Ethanol

Question 1

• Alcohol distributes to?
• Time to CNS effects? Peak effects?
• Liver metabolism: 0 order? 1st order? Then to? 3 steps? NAD+ turned to twice? Disrupted metab? (5)
• MOA of antabuse? Leads to?
• Ethanol effects on liver? kidney? fetus? 1st tri? 2nd? 3rd?
• Cross tolerance with?

Answer 1

• High blood flow area
• 5 min; 15-60min
• ADH; Mixed P4502EI; Acet. acted on by ald. deh; Ethanol, acetaldehyde, acetic acid; NADH
  1. ) High NADH = Low gluconeogenesis = hypoglycemia
  2. ) High Lactate = Acidosis
  3. ) High Mg excretion = convulsion
  4. ) High Acetyl CoA = Fatty liver
  5. ) Lower uric acid excretion = gout
• Ald. Deh. inhibitor; High acetaldehyde
• Incr. bleeding time; inhibits ADH release; morph altered; miscarriage risk; less growth

Question 2

• Withdrawal: Early/minor? Late/major?
• BDZ treatment? (2) Clonidine moa? Used for?
• 3 drugs for reducing consumption? (MOA)
• Effect with ASA? Metronidazole AB? Hypoglycemics?
• Wernickes symptoms? (3) Treat with?

Answer 2

• Risk of seizures; DT’s and life threatening but no seizures
• Lorazepam/chlordiazepoxide; a2 agonist autonomic hyperactivity
• Disulfirim; naltrexone (opoid antag); acamprosate (lower NMDA activation)
• Ulcers; disulfirim like for both
• Nystagmus, dementia ataxia; thiamine