Ethanol

Question 1

Ethanol Absorption

Answer 1

• rapid throughout GI tract

- presence of food slows absorption rate

Question 2

Ethanol Distribution

Answer 2

• distributed in total body water (TBW)
• placenta is permeable
• initial CNS effects in 5 mins, peak effects 15-60 min

Question 3

Ethanol metabolism generates:

Answer 3

• NADH

- NADH promotes production of lactate from pyruvate, leading to lactic acidosis

Question 4

Metronidazole Effects with EtOH

Answer 4

-similar to antabuse

Question 5

Alcohol Withdrawal Syndrome Tx

Answer 5

• BDZs (chlordiazepoxide, lorazepam)

- a2 adrenergic agonists (clonidine)

Question 6

Reducation of Alcohol Consumption

Answer 6

• Alc sensitizing drugs: disulfiram (antabuse)
• opioid antagonists: naltrexone
• NMDA receptor drugs: acamprosate

Question 7

Antabuse

Answer 7

• reaction-flushing, headache, nausea, dizziness, tachycardia
• supervision necessary
• side effects: metallic taste, headaches, fatigue, optic neuritis, peripheral neuropathy, hepatitis, rash
• DDI: alcohol, metronidazole, amitriptyline, phenytoin, etc.
• contraindications: MI, CVA, cognitive dysfunction, pregnancy, breast feeding

Question 8

Naltrexone

Answer 8

• pure opioid antagonist
• blocks mu opioid receptors
• side effects: nausea, headaches, anxiety, sedation, hepatic failure
• contraindications: pregnancy, breast feeding, hepatic failure, opioid withdrawal, hypersensitivity possible
• DDIs: opioid analgesics, antidiarrheals, opioid containing cough medicines

Question 9

Campral (acamprosate)

Answer 9

• structurally resembles GABA
• enhances GABA transmission
• interferes with Glu transmission
• reduces CNS hyperexcitability
• contraindications: hypersensitivity, severe renal impairment, pregnancy category C
• side effects: diarrhea, anxiety, depression, insomnia, suicidality

Question 10

Levels of NADH

Answer 10

• krebs activity- gluconeogenesis

- hypoglycemia

Question 11

Blood Lactate

Answer 11

• acidosis

- behavioral disturbances

Question 12

Mg++ Excretion

Answer 12

-can lead to convulsions

Question 13

Acetyl CoA

Answer 13

• FA synthesis

- fat breakdown-> fatty liver

Question 14

Uric Acid Excretion

Answer 14

-may precipitate gout attacks

Question 15

Delerium Tremens

Answer 15

• can be lethal

- occurs 2-8 days after initial withdrawal