Alcohol And CNS Depressants Flashcards
In most states, the legal limit of BAC is
80 mg/dL or 0.08 g/L or 8%
What are two alcohol bio markers for liver damage?
-Used to screen for heavy, chronic use
Gamma-glutamyltransferase (GGT) and Aspartate-aminotransferase (AST)
How long after abstinence will GGT remain elevated for?
2-6 weeks
How long after onset of abstinence will AST remain elevated?
7 days
What are two things we often see with chronic use of alcohol
Increased MCV and hypertension
Very high BAC causes
-Can be fatal
Respiratory depression
following abrupt cessation, heavy drinkers will experience withdrawal 6-24 hours after last drink. What is a major symptom?
Tremors (also anxiety, GI upset)
-Mental status is INTACT
6 to 48 hours after the last drink, we can see
-Occur in clusters of two or three
Alcohol seizures
Also during alcohol withdrawal, around 12-48 hours after last drink, patients may have
-Often animals or insects
Alcohol hallucinations
Occurs 72 and 96 hours after last drink
- Most severe withdrawal manifestation
- 20% mortality
Delirium Tremens
Characterized by delirium, markedly altered mental status, and autonomic hyperactivity
Delirium Tremens
Patients with delirium tremens may die from
Hyperthermia, arrhythmia, and fluid/electrolyte abnormalities
Treatment for alcohol withdrawal
-Improves agitation and prevents progression
Benzodiazepines
What are the three FDA approved drugs for alcoholism?
-reduce risk of relapse
Disulfiram, Naltrexone, and Acamprosate
Inhibits aldehyde dehydrogenase, which causes the accumulation of acetaldehyde
Disulfiram
Triggers catecholamine release and provides a negative response to drinking with sweating, flushing, palpitations, nausea, and vomiting
Disulfram
Long acting opioid antagonist that is given orally to prevent relapse
Naltrexone
Modulates NMDA receptors so that alcohol consumption will disrupt CNS equilibrium
Acamprosate
A common side effect of Acamprosate (15%) is
Diarrhea
Anti-seizure GABA activator with a narrow therapeutic index
-Has been largely replaced by Benzodiazepines
Barbituates
Barbituates are dangerous if used together with
Alcohol
An overdose of barbituates causes
Respiratory Depression
Heavy users of barbituates must be weaned. Abrupt withdrawal causes
Delirium, hallucinations, and seizures
CNS depression with normal vitals is a classic sign of overdose on
Benzodiazepines
Leads to altered mental status, slurred speech, and ataxia
Benzodiazepines overdose
Antagonist of benzodiazepine receptor that is used to treat benzo overdose
Flumazenil
Flumazenil may cause
Withdrawal seizures
Benzodiazepines withdrawal can cause tremors, anxiety, depressed mood, and
-Can be life threatening
Seizures
The treatment for Benzodiazepine withdrawal is
Benzos
