Alcohol & Substance Abuse Flashcards
3 C’s that indicate alcohol use disorder
control, craving, consequences
alcohol is a CNS ___
depressant
how does alcohol have stimulatory effects
depression of inhibitory control mechanisms in the brain
alcohol targets which 4 systems to exhibit acute and chronic effects
GABA, DA, glutamate, and opioid peptide
ordered hierarchy of affected brain areas leading to CNS effects with alcohol
frontal cortex, cortex, cerebellum, diencephalon, brain stem/midbrain
sequence of response to alcohol (actual seen effects)
euphoria, impaired thought processes, decreased mechanical efficiency
acute effects of alcohol on GABA
enhances
acute effects of alcohol on glutamate
inhibits and reduces release
acute effects of alcohol on doapmine
increases firing rate
chronic effects of alcohol on GABA
reduces effectiveness (down regulates)
chronic effects of alcohol on glutamate
increases receptors (upregulates)
chronic effects of alcohol on dopamine
withdrawal decreases firing rate/release
which 2 organ systems are most affected by chronic alcohol use
CNS & liver
potential chronic CNS effects from alcohol
addiction, Wernicke’s, cortical atrophy, dementia
potential chronic liver effects from alcohol
steatosis/fatty liver, alcohol hepatitis, cirrhosis, pancreatitis.
how is alcohol absorption affected by food? changes in women?
food delays absorption
women have less breakdown before absorption so higher bioavailability
distribution of alcohol is equal to
total body water
alcohol follows __ metabolism via __ and is primarily __
zero order/capacity limited
alcohol dehydrogenase
oxidized
minor signs of alcohol withdrawal occur within
5-10 hours
symptoms of minor alcohol withdrawal
autonomic hyperactivity: tremulousness, hyperhidrosis, tachycardia, HTN, GI upset
anxiety, insomnia, vivid dreams, anorexia, diaphoresis, palpitations, HA
major alcohol withdrawal effects occur within
12-72 hours
symptoms of major alcohol withdrawal
hallucinations, seizures
when does delirium tremens occur with alcohol withdrawal
48-96 hours
symptoms of delirium tremens in alcohol withdrawal
disordered consciousness, hallucinations, disorientation, tachycardia, HTN, fever, agitation, elevated cardiac indices, hyperventilation, etc.
which agents are used for management/prophylaxis of alcohol withdrawal
thiamine, D5 & 1/2NS, multivitamins, diazepam, lorazepam, or other benzos
agents used to maintain sobriety from alcohol
naltrexone
acamprosate
disulfiram
baclofen
gabapentin
topiramate
used for alcohol sobriety and blocks opioid receptors, given IM or PO
naltrexone
AEs of naltrexone
nausea, HA, dizziness, insomnia, anxiety