Ch 18 - Alcohol and Other Drug Abuse - DONE Flashcards
Name three types of alcohol:
- ethanol
- methanol
- ethylene glycol
What is ethanol´s mechanism of action?
Ethanol is a CNS depressant that works through γ-aminobutyric (GABA) receptors to enhance the GABA-mediated synaptic transmission.
What is ethanol metabolised to?
acetaldehyde
Which enzymes are responsible for the first steps in the metabolism of ethanol?
(READ MORE page 139)
- Alcohol dehydrogenase
- Microsomal ethanol oxidizing system (MEOS)
What is acetaldehyde further metabolised into?
acetaldehyde is converted into acetic acid by aldehyde dehydrogenase
Are there therapeutic indications for ethanol use?
READ MORE PAGE 140
Yes.
- Methanol overdose
- Ethylene glycol overdose
- One alcohol drink (red wine) a day may reduce the risk of coronary artery disease
What are the acute effects of ethanol intoxication?
- euphoria
- disinhibition
- slurred speech
- reduced visual acuity
- ataxia
- relaxation of vascular and uterine smooth muscle
- blood alcohol greater than 300mg/dL can lead to loss of consciousness and decreased myocardial action
- blood levels greater than 400mg/dL can be fatal
What are the chronic CNS effects of alcoholism?
A deficiency of thiamine associated with chronic alcohol use can lead to Wernicke-Korsakoff syndrome.
- This disease is characterised by opthalmoplegia, ataxia, and confusion.
What are the chronic peripheral effects of alcoholism?
- Decreased liver and pancreatic function
- GI irritation, inflammation, and bleeding
- Gynecomastia and testicular atrophy in men due to cirrhotic liver´s inability to metabolise Estrogen
- Hypertension
- Dilated cardiomyopathy
- Can lead to increased risk of GI cancers even tho it is not carcinogenic
Why is it unsafe for pregnant women to drink alcohol?
Ethanol use during pregnancy can lead to fetal alcohol syndrome, which includes:
- mental retardation
- growth deficiencies
- microencephaly
- malformations of the face and head
DTs =
Delirium Tremens
What are “the DTs”?
Delirium Tremens:
- tremor
- anxiety
- delusion
- agitation
These symptoms are experienced by chronic alcohol users who are suddenly deprived of ethanol
What is Disulfiram?
an aldehyde dehydrogenase inhibitor
What is Disulfiram used for?
- Disulfiram is used adjunctively in some alcohol treatment programs.
- Patients who drink while taking Disulfiram while experience nausea, hypotension, and vomiting.
- These adverse symptoms encourage avoidance of alcohol.
Which drugs are well known to cause disulfiram-type reaction when used in conjunction with alcohol?
- Metronidazole
- The cephalosporins
- Procarbazine
What is the management of alcohol toxicity?
In the acute phase, the patient is stabilized with supportive therapy such as fluids, thiamine, and electrolyte balancing.
- Long-time detox may include a long-acting sedative with gradual tapering of the dose.
What is Phencyclidine?
- Phencyclidine is a dissociative anesthetic that blocks N-methyl, D-aspartic acid (NMDA) receptors.
- It is also a Ketamine analogue.
PCP =
Phencyclidine
Angel dust =
Phencyclidine
What is the mechanism of action of Phencyclidine?
Phencyclidine block serotonin (5-HT) uptake
What are the central physiological actions of PCP?
- PCP causes a Schizophrenia-like psychosis involving distortion of time, space, and body image.
- Extremely high doses of PCP can cause seizures and coma
What are the peripheral physiological effects of PCP?
- increased BP and HR
- limb numbness
- ataxia
- hypersalivation
- nystagmus
LSD =
lysergic acid diethylamide
How does the LSD (lysergic acid diethylamide) work?
LSD interacts with 5HT receptors in the midbrain
