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Psych > Alcohol use & abuse > Flashcards

Alcohol use & abuse Flashcards

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1
Q

ethanol metabolism

Same for ethanol & ethylene glycol

A

via OH-H2ase to acetaldehyde
then via ALDH2ase to acetate

methanol … formaldehyde … formic acid
ethylene glycol … … oxalate

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2
Q

disulfram (& 4 things w/similar fx)

A

inhibits ALDH2ase

sulfa drugs, cefotetan, ketoconazole, procarbazine
“SiCK Pee”

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3
Q

formepizole

A

inhibits alcohol dehydrogenase - used for methanol/ethylene glycol/other alcohol poisoning. Original alcohols slowly filtered by kidneys.

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4
Q

chronic alcoholism vitamin deficiency

A

Thiamine (B1), causes Wernike-Korsikoff syndrome (ataxia, eye movement abnormalities, obdundation - can’t see, walk or think straight)

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5
Q

treat DTs

A

thiamine, (maybe dextrose?), BNZ

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6
Q

drinking cessation aids

A

disulfram (sick when drinking)
naltrexone (mu-opioid ant. take away the fun)
acamprosate (NMDA ant., activate GABAR)

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7
Q

naltrexone

A

(mu-opioid ant. take away the fun for drinkers)

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8
Q

acamprosate

A

(NMDA ant., activate GABAR)

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9
Q

ALDH21/22

A

mutation that gives azn flush, acetaldehyde

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10
Q

<50 BAL (mg/dL)

A

limited incoordination, need iodine swabs to check this low

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11
Q

50-100 BAL (mg/dL)

A

pronounced incoordination

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12
Q

100-150 BAL (mg/dL)

A

mood & personality changes, legal limit

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13
Q

150-400 BAL (mg/dL)

A

N/V, ataxia, amnesia, dysarthria (post-exam state)

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14
Q

> 400 BAL (mg/dL)

A

coma, resp insufficiency, death

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15
Q

Wernicke-Korsakoff syndrome

A

Ocular motor abnormalities, cerebellar dysfunction, altered mental state (give thiamine)

Can’t see, walk, or think straight = a drunk

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16
Q

alcoholics with acetaminophen - why a problem?

A

EtOH induces CYP2E1, which metabolizes acetaminophen to NAPQI (toxic).

Tx N-acetylcysteine (serves as substrate to conjugate NAPQI to nontoxic metabolyte)

17
Q

EtOH elimination
distribution
M vs F

A

In liver: EtOH –> acetaldehyde –> actate (via alcohol & aldehyde dehydrogenase, respectively) zero-order. Distribution in water only, so high body fat –> lower tolerance relative to weight (F).

18
Q

EtOH actions/rewards

A 
Upregulates: 
GABA (increases release & receptor density)
DA (NA/VTA)
ACTH (CNS & blood levels) 
Opioid (beta endorphins, activates mu receptors)
5-HT
Cannabanoid activity
Postsynaptic NMDA INHIBITION

Smooth muscle relaxation, vasodilation, CV depression.

DA activity in VTA/NA related to rewards

Psych (8 decks)

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