDICATION
Anti craving drugs are opioid antagonists these
drugs reduce the intoxication effect of alcohol and
the urge to drink.

11. COMMONLY USED DRUGS
 Naltrexone
Acamprosate
Naloxone
Subutex
Baclofen

12. INDICATION
 Alcoholism
 Opioid addiction
Nicotine addiction
Cocaine addiction

13. CONTRA INDICATION
 Pregnancy
Breast Feeding
Infant
Renal impairment

14. SIDE EFFECT
 CNS – anxiety, depression, headache, insomnia ,
tremor
CV – Palpitation, hypertension
G I – anorexia, constipation, diarrhea, abdominal
pain, vomiting

15. NURSES RESPONSIBILITY
 An informed consent should be taken before starting treatment.
 Ensure that at least 12 hours have elapsed since last ingestion of alcohol
before administering the drugs.
 Strictly wants to patient to not take alcohol or related substance.
 Advice not to use alcohol base lotion and advice against inhalation of paints
containing alcohol.
 Any topical applications containing alcohol should also be avoided.
 Caution patient against taking CNS depressants or any Over the counter
medications during disulfiram therapy.
 Instruct patient to avoid driving or other activities requiring alertness until
response to drug is known.

16. NURSES RESPONSIBILITY
Use the medication regularly to get the most benefit from it.
Maintain quite safe environment because excessive noise may
agitate the patient.
Emphasize the importance of follow up visit to the physician to
monitor progress in long term therapy.
Patient should carry identification cards describing disulfiram
alcohol reaction and the name and telephone number of
physician to called.