Chapter 23: Alcohols

Question 1

What sedative-hypnotic drug is the most important alcohol of pharmacologic interest?

Answer 1

Ethanol

Question 2

Ethanol has what type of elimination?

Answer 2

Zero-order elimination (kinetics)

1. Ethanol
2. Phenytoin (at high therapeutic or toxic concentrations)
3. Aspirin (at high therapeutic or toxic concentrations)

Question 3

Severe form of alcohol withdrawal whose main symptoms are sweating, tremor, confusion, and hallucinations

Answer 3

Delirium tremens (DTs)

Question 4

A syndrome of craniofacial dysmorphia, heart defects, and mental retardation (intellectual disability) caused by the teratogenic effects of ethanol consumption during pregnancy

Answer 4

Fetal alcohol syndrome

Question 5

A syndrome of ataxia, confusion, and paralysis of the extraocular muscles that is associated with chronic alcoholism and thiamine deficiency

Answer 5

Wernicke-Korsakoff syndrome

Question 6

At what level does the ingestion of modest quantities of ethanol raises serum levels of high-density lipoprotein (HDL) cholesterol (may protect against coronary heart disease)?

Answer 6

10–15 g/day

Question 7

What is the initial step in management of acute alcohol intoxication?

Answer 7

Correct thiamine before giving IV dextrose

Question 8

In intoxication of methanol, the alcohol is metabolized to what products, which causes severe acidosis, retinal damage, and blindness?

Answer 8

1. Formaldehyde

2. Formic acid

Question 9

In ethylene glycol poisoning, alcohol is metabolized to what toxic product?

Answer 9

Oxalic acid

Question 10

In order to reduce formation of formaldehyde in methanol intoxication, this should be administered intravenously.

MOA: an inhibitor of alcohol dehydrogenase, or ethanol, which competitively inhibits alcohol dehydrogenase oxidation of methanol

Answer 10

Fomepizole

Question 11

The intense craving experienced by those who are trying to recover from chronic alcohol abuse can be ameliorated by a drug that is an _____.

Answer 11

Antagonist of opioid receptors

Question 12

This is a competitive inhibitor of opioid receptors, decreases the craving for alcohol in patients who are recover- ing from alcoholism.

Answer 12

Naltrexone

Question 13

Catalyzes the conversion of alcohol to acetaldehyde

Answer 13

Alcohol dehydrogenase

Question 14

Catalyzes the conversion acetaldehyde to acetate

Answer 14

Aldehyde dehydrogenase

Question 15

What changes in the brain are seen in Wernicke-Korsakoff syndrome?

Answer 15

Hemorrhagic necrosis of the mamillary bodies

Question 16

What drugs can cause disulfiram reaction?

Answer 16

Mnemonic:
“Clara took the Pre-Medical Test in the PM”

1. Chlorpropamide
2. Procarbazine
3. Cefo Perazone
4. Cefo Mandole
5. Cefo Tetan
6. Metronidazole

Question 17

Symptoms of delirium tremens

Answer 17

Mnemonic:
“HAD-48”

1. Hallucinations
2. Autonomic instability
3. Delirium
4. 48-72 hours post-discontinuation

Question 18

Treatment for delirium tremens

Answer 18

Long-acting benzodiazepine:

1. Diazepam
2. Chlordiazepoxide

Question 19

Weak NMDA antagonist and GABAA receptor

activator used for alcohol dependence

Answer 19

Acamprosate