Alcohol and Hypnotics

Question 1

How long does it take for alcohol to be absorbed from the gut?

Answer 1

peak in 40 minutes on an empty stomach - supa fast

Question 2

What is the optimum concentration for bioavailability?

Answer 2

20% EtOH

Question 3

What is the volume of distribution of alcohol? Where does it distribute?

Answer 3

.7L/kg, easily goes to all tissues

Question 4

Where is alcohol metabolized?

Answer 4

In the liver, but some in the gut (especially in men)

Question 5

True or False: Alcohol is metabolized via first order metabolism.

Answer 5

False! Zero order, i.e. a fixed amount per unit time

Question 6

Does alcohol have a half life?

Answer 6

No

Question 7

What are the two metabolites involved with alcohol?

Answer 7

alcohol dehydrogenase, aceetaldehyde dehydrogenase

Question 8

What is the principle metabolite? Is it toxic? What is it broken down into and where?

Answer 8

acetaldehyde-toxic. further broken down in liver to acetate

Question 9

What are the acute CNS effects of alcohol (2)?

Answer 9

1) continuous CNS depressant

2) anticonvulsant in amounts that cause general CNS depression

Question 10

Alcohol causes continuous CNS depression, just like ___ and ___

Answer 10

general anesthetics and barbiturates

Question 11

which part of the cortex is depressed at low concentrations?

Answer 11

those involved in highly integrated functions

Question 12

what causes the “stimulant” effects of alcohol?

Answer 12

depression of inhibitory control mechanisms

Question 13

what succeeds the initial phase of alcohol?

Answer 13

general impairment of nervous function. muddled thoughts and awkward movements

Question 14

what is caused by high concentrations of alcohol?

Answer 14

general anesthesia

Question 15

What determines the CNS effects?

Answer 15

proportional to the concentration of alcohol in the blood

Question 16

What follows the anticonvulsant properties of alcohol?

Answer 16

followed by a long period of hyperexcitability

Question 17

What are the consequences of the hyperexcitability period?

Answer 17

alcohol is contraindicated in epilepsy and alcohol withdrawal in heavy users may cause seizures

Question 18

alcohol + which drugs can cause enhancement of CNS depression?

Answer 18

sedatives, hypnotics or tranquilizers

Question 19

What else can alcohol be used for?

Answer 19

topical antiseptic and astringent (not for sterilizing)

Question 20

What does alcohol do to respiration?

Answer 20

response to CO2 is depressed- can be dangerous

Question 21

What does alcohol do to the GI tract? In who is it therefore contraindicated?

Answer 21

increase in gastric juices: contraindicated in peptic ulcer

Question 22

what does alcohol do to the kidneys?

Answer 22

diuretic, inhibition of ADH

Question 23

what does alcohol do to the liver?

Answer 23

accumulation of fat: increased NADH/NAD ratio + mobilization of fat from peripheral tissues

Question 24

What does alcohol do to the CV system?

Answer 24

vasodilation. no significant until severe intoxicating levels are reached

Question 25

Physical dependence?

Answer 25

yes

Question 26

What does metabolic tolerance mean?

Answer 26

increased metabolism and inducible enzymes in liver. alcoholics will have cross tolerance with barbiturates

Question 27

What does functional tolerance mean?

Answer 27

changes the dunctional properties of many membranes (changes lipid environment of cell membranes). chronic alcohol leads to more rigid membranes, therefore more alcohol for same effect

Question 28

What does functional tolerance lead to?

Answer 28

dependence (withdrawal)

Question 29

what does behavioral tolerance mean?

Answer 29

recovery of ability to funtion socially in spite of the drug. can also refer to how others perceive the drug user

Question 30

What are the consequences of dependence?

Answer 30

abstinence syndrome, "purposeful behavior"

Question 31

What is alcoholism?

Answer 31

tolerance + physical dependence + withdrawal avoidance

Question 32

How do you treat alcoholism acutely?

Answer 32

Benzodiazepines to "taper off" over weeks. prevent respiratory failure, prevent seizures and arrhythmias during withdrawal

Question 33

How do you treat alcoholism chronically?

Answer 33

behavior modification, Disulfram for aversive therapy (prevents metabolism of acetaldehyde), Naltrexone = opiate antagonist

Question 34

What's up with methanol?

Answer 34

misguided ethanol substitute that has very toxic breakdown products.

Question 35

What do you use to treat methanol poisoning?

Answer 35

ethanol and dialysis