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Year II Pharmacology > Alcohol Pharmacology PSYCH > Flashcards

Alcohol Pharmacology PSYCH Flashcards

1
Q

Which 4 NT pathways does alcohol activate

A
  • Increase GABA A (CNS depressant, relaxation, spurred speech poor coordination, motor slowing)
  • Inhibition of glutamatergic system (memory loss, sedation, cognition)
  • Opioid (indirect stimulation of B endorphins, euphoria & reinforcement)
  • Dopamine (Indirect stimulation of dopamine neurons, pleasure, reward, motivation…)
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2
Q

Why do women experience alcohol symptoms sooner then men?

A

• Women: lower ADH and body water

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3
Q

Can alcohol cross the placenta

A

Yes

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4
Q

Which enzyme primarily degrades alcohol

A

Alcohol dehydrogenase

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5
Q

Which enzyme can system can be used to degrade alchol when it reaches levels above 100 mg/dl

A

Microsomal Ethanol Oxidizing System

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6
Q

What is disulfiram

A

• Disulfiram (Anti-abuse) inhibitor of ALDH so accumulate acetaldehyde so that get very sick and hope that will deter the patient

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7
Q

BAC for intoxication/can’t drive

A

0.08%

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8
Q

Name any 5 signs of chronic alcohol use

A 
•	Macrocytic anemia (folate deficiency)
•	Protein malnutrition
•	Neurotoxicity
o	Cognitive impairment & executive function & social abilities
o	Increased risk of relapse
•	Wernicke-korsakoff Syndrome
o	Ophthalmoplegia (paralysis of the EOM), nystagmus, Ataxia, confusion
o	Treat thiamine
•	Korsakoff’s Psychosis
o	Anterograde and retrograde amnesia
o	Confabulation
o	Lack of Insight
o	Apathy
o	Treat thiamine
•	Alcohol hepatic
•	Increased gastritis
•	Pancreatitis
•	Decreases absorption of water-soluble vitamins
•	Cardiac: cardiomyopathy, arrhythmias, HTN, CHD)
•	Oral pharynx cancers
•	Fetal alcohol syndromes
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9
Q

• Wernicke-korsakoff Syndrome

A 
o	Ophthalmoplegia (paralysis of the EOM), nystagmus, Ataxia, confusion
o	Treat thiamine
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10
Q

• Korsakoff’s Psychosis

A 
o	Anterograde and retrograde amnesia
o	Confabulation
o	Lack of Insight
o	Apathy
o	Treat thiamine
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11
Q

Toloerence

A

A. Tolerance
• Acclimation to drinking over time
• Induction of hepatic enzymes
• Neuro-adaptation by GABA, glutamate & dopamine pathways

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12
Q

Alcohol withdrawal - what happens neuronally?

Which part or brain most effected by chronic EtOH exposure?

A

• Glutamate storm
• GABA production had been suppressed by alcohol
• Locus coeruleus effected by chronic ETOH (DA → NE→ , P) so when you stop:
o  intrinsic GABA activity: neuromuscular excitation: tremor, seizures
o  dopamine activity: anhedonia, lack of motivation, dysphoria
o Compensatory  GABA,  glutamate,  dopamine
o Receptor density:  GABA-A,  NMDA,  DA
• Delirium & hallucinations
• 3-4 days

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13
Q

Treatment options for acute alcohol withdrawl

A
  • Banana (glucose, multivitamins, folate, potassium)
  • Benzodiazepines (lorazepam, oxazepam)
  • Chlordiazepoxide or diazepam
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14
Q

Name two anti-convulsant that are not FDA approved but can be used to treat alcohol dependence

A

Gabapentin

Topiramate

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15
Q

Name 2 benzodiazpines that can be used to treat alcohol ddpendence

A

Lorazepam

Chlordiazepoxide

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16
Q

Which drug is used in alcohol dependence couples therapy?

How long is it effective?

What ust be moitered/SE

A

Disufiram

•	Blocks Aldehyde dehydrogenase causing an instant hangover
•	COUPLES THERAPY
•	5-10minures onset
•	Not effective post 1 year
•	
•	Hepatitis
•	Peripheral neuropathy
•	Neuropsychiatric changes
•	CAD
H
17
Q

Name an opiod antagonist that can be used to treat alcohol dependence

A 
Naltrexone
•	Opioid antagonist
•	µ-opioid receptor antagonist
•	Monthly injection
•	Liver
•	Inhibits opiates
•	Nausea
18
Q

Excluing benzodiazapines, name another Gaba agonist that can be used to treat Alcohol dependence

Class
Mechanism
Metabolized y/n
Which patient populations would you use cauin in before prescribing his drug?

A 
Scram postage
•	GABA analogue
•	NMDA antagonist
•	GABA agonist
•	Restore serotonergic, noradrenergic & dopamine receptor
•	Renal excretion
•	Not metabolized
•	Caution in depressed
•	Caution in renal impairment
19
Q

First choice for acute therapy of alcahol depndence

A

• Acute therapy: thiamine, glucose, MVI, folate, BZD

20
Q

First choice for chronic/outpatient therapy of alcohol dependence?

A

Naltrexone IM, topiramate

21
Q

Which drug can be used to treat alcohol dependence if the patient has liver failure

A

acamprosate

Year II Pharmacology (14 decks)

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