AHD-CLINICAL-004 — IV Library v0.1

Status: DRAFT v0.1 (REPLACED BY v1.0 protocols in AHD-RESEARCH-SYNTHESIS-v1.0 §SEAT 04)

v1.0 IV Library (from NEXUS clinical research)

Protocol IV-01: Wernicke Prevention Infusion (WPI)

• Composition: Thiamine 500mg in 100mL normal saline
• Indication: All AUD presentations
• Dose: 500mg IV TDS Day 1, reducing to BD Day 2-3 if no Wernicke signs
• Rate: Over 30 minutes
• Evidence: HIGH (RCP/NICE CG100)

Protocol IV-02: Targeted Rehydration + Electrolytes

• Composition: Normal saline 500mL-1L with KCl 20mmol if K<3.5
• Indication: Clinical dehydration only (NOT routine)
• Evidence: HIGH (targeted), LOW (routine)

Protocol IV-03: Magnesium Repletion (4g IV)

• Indication: Hypomagnesaemia in AUD
• Rate: Over 30-60 minutes
• Evidence: HIGH

Protocol IV-04: Modified Rally Pack

• Composition: Thiamine 100mg + folate 1mg + Mg 2g + multivitamin in 1L NS
• Indication: Daily nutritional support Day 2-5
• Evidence: MEDIUM (banana bag thiamine subtherapeutic alone)

Protocol IV-05: Glutathione Push

• Composition: 600-1200mg in 10-50mL NS
• Indication: Hepatic impairment, elevated LFTs
• Frequency: 2-3x weekly
• Evidence: LOW (NAFLD pilot data only)

Protocol IV-06: NAD+ Loading Infusion

• Composition: NAD+ 250-500mg in 250mL NS
• Indication: Post-acute Day 4+ in AUD/OUD
• Rate: SLOW, 4-6 hours
• Evidence: LOW (no RCTs); MEDIUM (safety + mechanism)

Protocol IV-07: Methylated B-Complex Push

• Composition: Methylcobalamin 1mg + methylfolate 1mg + B6 50mg + B2/B5
• Indication: Day 2+ general
• Evidence: MEDIUM

Protocol IV-08: Vitamin C High-Dose

• Composition: 2-5g in 100mL NS
• Indication: Optional adjunct, high oxidative stress
• Frequency: Every 2-3 days
• Evidence: LOW

Defensible Marketing Claims (per NEXUS clinical evidence research)

• “IV NAD+ provides mitochondrial cofactor repletion during a period when chronic substance use has depleted cellular energy substrates.”
• “Thiamine repletion is clinically established to prevent Wernicke encephalopathy in alcohol-dependent patients.”
• “Glutathione infusion supports hepatic antioxidant capacity during alcohol detoxification.”

Claims to AVOID

• “Evidence-based NAD+ treatment”
• “NAD+ eliminates withdrawal symptoms”
• “NAD+ rewires the brain’s reward pathways”
• “Endorsed by addiction medicine specialists”