depressants

Question 1

major inhibitory NT in CNS

Answer 1

GABA

Question 2

Barbiturates absorption

Answer 2

small intestine

Question 3

Barbiturates distribution

Answer 3

highly lipid soluble

fast rate of entry into CNS

Question 4

Barbiturates metabolism

Answer 4

slow

induce hepatic drug-metabolizing enzymes (Rx interactions)

Question 5

Barbiturates MOA

Answer 5

bind GABA-A receptor
increases duration of channel opening

high conc: directly activate
hella high conc: decrease release of other NTs

Question 6

Barbiturates effects

Answer 6

CNS depression
low therapeutic index
hypotension
anticonvulsant activity
not analgesic
reduce REM sleep
induce own metabolism

Question 7

Barbiturates dependence

Answer 7

psychological
physical

status epilepticus

abrupt withdrawal is life-threatening

Question 8

Methohexital

Answer 8

ultra-short acting BARB

anesthesia
short procedures

Question 9

Secobarbital

Pentobarbital

Answer 9

short/intermediate acting BARB

sedation
insomnia

Question 10

Phenobarbital

Answer 10

long acting BARB

epilepsy

Question 11

Barbiturates SE

Answer 11

CNS depressant
OD: death
contraindicated in acute intermittent porphyria

Question 12

Barbiturates Rx interactions

Answer 12

additive effects w/CNS depressants
cross-tolerance w/CNS depressants
induction of P450

Question 13

Ethanol absoprtion

Answer 13

GI tract

Question 14

Ethanol distribution

Answer 14

cross BBB

cross placenta

Question 15

Ethanol metabolism

Answer 15

liver
unchanged in urine
sweat

Question 16

alcohol dehydrogenase

Answer 16

oxidizes ethanol to acetaldehyde

Question 17

acetaldehyde dehydrogenase

Answer 17

oxidizes acetaldehyde to acetate

Question 18

Ethanol MOA

Answer 18

dissolves in neuronal embranes
enhances GABA inhibition
inhibits NMDA Glu-ergic

Question 19

Ethanol effects

Answer 19

CNS depression
heat loss (hypothermia)
vasodilation
depress myocardial contractility
stimulates gastric secretions
decreases testosterone
inhibits ADH secretion

Question 20

Ethanol dependence

Answer 20

psychological
physical

withdrawal: early awakening, anxiety, tremor, can be life-threatening

Question 21

delirium tremens

Answer 21

full-blown alcohol withdrawal syndrome

tremors, motor agitation, anxiety, hyperexcitability, hyperactivity, hyperthermia, hallucinations, toxic psychosis, seizures, death

15% chronic users

Tx: diazepam/clonazepam

Question 22

Ethanol SE

Answer 22

blackouts
death by hypothermia
peripheral nerve damage
cerebellar cortical degeneration
macrocytic anemia
iron deficiency
GI bleeding
nutritional deficiencies
pancreatitis
fatty liver
cirrhosis 15%
slow metabolism of other drugs

Question 23

Wernicke-Korsakoff syndrome

Answer 23

alcoholic encephalopathy
thiamine deficiency

confusion, abnormal ocular motility, ataxia, polyneuropathy, learning/memory problems

Question 24

fetal alcohol syndrome

Answer 24

deformities of face/head (midline), hydrocephaly, holoprosencephaly, prenatal growth deficiency, postnatal growth deficiency

Question 25

Ethanol Rx interactions

Answer 25

additive effect

acute: inhibit metabolism of other drugs
chronic: increase rate of drug metabolism

Question 26

Ethanol Tx

Answer 26

1) detoxification

2) abstinence

Question 27

Disulfiram

Answer 27

inhibits acetaldehyde dehydrogenase

Question 28

Methanol

Answer 28

acidosis, optic nerve damage, blindness

Tx: sodium bicarbonate, ethanol

Question 29

alcohol dehydrogenase

Answer 29

0th order kinetics