Alcohols

Question 0

what enzyme converts acetaldehyde to acetate. and inhibited by what drug?

Answer 0

enzyme: aldehyde dehydrogenase

inhibited by: disulfiram

Question 1

What enzyme converts ethanol to acetaldehyde? and inhibited by what drug?

Answer 1

enzyme: alcohol dehydrogenase

inhibited by: fomepizole

Question 2

because of the limited supply of coenzyme NAD+; the reaction for ethanol metabolism has _______ order kinetics

Answer 2

Zero-order kinetics

*fixed capacity for ethanol metabolism is 7-10g/h

Question 3

why is there lactic acidosis and hypoglycemia in ethanol ingestion?

Answer 3

increased metabolism – diverts pyruvate to lactate and OAA to malate
inhibited gluconeogenesis – hypoglycemia
lactate – acidosis
malate – fatty acid synthesis
dec. OAA – ketone production

Question 4

what is responsible for ethanol metabolism at blood levels > 100mg/dl?

Answer 4

MEOS - microsomal ethanol oxidizing system

Question 5

most common complication of chronic alcohol abuse

Answer 5

liver disease

Question 6

what is the result of CNS adaptation and increased ethanol metabolism?

Answer 6

tolerance and dependence

• cross tolerance with bdz and barbs

Question 7

most common neurologic abnormality in chronic alcoholics

Answer 7

peripheral neuropathy

Question 8

what neurologic condition is seen in chronic alcoholics and presents as ataxia, confusion and ophthalmoplegia?

Answer 8

Wernicke-Korsakoff syndrome

• also seen in thiamine deficiency

WEIRD ACO wernicke - Ataxia Confusion Ophthalmoplegia

Question 9

what changes in the brain is seen in wernicke korsakoff syndrome?

Answer 9

hemorrhagic necrosis of the mammillary bodies

Question 10

complication of wernicke korsakoff syndrome

Answer 10

Korsakoff Pyschosis
irreversible memory loss
confabulation
personality changes

Question 11

A pregnant woman had heavy consumption of alcohol on her first trimester, what fetal complication may be expected?

Answer 11

Fetal Alcohol Syndrome
  mental retardation (most common)
  growth deficiencies
  microcephaly
  underdeveloped midface region

Question 12

what is the DOC for Alcohol Withdrawal Syndrome?

Answer 12

long-acting benzodiazepine

if with compromised liver function - use short acting bdz

Question 13

neurologic condition associated with acute alcohol withdrawal syndrome

Answer 13

Delirium Tremens
HAD-48
   hallucinations
   autonomic instability (unstable vs)
   delirium
    48-72 hours post discontinuation

Question 14

how do u treat alcohol withdrawal syndrome?

Answer 14

correct electrolyte imbalance
administer thiamine
administer sedativehyponotics

Question 15

an opioid receptor antagonist used in treatment of alcoholism

Answer 15

naltrexone

Question 16

NMDA receptor antagonist used to treat alcoholism

Answer 16

Acamprosate

Question 17

what drugs can cause disulfiram reaction?

Answer 17

Clara took the Pre-Medical Test in the PM
Chlorpropamide
Cefo perazone 
         mandole
         tetan
Procarbazine
Metronidazole

Question 18

what is the most common symptom seen in methanol exposure?

Answer 18

visual dysfunction

Question 19

cite the methanol metabolism

Answer 19

methanol -(alc dehy)- formaldehyde -(ald dehy)- formate —co2 h2o

accumulation of formaldehyde and formic acid
- severe acidosis, retinal damage, blindness

Question 20

what causes the severe acidosis and retinal damage in ethylene glycol poisoning?

Answer 20

accumulation of oxalic acid

ethylene glycol —> oxalic acid

Question 21

what is the treatment of methanol/ethylene glycol poisoning?

Answer 21

Ethanol - competes for oxidation by alcohol dehydrogenase

Fomepizole - slows or prevents formation of formaldehyde/oxalic acid

Question 22

what is the drug that acts as a preferred substrate for alcohol dehydrogenase?

Answer 22

ethanol