26 alcohol Flashcards
what is the standard does of alcohol?
14 g
what does the standard dose give you a BAC of?
0.03% 30 mg/dcL
what does the rate of absorbtion of alcohol depend on?
the concentration, the rate of absorbtion and the compostion of the gastric contents.
what is the distribution of alcohol like?
the volume of distribution is equal to the total body water.
where is alcohol primarily absorbed
in the small intestine
is the first pass effect strong for ethanol?
yes it is mostly metabolized to acetaldehyde in from the first pass effect of the liver.
what is the primary path way for ethanol oxidation to to acetaldhyde?
the ALCOHOL DEHYDROGENASE PATHWAY it is the rate limiting pathway.
what is the rate limiting step of alcohol dehydrogenase?
the alcohol dehydrogenase pathway
what is the kinetics of the alcohol dehydrogenase pathway?
zero order kinetics
what is the pathway that uses CYP2E1?
the Microsomal Ethanol Oxidizing System Mixed Function Oxidase System) (MFOS)
what does the Mixed Function Oxidase System) (MFOS) do?
it has a high KM - so it isnt used unless concentrations get really high. it uses CYP2E1 to convert ethanol to acetaldehyde. needs NADP+ as a cofactor.
what converts the acetaaldehyde to acetate? what kind of reaction is it?
mitocondrial aldehyde dehydrogenase it is an oxidation of acetaldehyde to acetate.
what drug inhibits the acetaldehyde dehydrogenase?
disulfiram
what are the 2 metabolic consequences of ethanol metabolism?
1) Increased NADH results in inhibition of TCA cycle
- Decreased oxidation of fats
2) Increased acetaldehyde
- Generation of protein adducts
- Decreased glutathione
- Inhibits microtubules
what is the effect of ethanol in the CNS?
Ethanol is a dose-dependent, CNS depressant
what happens in the liver when you have chronic alcohol consumption?
steatosis - fatty liver.
hep C
you get alcohol cirosis - from necrosis and chronic inflammation.
what happens in the GI when you have chronic alcohol?
1) Chronic gastritis
2) Pancreatitis
3) Diarrhea
4) Malabsorption of Vitamins
what are the effects of chronic alcohol use on the CNS?
you get tolerance causing neuronal changes and metabolic tolerance.
dependance
a) Psychological dependence - craving
b) Physical dependence - withdrawal is dangerous, can get seizures
what happens in neruotoxicity of in chronic alcohol consumption?
Neurotoxicity
1) Neuralgias and peripheral nerve injury
2) Cerebral/Cerebellar Atrophy
3) Wernicke’s Encephalopathy
4) Korsakoff’s Psychosis
5) Psychiatric Disorders
what are the tetrogenic effects of alcohol?
what is the mechanism?
fetal alcohol syndrome
Mechanism of Teratogenic Effect- direct inhibitory effect of ethanol or acetaldehyde on embryonic cellular proliferation.
Complex syndrome characterized by retarded body growth, micro- cephaly, poor coordination, facial abnormalities and minor joint abnormalities
what does acute high doeses of alcohol do to CYP2E1?
what does chronic alcoholism do?
it inhibits CYP2E1
chronic alcohol use causes the CYP2E1 to be induced and accelerates the metabolism of some drugs.
what drugs are used for the management of alcohol withdrawl syndrome?
what is the point of using these drugs?
Benzodiazepines
– Diazepam
- Chlordiazepoxide
and atenolol for beta blocker
Objectives of drug therapy - prevention of seizures, delirium and arrhythmias
1) Gradual reduction of dose “tapering off”
what drug is reduces the urge to drink?
what is its mechanism of action?
naltrexone
it is a opioid receptor antagonist.
what drug is a GABA mimetic that decreases drinking frequency and reduces relapse?
Acamprosate
