Alcohol/psych drugs Flashcards
Alcohol causes metabolic acidosis or alkalosis?
Metabolic acidosis
What is the end product of ethylene glycol metabolism and what organ does it affect?
Glycolic and oxalic acid/kidney damage
What is the product of methanol metabolism and what damage does it do?
Methanol—>formaldehyde—>formic acid
Ocular damage
What is ethanol metabolism pathway?
Ethanol—(alcohol dehydrogenase)—>acetaldehyde (hangover)—(acetaldehyde dehydrogenase)—>acetic acid
What is the antidotes for methanol and ethylene glycol overdose?
Ethanol (best substrate for alcohol dehydrogenase)
Fomepizole—>inhibitor of alcohol dehydrogenase
What is the mechanism of disulfram?
Inhibit acetaldehyde dehydrogenase—>accumulation of acetaldehyde—>nausea vomiting
What other drugs have disulfram like affect?
Metronidazole
What drug is used for alcohol withdraw and what are used to prevent Wernicke syndrome?
Long acting benzo
Thiamine and folic acid
What are the DA and ACh level in substantial nigra of Parkinson’s disease?
What about the DA and 5HT level in mesolimbic tract of psychosis?
What about NE and 5HT level in depression?
Parkinson’s—>decreased DA/increased ACh
Psychosis—>increased DA and 5HT
Depression—>decreased NE and 5HT
What are the uses for SSRI? what is its major side effect?
Depression/OCD/bulimia/chronic anxiety/PTSD
Sexual dysfunction—>aorgasm/decrease libido
Watch for serotonin syndrome
Which SSRIs are P450 inhibitors? what is their drug interaction? and which SSRI is safer in terms of drug interaction
Fluoxetine and fluvoxamine
Increase level of benzo
Citalopram
What is the mechanism of TCAs? what do you use it for?
NE and 5HT reuptake inhibitor
Diabetic or postherpetic neuralgia
Enuresis (bed wetting)
What are the drugs that are used for diabetic or postherpetic neuralgia?
TCAs/gabapentin/pregabalin
What other receptors do TCA block?
Antimuscarinic/alpha 1 blockers/antiH1—>sedating
The 3Cs of TCA toxicity?
Coma/convulsion/cardiotoxicity (also cause torsades)