Ethanol and Drugs of Abuse

Question 1

define drug abuse

Answer 1

use of drug for non-therapeutic purposes to obtain euphoric mood

Question 2

define psychological dependence

Answer 2

strong urge to obtain drug to achieve euphoric mood

Question 3

define physical dependence

Answer 3

state of physiological adaptation to drug

results in withdrawal syndrome

Question 4

define tolerance

Answer 4

state of physiological adaptation to drug such that progressive higher doses are required to produce the desired effects

Question 5

alcohol/ethanol was initially a

Answer 5

‘social drug’

Question 6

what are the 4 therapeutic indication of ETOH?

Answer 6

1. irreversible nerve block or tumor destruction
2. topical reduction of body temperature
3. antiseptic
4. early anesthetic agent

Question 7

what are the effects of alcohol?

Answer 7

disinhibitor & euphoriant

Question 8

alcohols produces additive effects w/

Answer 8

• benzodiazepines
• barbiturates

Question 9

alcohol has additive effects through what reward pathway of the brain?

Answer 9

• dopaminergic “reward” pathway in the brain

Question 10

alcohol increases the synthesis or release of….

this leads to….

Answer 10

• endogenous opioid endorphins
• an increase of dopamine release

Question 11

in general ethanol acts via

Answer 11

modifying activity of ligand-gated ion channels

Question 12

with ethanol generally what is inhibited and facilitated?

Answer 12

• inhibited: cations (Na+, K+, Ca++)
• facilitated: anions (Cl-)

Question 13

alcohol is absorbed via

Answer 13

passive diffusion

Question 14

the distribution rate of alcohol is proportional to

Answer 14

blood flow

Question 15

high concentrations of alcohol reach the brain because of

Answer 15

• large amount of blood flow
• ease of membrane passage

Question 16

alcohol metabolism is rapid through a

Answer 16

high first pass effect

Question 17

what does the high first pass effect mean?

Answer 17

that more than 90% is metabolized by the liver

Question 18

the metabolism of alcohol occurs by what 2 enzymes in the liver?

Answer 18

1. ADH
2. ALDH

ADH: alcohol dehydrogenase
ALDH: aldehyde dehydogenase

Question 19

what do chronic alcoholics experience?

Answer 19

enzyme induction

Question 20

chronic alcoholics experience enzyme induction which indicates that

Answer 20

larger amounts of ethanol are required to reach a blood plasma concentration that will produce the desired effects

Question 21

ETOH is metabolized by

Answer 21

zero order kinetics

Question 22

what does zero order kinetics mean?

Answer 22

that its concentration independent and a constant amount is metabolized over time

Question 23

what is a drug that is used to discourage the use of alcohol?

Answer 23

disulfiram (Antabuse)

Question 24

why is disulfiram (Antabuse) effective in treating chronic alcoholism?

Answer 24

b/c it leads to an accumulation of acetaldehyde in the plasma which can be really painful to the individual

Question 25

what is the MOA for disulfiram?

Answer 25

it inhibits aldehyde dehydrogenase leading to the increase acetaldehyde

Question 26

what are the effects of disulfiram?

Answer 26

- flushing - sweating - nausea - tachycardia

Question 27

methanol uses what enzymes for metabolism?

Answer 27

- ADH - ALDH

Question 28

what are the metabolites produced from the metabolism of methanol?

Answer 28

- formaldehyde - formic acid

Question 29

what adverse effects are produced by formaldehyde & formic acid?

Answer 29

- blindness - abdominal and GI disturbances - acidosis - respiratory failure - coma & death

Question 30

what is the common antidote for methanol poisoning?

Answer 30

alcohol

Question 31

why is alcohol the antidote to methanol poisoning?

Answer 31

ETOH saturates the acetaldehyde enzyme b/c it has a higher binding affinity than methanol | prevents the formation of toxic metabolites

Question 32

what are the 6 primary side effects of alcohol toxicity?

Answer 32

1. GI 2. liver 3. pancreas 4. cardiovascular 5. kidney 6. neurological

Question 33

how is the GI affected by alcohol toxicity?

Answer 33

- bleeding ulcers - cancer - gastritis

Question 34

how is the liver affected by alcohol toxicity?

Answer 34

increased NADH leading to a fatty liver and cirrhosis

Question 35

how is the pancreas affected by alcohol toxicity?

Answer 35

pancreatitis

Question 36

how is the cardiovascular system affected by alcohol toxicity?

Answer 36

- hypertension - tachycardia - arrhythmias

Question 37

how are the kidneys affected by alcohol toxicity?

Answer 37

ADH is inhibited increasing diuresis

Question 38

how is the neurological system affected by alcohol toxicity?

Answer 38

neural atrophy & demyelination

Question 39

why can BAC be 20-30% higher in females?

Answer 39

- smaller volume of distribution (Vd) - less First Pass Effect in the liver

Question 40

what is the most common cause of preventable birth defects?

Answer 40

FAS (fetal alcohol syndrome)

Question 41

ethanol is considered a ______________ in humans

Answer 41

teratogen

Question 42

what are the effects of alcohol abuse during pregancy?

Answer 42

abnormalities and retardation of growth and development of the brain and CNS