Alcohol

Question 1

Acamprosate [Campral]

Answer 1

Alcohol Dependence

MoA: modify EtOH metabolism and VTA/NA reward response

Question 2

Disulfiram [Antabuse]

Answer 2

Inh Acetaldehyde Dehydrogenase
Use: promote alcohol sobriety
Accumulation of Acetaldehyde -> discomfort + possible reinforcement of alcohol seeking behavior
N/V + skin flushing (*Asian Polymorph)
Disulfiram-Like: sulfonylureas, Cefotetan, Ketoconazole, Procarbazine, Metronidazole

Question 3

Ethanol

Answer 3

BAL: 400 (coma, resp insuff, death)
PK: liver ZERO order
1. alcohol dehydrogenase -> acetaldehyde -> 2. acetaldehyde dehydrogenase -> acetate
ADE: CNS depression, acetominophen toxic (2E1), bleeding (w/ NSAIDs), Fetal Alcohol Syndrome, Wernicke-Korsakoff (B1 def.), anemia (B12 def.), etc.

Question 4

Ethylene Glycol

Answer 4

Alcohol Dehydrogenase -> acidosis + nephrotoxic

Tx: Fomepizole or Alcohol

Question 5

Methanol

Answer 5

Alcohol Dehydrogenase -> acidosis + retinal damage

Tx: Fomepizole or Alcohol

Question 6

Fomepizole [Antizol]

Answer 6

Inh Alcohol Dehydrogenase

Use: ethylene glycol or methanol toxicity

Question 7

Thiamine [Vit B1]

Answer 7

Deficient in chronic alcoholics -> metabolism dysfunction + Wernicke-Korsakoff Encephalopathy
1st Thiamine + 2nd Glucose (otherwise encephalopathy worse)