Alcohol Use and Abuse (PHARM)

Question 1

administration of ___ will prevent the metabolism of methanol or ethylene glycol

Answer 1

ethanol (compettive inhibitor) or fromepizole

Question 2

MOA Fomepizole

Answer 2

inhibits alcohol dehydrogenase

Question 3

MOS Disulfiram

Answer 3

inhibits adehyde dehydrogenase
**used to encourage abstinence from alcohol bc it allows for the accumulation of intermediate (acetaldehyde) which leads to nausea and flushing

Question 4

difference in metabolism in chronic alcoholic

Answer 4

chronic alcohol use induces CYP actions

Question 5

why do some alcoholics find acetaldyhyde pleasureable (and therefore like disulfram)

Answer 5

promotes DA release and condenses with DA to form salsolinol (an agent that reinfoces behavior (i.e. drinking)

Question 6

why does alcohol and acetaminophen not mix

Answer 6

ethanol induces CYP which metabolizes acetaminophen to hepatotoxic intermediated NAPQI (which accumulates bc the reaction to convert NAPQI becomes depleted)

Question 7

MOA of N-acetyl cysyeine

Answer 7

provides fresh conjugate substrate for NAPQI to be detoxified

Question 8

Effect of ethanol on GABA

Answer 8

inc its release and receptor density

Question 9

effect of ethanol on NMDA

Answer 9

inhibit post synaptic receptors

Question 10

effect of ethanol on DA

Answer 10

increase release and effected in VTA

Question 11

effects of ethanol on ATCH

Answer 11

inc levels of it in the blood

Question 12

effects of ethanol on opiod

Answer 12

release of Beta endorphins and activation of mu receptors

Question 13

effects of ethanol on 5-HT

Answer 13

inc 5-HT in synaptic space

Question 14

more fat content correlate to higher or lower BAL

Answer 14

higher bc ethanol does not distribute to adipose

Question 15

effects of chronic alcoholism on the liver

Answer 15

dec gluconeogenesis--> hypoglycemia
fatty liver (hepatitis and chirrosis)

Question 16

effects of chronic alcoholism on the GI tract

Answer 16

bleeding ans scaring –> abs an nutritional def

Question 17

effects of chronic alcoholism on the CNS

Answer 17

peripheral neuropathy

Werike-Kosakoff syndrome = ataxia, confusion, ocular muscle paralysis

Question 18

effects of chronic alcoholism on endocrine sys

Answer 18

dec steroid production –> gynocomastia and testicular atrophyy

Question 19

Fetal Alcohol Syndrome is characterized by

Answer 19

IU growth retardation 
Microcephaly
Poor coordination 
flattened face (midfacial underdevelopment) 
minor joint abnormalities

Question 20

treatment for intoxicated pt vs withdrawing pt (from alcohol)

Answer 20

intox: thamine then D50 then correct electrolytes
withdrawal: BNZ sedative (diazepam or laorazepam if hepatic function compromised (has shorter t1/2 due to metabolism by glucuronidation))

Question 21

drugs that have disulfram effects

Answer 21

sufonylureas, ceftotetan, ketoconazole, and procarbazine

Question 22

MOA and effect of Naltrexone

Answer 22

mu opioid antagonist to de the feelings of reward or cravings

Question 23

MOA and effect if Acamprostate

Answer 23

activator of GABA receptors and weak NMDA antagonist

dec reinforcement/reward

Question 24

How is NAPQI detoxified

Answer 24

conjugated to cysteine or mercapturic acid

Question 25

what BAL is needed to cause coma, resp insuff, and death

Answer 25

> 400 mg/dL

Question 26

What BAL is needed to cause limited muscle in coordination? pronounced incoordination? ataxia?

Answer 26

< 50
50-100
150-400

Question 27

at what BAL will you see mood and personality changes

Answer 27

100-150

Question 28

what is the mech behind blackouts?

Answer 28

NMDA/glutamate receptor inhbibition by the ethanol

Question 29

why is thiamine given before D50?

Answer 29

if not can exacerbate wernikie-korsakoff syndrome

Question 30

What areas of the brain are activated to reinforce alcohol addiction via activation of reward

Answer 30

VTA and nucleus accumbans

Question 31

competitive alcohol dehydrogenase inhibitor

Answer 31

fromepizole (prevent met of alcohols)