Alcohol

Question 1

What are the two pathways for alcohol metabolism? (to acetaldehyde)

Answer 1

Alcohol Dehydrogenase Pathway (ADH)

Microsomal Ethanol Oxidizing System (Mixed Function Oxidase System) (MFOS)

Question 2

Alcohol dehydrogenase follow ____ order kinetics: ___ g/hr in 70 kg person.

Answer 2

Zero; 10

Since one drink is about 14 g, it takes about 1.5 hrs to metabolize one drink

Question 3

Which P450 enzyme is induced by alcohol in MFOS?

Answer 3

CYP2E1

Question 4

How is acetaldehyde metabolized?

enzyme and end product

Answer 4

aldehyde dehydrogenase (ALDH)
oxidizes to acetate

Question 5

What are the two major metabolic consequences of alcohol?

Answer 5

increased NADH -> inhibition of TCA cycle & reduced fatty acid oxidation
Increased acetaldehyde -> protein adduct & inflammation & depletion of glutathione & inhibits microtubules

Question 6

What is the relation between heavy alcohol use and hypoglycemia?

Answer 6

insulin secretion
depletion of NAD+ leads to block of gluconeogenesis
Alcohol-induced ketoacidosis

Question 7

What is the mechanism of action in the CNS?

Answer 7

activates GABA receptor-ligand gated Cl- channel

=> hyperpolarize => disturb balance between excitatory and inhibitory neurotransmission

Question 8

What is alcohol’s effect on the liver? (3)

Answer 8

steatosis
hepatitis C (co-morbid)
cirrhosis

Question 9

What is alcohol’s effect on the GI? (4)

Answer 9

chronic gastritis
pancreatitis
diarrhea
malabsorption of vitamins

Question 10

What is Wernicke’s encephalopathy?

Answer 10

A syndrome characterized by ataxia, ophthalmoplegia, nystagmus, confusion, impairment of short-term memory
due to thiamine deficiency

Question 11

What is Korsakoff’s psychosis?

Answer 11

continuation of Wernicke’s
amnesia
apathy
due to neuronal loss

Question 12

What is the Triad of symptoms caused by alcohol’s teratogenic effects?

Answer 12

1. retarded body growth
2. facial abnormalities
3. CNS dysfunction

Question 13

How does alcohol interact with other drugs? (3)

Answer 13

• acute high doses can inhibit CYP-mediated metabolism
• chronic use induces CYP2E1
• acetaminophen toxicity can arise when intoxicated since glutathione is depleted

Question 14

Which drugs are used as a substitute for alcohol as a therapy?

Answer 14

benzodiazepines: diazepam, chlordiazepoxide

Question 15

Which drug reduces the urge to drink by antagonizing opioid receptor?

Answer 15

Naltrexone

Question 16

Which drug is a GABA-A agonist that decreases drinking frequency?

Answer 16

Acamprosate

Question 17

Which drug inhibits aldehyde dehydrogenase?

Answer 17

Disulfiram (Antabuse)