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Pharm Exam 4 - Class Review > ch 33 > Flashcards

ch 33 Flashcards

1
Q

2 effects of alcohol on the brain

A

depression of CNS

activation of reward circuit

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2
Q

Three target proteins that alcohol interacts with

A

GABA
Glutamate
5HT3

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3
Q

rewarding effects of alcohol

A

result from binding with 5HT3 receptors in the brains reward circuit. when these receptors are activated, they promote release of dopamine, the major transmitter of the reward system. When alcohol binds with the receptors, it enhances serotonin-mediated release of dopamine and intensifies the reward process.

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4
Q

what is the major reward neurotransmitter

A

dopamine

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5
Q

characterized by confusion, nystagmus, abnormal ocular movements

A

Wernicke encephalopathy

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6
Q

characterized by polyneuropathy, inability to convert short-term memory into long term memory and confabulation (unconscious filling of gaps in memory with fabricated facts and experiences)

A

Korsakoff psychosis

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7
Q

which neuropsychiatric syndrome is not reversible

A

Korsakoff psychosis

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8
Q

Neuropsychiatric syndromes are caused by what deficiency

A

thiamin from poor diet and alcohol induced suppression of thiamin absorption

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9
Q

cerebral effect excessive alcohol

A

enlargement of cerebral ventricles in response to atrophy of the cerebrum itself. - may reverse in some individuals with cessation

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10
Q

alcohol consumption to preserve cognitive function

A

low to moderate in older people may protect against the development of dementia.

red wine only - Resveratrol is responsible

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11
Q

alcohol effect on sleep

A

disruptive

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12
Q

Alcohol acute for cardiac

A

dilation of cutaneous blood vessels increasing blood flow to skin

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13
Q

alcohol abuse and heart affects

A

direct damage to myocardium -> increased r/o heart failure

major cause of cardiomyopathy

dose dependent elevation of blood pressure

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14
Q

moderate drinking women

A

1 drink a day or less

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15
Q

moderate drinking men

A

2 or less a day

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16
Q

moderate drinking is associated with

A

less ischemic stroke
CAD
MI
heart failure

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17
Q

heavy drinking is defined as

A

5 or more a day

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18
Q

heavy drinking and cardiac

A

increases risk of heart disease and stroke

19
Q

moderate drinking protects against heart disease by

A

raising levels of HDL

20
Q

what type of cholesterol protects against CAD

A

HDL

21
Q

what type of cholesterol promotes CAD

A

LDL

22
Q

Of all of the agents that can raise HDL, what is the most effective

A

alcohol

23
Q

How does alcohol offer heart protection

A

decreases platelet aggregation
decreases levels of fibrinogen
increases levels of tissue plasminogen
suppresses inflammatory component of atherosclerosis

24
Q

cardiac protection is determined primarily by

A

amount of alcohol consumed
and the pattern of drinking
NOT what you drink

25
Q

protection is greater for people who drink

A

moderately - 3-4 days a week as opposed to 1-2.

26
Q

cardioprotection is greater for those with an ____ lifestyle

A

unhealthy - up to 50% reduction in risk

for those who eat fruits, vegetables, do not smoke - alcohol has little or no effect on incidence of coronary events

27
Q

alcohol metabolizes at what rate

A

constant rate no matter how you drink

15 mL per hour (0.5 oz)

1 drink per hour (practical)

28
Q

enzyme that metabolizes alcohol is

A

alcohol dehydrongenase

29
Q

alcohol ____ BP

A

raises

low to moderate may help
heavy drinking will cause HTN

30
Q

Alcohol overdose symptoms

A

vomiting
coma
hypotension
resp depression

vomiting plus unconsciousness can cause aspiration -> pulmonary obstruction and pneumonia

alcohol induced hypotension results from a direct on the peripheral blood vessels and cannot be corrected with vasoconstrictors (epi)

hypotension -> renal failure -> cardiovascular shock -> death

do not give stimulants such as caffeine -> seizures

31
Q

a chronic, relapsing disorder characterized by impaired control over drinking, preoccupation with alcohol consumption, use of alcohol despite awareness of adverse consequences and distortions in thinking

A

alcohol use disorder

32
Q

the development of alcohol use disorder is influenced by what factors

A

genetic
psychosocial
environmental

33
Q

aging ____ body’s tolerance for alcohol

A

lowers

34
Q

what drug does not have a cross dependence for alcohol

A

opioids

35
Q

benzodiazepines used most often for alcohol withdrawal

A 
chlordiazepoxide
clorazepate (Tranxene)
oxazepam 
Lorazepam
Diazepam

fixed schedule or PRN can be effective

36
Q

adjuncts to benzodiazepines for alcohol withdrawal

A

carbamazepine (antiepileptic)

clonidine (Alpha adrenergic agonist)

atenolol and propranolol (b blockers)

37
Q

drugs used to maintain alcohol abstinence

A

Naltrexone (Vivitrol) - blocks reward circuit

Acamprosate - helps with anxiety and tension during abstinence

Disulfiram (Antabuse) - makes deathly ill

38
Q

Naltrexone (Vivitrol) adverse effect

A

cannot be dependent! will precipitate withdrawal!

nausea
headache
anxiety
sedation

39
Q

Disulfiram (antabuse) side effects

A 
nausea
copious vomiting
flushing
palpitations
headache
sweating
thirst
chest pain
weakness
blurred vision
hypotension -> shock-> death
cardiac dysrhythmias
resp depression
cardiovascular collapse
Congestive heart failure
death
40
Q

Disulfiram effects can last from

A

30 min to several hours

41
Q

Cross tolerance to alcohol is associated with

A

general anesthetics and other CNS depressants but not opioids

42
Q

Abstinence syndrome occurs how long after last drink

A

12 - 72 hours

43
Q

What OTC med is contraindicated in chronic alcohol abusers

A

Tylenol - Liver

Pharm Exam 4 - Class Review (14 decks)

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