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Pharmacology > Alcohol > Flashcards

Alcohol Flashcards

1
Q

potency of alcohol

A

low

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2
Q

how is absorption of alcohol increased

A

carbonated beverages

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3
Q

how is absorption of alcohol decreased

A

presence of food

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4
Q

distribution of alcohol

A

in total body water

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5
Q

metabolism of ethanol

A

90-98% metabolized to acetaldehyde

remaining eliminated as ethanol in breath, sweat, saliva

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6
Q

where does the significant first pass effect of alcohol occur?

A

liver, stomach- alcohol dehydrogenases

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7
Q

What is the rate limiting step of alcohol metabolism?

A

alcohol dehydrogenase–zero order kinetics because it’s saturated

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8
Q

What are the two methods of metabolizing ethanol?

A

alcohol dehydrogenase

CYP2E1

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9
Q

what byproducts are made in the metabolism of ethanol to acetaldehyde

A

NADH

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10
Q

When does CYP2E1 take action?

A

chronic users of alcohol or high doses of alcohol

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11
Q

What steps convert NAD+ to NADH in the metabolism of ethanol?

A

ethanol to acetaldehyde

acetaldehyde to acetic acid

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12
Q

What is the enzyme that converts acetadehyde to acetic acid?

A

aldehyde dehydrogenase

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13
Q

What is the primary first step in metabolizing ethanol?

A

alcohol dehydrogenase

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14
Q

What is the mixed function oxidase system?

A

system used to convert ethanol to acetaldehyde via CYP2E1

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15
Q

What is the Km of CYP2E1 for alcohol?

A

high

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16
Q

What contributes to the fact that Asians are more likely to get flushing with alcohol consumption

A

genetic polymorphism in aldehyde dehydrogenase

17
Q

what does acetaldehyde cause

A

unpleasant feeling, headache

18
Q

what are the consequences of alcohol metabolism?

A

increased NADH:
inhibits TCA cycle–decreases gluconeogenesis
decreases fatty acid oxidation–deposition of fat

increased acetaldehyde:
makes protein adducts–causes inflammation
inhibits microtubules
decreases glutathione

19
Q

what does induction of CYP2E1 affect?

A

metabolism of xenobiotics to carcinogens

20
Q

how does ethanol cause hypoglycemia?

A

induces insulin secretion

21
Q

why does alcohol induce ketoacidosis?

A

can cause hypoglycemia

22
Q

ethanol in the CNS affects

A

GABA A receptor ligand gated chloride channel

23
Q

What explains the excitement one gets with alcohol?

A

inhibits inhibitory neurons

24
Q

Effects of alcohol at 100-200mg%

A

poor motor function

ataxia

25
Q

chronic ethanol consumption causes what effects on the liver

A

steatosis-fatty liver
hepatitis C-often co-morbid
cirrhosis-b/c of liver necrosis/inflammation
liver cancer

26
Q

effects of chronic ethanol consumption on GI

A 
gastritis
pancreatitis
malabsorption of vitamins
diarrhea
esophageal cancers
27
Q

effects of chronic ethanol in CNS

A

tolerance due to:

  • -neuronal change: chronic alcohol causes upregulation of excitatory transmission as compensation
  • -metabolic: upregulation of CYP2E1

psychological craving and physical dependence

28
Q

how is alcoholism neurotoxic

A

neuralgia (firing of pain neurons when there isn’t pain)
peripheral nerve injury
memory impaired
poor nutrient absorption/thiamine deficiency can lead to cerebral/cerebellar atrophy, Wericke’s encephalopathy, Korsakoff’s psychosis

29
Q

symptoms in newborn in mother who uses alcohol chronically

A

retarded body growth
facial abnormalities
CNS problems

30
Q

Drugs interactions of alcohol

A

additive with CNS depressants

high doses inhibit CYP metabolism, whereas chronic use induces CYP2E1 and can increase metabolism of other drugs

Depletes glutathione so can result in acetaminophen toxicity

31
Q

Clinical treatment of acute intoxciation of ethanol

A

support respiration

fix metabolic issues–dehydration, hypoglycemia, ketosis, electrolyte imbalance

32
Q

How do you treat alcohol withdrawal

A

want to prevent seizures and delirium and arrythmias

treatment: short acting benzodiazepines-diazepam and chlordiazepoxide, atenolol for prevention of cardiac arrythmia

33
Q

how to treat alcoholism

A

naltrexone
acamprosate
disulfiram

Pharmacology (10 decks)

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