Before starting acamprosate in a 55-year-old man with alcohol use disorder, which baseline investigation is essential because the drug is contraindicated when markedly abnormal?

• A Thyroid stimulating hormone
• B Serum calcium and phosphate
• C Fasting lipid profile
• D Serum creatinine and estimated glomerular filtration rate ✓

Explanation

Acamprosate is excreted almost entirely unchanged by the kidneys and is contraindicated in severe renal impairment (creatinine clearance below 30 mL/min), so renal function must be checked before prescribing. This contrasts with disulfiram, whose main concern is hepatotoxicity, and naltrexone, which is avoided in acute hepatitis and marked transaminase elevation. Calcium, lipids, and thyroid function have no bearing on acamprosate safety.

Reference: Katzung's Basic and Clinical Pharmacology, 16th ed.

High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP

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