7 - Alcohols

Question 1

Metabolism of Ethanol: Alcohol Dehydrogenase (ADH) Pathway Steps

Answer 1

Conversion of alcohol to acetaldehyde via ADH

Acetaldehyde to acetate by aldehyde dehydrogenase (ALDH Pathway) in liver

Question 2

Significant amount of ethanol metabolism by gastric ADH occurs in?

Answer 2

The Stomach

Question 3

Disulfiram inhibits what and causes what?

Answer 3

Inhibits oxidation of acetaldehyde

Causing Aldehyde Syndrome (flushing and headache)

Question 4

Acute Alcohol Intoxication Management (4)

Answer 4

1. Treatment of hypoglycemia and ketosis by administering gluciose
2. Phosphate
3. IV Thiamine for Wernicke-Korsakoff Syndrome (nystagmus, ataxia, and confusion)
4. Electrolyte solutions - IV Potassium (hypokalemia from vomiting)

Question 5

Alcohol Withdrawal Syndrome Management (3)

Answer 5

1. Substituting alcohol for long-acting sedative-hypnotic drug (chlordiazepoxide, diazepam, lorazepam, or oxazepam)
2. Gradually reducing (“tapering”) the dose of the long-acting sedative hypnotic
3. Delirium tremens occurrs within a week

Question 6

Treatment of Alcoholism: Naltrexone (1)

Answer 6

Reduce craving for alcohol and to reduce the rate of relapse to either drinking or alcohol dependence

Question 7

Treatment of Alcoholism: Acamprosate (1)

Answer 7

Weak NMDA-receptor antagonist and a GABA-A receptor activator

Question 8

Treatment of Alcoholism: Disulfiram (1)

Answer 8

Induce uncomfortable symptoms within a few minutes after drinking alcohol (e.g. flushing, headache, NV, hypotension, and confusion)

Question 9

Other Alcohols: Methanol Use

Answer 9

Industrial applications and very cheap

Question 10

Other Alcohols: Methanol Effects (2)

Answer 10

Blindness if not treated properly

Metabolic acidosis with increased anion gap (from formic acid)

Question 11

Other Alcohols: Methanol Poisoning Treatment (4)

Answer 11

1. IV Ethanol - more affinity to enzyme
2. Fomepizole - inhibits alcohol dehydrogenase
3. Sodium Bicarb - for metabolic acidosis
4. Hemodialysis - for high levels

Question 12

Other Alcohols: Ethylene Glycol (3)

Answer 12

Used as a heat exchanger in antifreeze

Poisoning can occur in children due to sweet taste

Forms kidney stones (calcium oxalate)

Question 13

Other Alcohols: Ethylene Glycol Effects (3)

Answer 13

Transient excitation followed by CNS depression

Severe metabolic acidosis with increased anion gap

Delayed renal insufficiency due to oxalate stones

Question 14

Other Alcohols: Ethylene Glycol Treatment (3)

Answer 14

1. IV Ethanol
2. IV Fomepizole
3. Hemodialysis for high levels