Alcohols Flashcards
What are the drugs used to treat alcohol dependence?
DNA
Disulfiram
Naltrexone
Acamprosate
What is alcohol dehydragenase?
A cytosolic, NAD+ dependent enzyme, found in the liver and gut
Metabolizes ethanol following zero-order kinetics due to limited supply of NAD+
Pathyphysio of lactic acidosis and hypoglycemia in excess ethanol intake
Ethanol metabolism -> decreased NAD+ supply
Increased NADH:NAD+ ratio
Increased pyruvate -> lactate (+NAD)
Increased OOA -> malate (+NAD)
Inhibited gluconeogenesis + FA stimulation -> hypogly + hepatic fatty change
What is MEOS?
Microsomal Ethanol Oxidizing System
-metabolize ethanol levels greater than 100mg/dL
What drugs inhibit aldehyde dehydrogenase?
CDHM Cephalosporins Disulfiram Hypoglycemics Metronidazole
Wernicke-Korsakoff Syndrome triad
“Weird ACO”
Ataxia
Confusion
Ophthalmoplegia
What brain changes is seen in WKS?
Hemorrhagic necrosis of the mamillary bodies
What is the recommended amount of alcohol intake per day to increased HDL levels and protect against CAD?
10-15g/day
What are the measures done in excessive CNS depression?
Maintain vital signs Aspiration precaution IV dextrose Thiamine Electrolyte correction
What are the characteristics of delirium tremens?
HAD 48 Hallucinations Autonomic instability Delirium 48-72hours post-discontinuation
What is the drug of choice for alcohol withdrawal syndrome?
Long-acting benzodiazepine (diazepam, chlordiazepoxide)
Short-acting benzodiazepine (Lorazepam) for patients with compromised liver function
What is the mode of action of drugs for alcohol dependence?
D-isulfiram: aldehyde dehydrogenase inhibit
N-altrexone: dec CNS effects of endogenous opioid peptides
A-camprosate: NMDA receptor antagonist
What are some of the features of methanol toxicity?
Severe acidosis
Retinal damage
Blindness
Treatment of methanol toxicity?
Ethanol: competitive substrate for alcohol dehydrogenase
Fomepizole: inhibits alcohol dehydrogenase
Ethylene glycol, used as antifreeze, may be toxic due to what? What are the clinical manifestations of toxicity?
Accumulation of oxalic acid
Renal damage, severe acidosis
