abciximab
abciximab
Exact mechanism of action not understood; acts with glutamate and GABA neurotransmitter systems in the CNS to restore balance between neuronal excitation and inhibition that may be altered by chronic alcohol exposure.
Indications
Maintenance of abstinence from alcohol in patients with alcohol dependence who are abstinent at treatment initiation as part of a comprehensive management program that includes psychosocial support Contraindications and cautions
Contraindicated with allergy to any component of the drug or severe renal impairment (creatinine clearance 30 mL/min or less). Use cautiously with pregnancy, lactation, moderate renal impairment, history of depression and suicidal thoughts. Available forms DR tablets—333 mg Dosages Adults 666 mg (two 333-mg tablets) PO tid; may be taken with meals to aid compliance. Dosage should begin as soon as possible after period of alcohol withdrawal when the patient has achieved abstinence, and should be maintained if patient relapses. Should be part of a comprehensive psychosocial treatment program. Pediatric patients Safety and efficacy not established. Patients with renal impairment Moderate impairment (creatinine clearance 30–50 mL/min): 333 mg PO tid; severe renal impairment (creatinine clearance30mL/min or less): do not use acamprosate. Pharmacokinetics
Metabolism: Not metabolized; T1/2: 20–30 hr Distribution: May cross placenta; may pass into breast milk Excretion: Urine, unchanged Adverse effects
CNS: Anxiety, depression, dizziness, impaired judgment, insomnia, paresthesia, asthenia, insomnia, suicidal thoughts GI: Anorexia, diarrhea, dry mouth, flatulence, nausea Respiratory: Bronchitis, cough, dyspnea, pharyngitis, rhinitis Skin: Increased sweating, pruritus Other: Back pain, flulike symptoms, impotence, muscle aches and pains, weight gain Nursing considerations
Assessment
History: Allergy to any component of the drug, renal impairment, pregnancy, lactation, history of depression and suicidal thoughts, alcohol intake Physical: Skin, lesions; orientation, reflexes, affect; abdominal examination Interventions
Ensure that patient is abstaining from alcohol intake when treatment is initiated. Ensure that patient is participating in a comprehensive program, including psychological and social support, to manage abstinence from alcohol. Give drug three times a day with meals— timing may be helpful in aiding compliance to the regimen when the patient is managing the drug regimen at home. However, drug may be given without regard to meals. Instruct patient to continue to take the drug even if a relapse to alcohol consumption occurs; encourage patient to notify health care provider if a relapse occurs. Encourage use of barrier contraceptives during treatment with this drug; fetal abnormalities are possible. Teaching points
This drug is given as part of a comprehensive program to support your abstinence from alcohol; it is important that you continue that program while taking this drug. Take this drug three times a day; taking the drug with meals may be a helpful reminder. If you forget a dose, take it as soon as you remember and return to your usual regimen. Do not make up doses and do not take more than three doses in 24 hours. Continue to take the drug even if you relapse and drink alcohol. Notify your health care provider to discuss the renewed drinking. You may experience impaired judgment, impaired thinking, or impaired motor skills. You should not drive or operate hazardous machinery or sign important documents or make important decisions until you are certain that Campral has not affected your ability to engage in these activities safely. Adverse effects
in italics are most common; those in bold are life-threatening. U Do not crush. You should not take this drug during pregnancy; if you suspect that you are pregnant, or wish to become pregnant, consult your health care provider. You should find another method of feeding the infant if you are breast-feeding; it is not known if this drug crosses into breast milk. You may experience these side effects: Flatulence, diarrhea, abdominal discomfort; depression; thoughts of suicide (if this occurs, consult with your health care provider); muscle or joint aches and pains (consult your health care provider, an analgesic may be helpful). Report depression or thoughts of suicide, numbness or tingling, fever, severe diarrhea.
