Alcohol and Adverse Drug Reactions (9) Flashcards
What claims more lives than drugs?
Alcohol
EtOH
Alcohol
Impaired ability to control alcohol use despite adverse effects
Alcohol Abuse Disorder
How does alcohol get digested?
It is absorbed into the blood stream UNALTERED
Due to alcohol being unaltered in the blood stream, the amount exhaled is?
Proportional to the blood level
Drunk driving blood alcohol level and drink number
80 mg/dl
= 3 drinks
A blood alcohol content of 300 mg/dl will cause?
Coma
Alcohol tolerance
Alcoholics metabolize alcohol at a HIGHER rate, thus they have lower alcohol levels in blood even after same number of drinks
What enzyme breaks down alcohol?
Alcohol Dehydrogenase
Alcohol is taken to ______ by alcohol dehydrogenase
Acetaldehyde -> Acetate
What ethnicity has decreased ability to metabolize alcohol because they have decreased levels of alcohol dehydrogenase?
Asians
Describe how alcohol causes liver injury
- Alcohol causes Endotoxin release from Gram (-) bacteria
- Endotoxins cause release of TNF from macrophages
= Hepatic injury
Acute Alcoholism effects can be reversed if consumption is stopped. What are those effects?
CNS depressant effects
Steatosis of liver
Chronic Alcoholism effects on the liver?
Steatosis
Cirrhosis (nodules)
Chronic Alcoholism causes a deficiency in what vitamin?
Thiamine (B1)
– Wernicke-Korsakoff Syndrome
How does Chronic Alcoholism increase risk of coronary artery disease?
Lowers HDL
Fetal Alcohol syndrome findings?
Microcephaly
Facial anomalies
Decreased mental functions
Drinking alcohol at what point in pregnancy is the most harmful?
1st trimester
Wernicke Encephalopathy
Reversible Thiamine (B1) deficiency
Wernicke Encephalopathy symptoms and physical findings?
Psych symptoms and opthalmoplegia
- Hemorrhage and necrosis of mammillary bodies
If Wernicke Encephalopathy goes untreated, what will result?
Korsakoff Syndrome
What symptoms are seen with Korsakoff Syndrome?
Memory loss and confabulation
Chronic alcohol use can also affect the brain. Describe what it does.
Atrophy of ANTERIOR Vermis
- Causes unsteady gait and ataxia
Untoward effects of drugs that are given in therapeutic settings
Adverse Drug Reactions
What antibiotic causes discoloration of the skin?
Minocycline
Minocycline causes?
Discoloration of the skin
Most common physical exam finding with hypersensitivity reactions?
Skin rashes
What age population is more likely to suffer an Adverse Drug Reactions?
Older people
Anticoagulants such as warfarin and pradaxa cause what adverse effect?
BLEEDING or thrombosis due to insufficient dosage
Warfarin
Inhibits vitamin K
- Anti-clot
Pradaxa
Inhibits Thrombin
- Anti-clot
What is menopausal hormone therapy?
Giving menopausal women estrogen and progestons
Good and Bad effects of menopausal hormone therapy?
Good - may protect against CAD
Bad - Increases risk of breast cancer and stroke
Oral contraceptives protect against what cancers?
Ovarian and Endometrial
Bad effects of oral contraceptives?
Increase cervical cancer risk and DVT risk
If you smoke and take oral contraceptives, what are you at risk for?
DVT
Prolonged Oral contraceptive use may cause what cancer?
Hepatic Adenoma
These cause stunted growth, acne, testicular atrophy, facial hair in females, increased MI risk
Anabolic steroids
Acetomenophin toxic agent created?
NAPQ1
Acetomenophin can be toxic to what organ?
Liver
Chronic Aspirin (salicyclate) poisoning exam findings?
Tinnitus (ringing), dizziness, bleeding, coma
What is the inactive form of Alcohol Dehydrogenase seen in some Asian populations?
ALD*2 - Aldehyde dehydrogenase
What are the symptoms of having the inactive version of alcohol dehydrogenase (ALD*2)?
Flushing, nausea, Increased HR with alcohol consumption
How does alcohol increase the effect of other drugs?
It DELAYS their catabolism by competing for the CYP2E1 substrate
