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Pharmacology II > Alcohol > Flashcards

Alcohol Flashcards

1
Q

Ethanol: Behavior Effects

A

Sedative Hypnotic/CNS Depressant

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2
Q

Ethanol: Absorption

A

Rapid and distributes to all tissues (placental included). Slowed by previous food intake

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3
Q

Explain the Metabolism of Ethanol

A

Alcohol is metabolized by alcohol dehydrogenase (ADH) at levels <0.1%
Microsomal Ethanol Oxidizing System metabolizes at blood ethanol levels above 0.1%

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4
Q

What BAC level is considered the “danger zone”?

A

100-200 mg/dL
This is the level of social dysfunction (Excitement, decreased inhibitions, impaired motor function, slurred speech, ataxia)

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5
Q

EtOH Major Actions in CNS

A

Sedative effects

  1. Enhances the affinity for GABA at its receptor. Remember GABA is inhibitory
  2. Inhibit glutamate activation of glutamatergic NMDA receptors.
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6
Q

Additional EtOH effects in the CNS

A
  1. Chronic uses increases the synaptic concentrations of dopamine, serotonin, and endogenous opioids in nucleus accumbens and the VTA
  2. Enhances calcium-activated, voltage gated BK potassium channels
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7
Q

Treatment for Acute Intoxication

A

Maintain VS and prevent aspiration

Give “Banana Bag” and IV dextrose if Wernicke-Korsakoff is suspected

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8
Q

The Mechanism of Disulfiram

A

Inhibits acetaldehyde dehydrogenase, causing a buildup of acetaldehyde.
Acetaldehyde leasd to nausea, vomiting, headache, and hypotension.

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9
Q

Mechanism of Clonidine, Propanolol

A
  1. Clonidine activates alpha2 adrenergic receptors in CNS to decrease sympathetic outflow
  2. Propanolol blocks beta adrenergic receptors in CNS to decrease sympathetic outflow
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10
Q

Therapeutic Use of Clonidine, Propanolol

A

Used to treat mild alcohol withdrawal symptoms (anxiety, insomnia, tremors, muscle aches, sweating, cramping, arrhythmias)

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11
Q

Clinical Use of Diazepam

A

Severe alcohol withdrawal syndrome leading to convulsion

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12
Q

Mechanism of Action of Diazepam

A

Activates GABA-A receptors in CNS. Benzos act by increasing affinity of endogenous GABA to GABA-A receptor

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13
Q

Naltrexone: MOA

A

Inhibits mu opioid receptors in the VTA

This is anti-craving therapy used to prevent relapse in recovering alcoholics

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14
Q

Topiramate: MOA and Indication

A

MOA: enhances GABA-A receptor activity and inhibits excitatory glutamatergic receptor activity
Indication: anti-craving medication NOT for withdrawal symptoms

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15
Q

Fomepizole: Indication

A

Used for methanol and ethylene glycol poisioning

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16
Q

Fomepizole: MOA

A

Binds with ADH to prevent to metabolism of methanol and ethylene glycol to toxic metabolites

17
Q

N-acetylcysteine (NAC)

A

Used to treat chronic alcoholics suspected of acetaminophen poisoning

18
Q

Clinical Use of Naloxone

A

Suspect recovering alcoholic is abusing opioids; perform Narcan challenge test prior to treatment with naltrexone

19
Q

Naloxone: MOA

A

Inhibits mu opiod receptors in VTA

20
Q

Two Kinds of Tolerance

A
  1. Metabolic tolerance (pharmacokinetic)- induction of MEOS enzymes
  2. Functional tolerance (pharmacodynamic)- reduction of CNS sensitivity to ethanol due to adaptive changes in neurons
21
Q

What BAC level is associated with respiratory depression and death?

A

> 500 mg/dL

22
Q

How long does it take for ADH to metabolize a single drink (15 g ethanol)

A

1.5-2 hours

23
Q

Liver Effects of Ethanol

A

Decreased gluconeogenesis, hypoglycemia, NAD depletion, fatty accumulation in the liver. Eventual hepatitis and cirrhosis

24
Q

GI Effects of Ethanol

A

Inflammation, bleeding, scarring –> eventual absorption deficits

25
Q

Endocrine Effects of Ethanol

A

Altered steroid metabolism (gynecomastia, testicular atrophy, salt retention)

26
Q

Cardiovascular Effects of Ethanol

A

Anemia, Hypertension, Ventricular hypertrophy (increased risk for MI)

27
Q

Neoplasia and Ethanol

A

Increased incidence of esophageal, mouth, breast, ovarian and colorectal cancer

28
Q

Nervous System Effects of Ethanol

A

Peripheral Neuropathy

29
Q

Wernicke-Korsakoff Syndrome

A

Associated with thiamine deficiency resulting in encephalopathy
Symptoms: ataxia, confusion, paralysis of extraocular muscles, memory loss; can progress to coma and death

30
Q

Fetal Alcohol Syndrome

A

Intellectual disability, growth deficiencies, microcephaly, underdevelopment of the mid-face region

31
Q

Alcohol Withdrawal Syndrome

A

Mild: anxiety, insomnia, tremors, agitation, muscle aches, sweating, cramping, N/V/D, arrhythmias
Severe: hallucinations, DTs, and seizures

Pharmacology II (11 decks)

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