Can you answer this question?

By usmlevideoss

A 36 year-old male patient comes to your office seeking treatment for his opioid abuse and alcohol abuse. He is particularly interested in using naltrexone maintenance. His past medical history is significant for chronic Hepatitis C. His most recent alanine aminotransferase (ALT) level is 80 U/L and Aspartate aminotransferase (AST) level is 90 U/L. Regarding naltrexone maintenance, which of the following statements is true? 

  1. Naltrexone is contraindicated in this patient because his ALT is elevated 
  2. Naltrexone is contraindicated in this patient because his AST is elevated 
  3. He can take naltrexone only for a few months 
  4. He can take naltrexone only for opioid abuse, but not for alcohol abuse. 
  5. He can take naltrexone for both opioid and alcohol abuse  for long term maintenance while monitoring his liver function 

Correct Answer is E. This individual can rely on naltrexone for both opioid and alcohol abuse for long term maintenance while monitoring his liver function. Naltrexone is a long-acting orally active pure opioid antagonist, which blocks μ-opioid receptors . Because it blocks opioid receptors, it tamps down cravings for alcohol and the euphoric sensations (reward) associated with drinking. It also provides modest relief from craving for opioids. 

Incorrect Answers 

A and B. While it should be used with caution in patients with elevated serum aminotransferase activity, it is not contraindicated. 

C. He can take it for long term while monitoring his liver function 

D. He can take it for both opioid and alcohol abuse