A 42-Year-Old Man Comes to the Office for a Follow-Up

question 239

Multiple Choice

A 42-year-old man comes to the office for a follow-up.  He has a history of gastroesophageal reflux disease, hypertension, and alcohol use disorder.  Last year, the patient was hospitalized for acute gastritis.  During the hospitalization, he went into alcohol withdrawal that was treated with chlordiazepoxide.  The patient was abstinent for 2 weeks following discharge but then started drinking 2 or 3 beers several times a week.  Over the past several months, he has been drinking 6-10 beers daily.  The patient says, "I want to cut down, but the cravings are too strong."  He fears he will lose his job and family if he continues to drink.  He has had a history of alcohol abuse since age 14 and has smoked 1.5 packs of cigarettes daily for the past 12 years.  The patient does not use illicit drugs.  There is a family history of alcohol abuse in his mother and heroin abuse in his brother.  Vital signs and physical examination are within normal limits.  In addition to psychosocial interventions, which of the following is the most appropriate pharmacotherapy for this patient's alcohol use disorder?

• A)Buprenorphine
• B)Bupropion
• C)Chlordiazepoxide
• D)Disulfiram
• E)Naltrexone
• F)Valproate
• G)Varenicline

---

Definitions:

Developmental Norm

A benchmark in child development that outlines typical milestones or behaviors at various ages.

Achieves

Accomplishes or succeeds in bringing about a desired result or reaching a target.

Deformities

Abnormalities in the form or shape of a part of the body, often resulting from genetic factors, trauma, or disease.

Mental Retardation

An outdated and offensive term formerly used to describe individuals with significantly below-average cognitive ability and limitations in daily functioning; now more appropriately referred to as intellectual disability.