Alcohols and drugs of abuse Flashcards
Where is over 80% of alcohol absorbed?
Duodenum-jejunum
What is the breakdown pathway for alcohol?
Alcohol is broken down by alcohol dehydrogenase to acetaldehyde. Acetaldehyde is broken down aldehyde dehydrogenase to acetate.
What are the kinetics of alcohol absorption?
Zero order
What impact does metronidazole have on alcohol breakdown?
Inhibits aldehyde dehydrogenase
What roles do: acamprosate, nalmafrene, naltrexone in the pharmacological maintenance of abstinence?
Acamprosate- stabilises GABA and glutamate Nalmafrene- Opioid receptor modulator Naltrexone- Maintenance support
What are the principles of management for stimulant overdose?
Diazepam 10mg/IV as necessary Active cooling Dantrolene- interferes with Ca2+ efflux in skeletal muscle fibres
What is the management of hyperthermia due to stimulant overdose?
Active cooling and possibly dantrolene (interferes with calcium efflux in skeletal muscle cell, reducing contraction)
Is the half life of naloxone short or long?
Short (30-60 mins)
What are the features of synthetic cannabinoids?
Nausea and vomiting • Sinus tachycardia • Coma (transient) • Acute respiratory failure • Agitation, paranoia • Seizures • Rarely MI, stroke, AKI
What criteria need to be satisifed to say someone is dependent on ACOHOL?
– needs 3 of 7 conditions over 12 months: tolerance; withdrawal symptoms; ingestion in larger amounts; persistent desire; expenditure of increasing time in drinking / recovering; abandoning social/work activities; continued ingestion despite problems
How does the DCM classify alcohol use disorder?
DSM–5 integrates alcohol abuse and alcohol dependence, into alcohol use disorder (AUD) mild, moderate, or severe subclassifications
What is the clearance rate of alcohol?
6g/H
What are the blood alcohol contents for oblivion, staggering, loss of self control, risk-taking behaviour, mood changes and accident risk?
400, 200, 150, 80, 50,30
What are the components of the CAGE questionnaire?
Cut-down amount of drinking Annoyed by criticism Guilty feelings about drinking Eye-opener in the morning
What is the timecourse for emergence problems with alcohol withdrawal?
6-12 hours- Insomnia, tremulousness, anxiety, gastrointestinal upset, headache, diaphoresis, palpitations, anorexia
12-24 hours- Alcoholic hallucinosis: visual, auditory, or tactile hallucinations
24-48 hours- withdrawal seizures: generalized tonic-clonic seizures
48-72 hours- Delirium tremens: hallucinations disorientation, tachycardia, BP, mild fever, agitation, diaphoresis
