alcohol pharm Flashcards
1. Describe the absorption, distribution and metabolism of ethanol and methanol. 2. List the pharmacological and toxic effects of ethanol and methanol and the mechanism of action for each effect. 3. Describe the tolerance and physical dependence that develops following chronic ethanol administration. 4. Describe the pharmacological approaches to the treatment of alcoholism. 5. Describe the pharmacological approaches to the treatment of methanol poisoning and the mechanism of action of the ag
kcal yield of EtOH
7 kcal/g
effective dose of EtOH
1-3 g/kg
mode of EtOH absorption
passive diffusion in the SI
delays the absoption of EtOH
food in stomach
distribution of EtOH in body
in total body water
most EtOH is metaboloized by
alcohol dehydrogenase
some EtOH metabolized via
P450
end result of EtOH metabolizism
acetyl CoA
rate limiting step of EtOH metabolism
EtOH to acetaldehyde
rate of EtOH metabolism
7-10 gm/hour
% of EtOH metabolized by P450
10%
main enzyme in P450 that metabolizes EtOH
CYP3A4/5
receptor inhibited by EtOH
glu (NDMA and kianate)
recptor enhanced by EtOH
GABAA
def: Dispositional tolerance
reduced effect and reduced concentration in plasma
def: pharmacodynamic tolerance
reduced effect at SAME concntration in plasma
def: mellanby effect
impairment is worse at the same BAC level as levels increase than as they are on the way down
common cause of death in EtOH intox
respiratory depression
liver effects of EtOH
fatty liver –> cirrhosis–> portal hypertension
endocrine effects of EtOH
gynomastia, testicular atrophy, reduced prolactin, GH, and ADH
ddx of actute EtOH intox
diabetic coma
drugs that can cause same reaction to EtOH as disulfram
cephlasporins, griseofulvin, metrinidazole, procarbazine
drug that reduces EtOH craving
naltrexone
contraindication of acamprosate
kidney pts
MOA of acamprosate
glutamatergic NMDA antagonist/GABAA agonist
alcohol found in moonshine
methanol
mech of methanol poisoning
metabolites are more toxic - causes retinal damage and metabolic acidosis
toxic metabolite of methanol
formic acid
treatment for methanol poisoning
high dose ethanol or fomepizole
MOA of ethanol for methanol poisoning
competes for Alcohol dehydrogenase, reventing metabolism of methanol to toxic metabolites
non alcohol methanol and ethylene glycol antidote
fomrpizole
MOA of fomepizole
competitive alcohol dehydrogenase inhibitor
tx for methanol poisoning
ABC, bicarb, large doses of EtOH, hemodialysis in severe cases, emesis in conciious pts if presented early
