Ethanol and Methanol Flashcards

1
Q

name the medical uses of ethanol

A

antiseptic, analgesic, anesthetic, weak general anesthetic

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2
Q

describe pharm of ethanol

A

both lipid and water-soluble: goes where it wants

CH3-CH2-OH

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3
Q

MoA? and sites of action?

A

has a general depressant action on most cells

ethanol inhibits excitatory (glutamine) pathways and appears to activate GABAergic pathways

may also activate DA pathways in “pleasure center”

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4
Q

Name sites of action for alcohol / effects

A

ethanol inhibits higher cortical functions (inhibits critical faculties) -> excitement and euphoria

  • lack of critical judgement and decreased social inhibtions
  • often memory impairment
  • slows reaction time
  • decreased visual activity
  • decreased visual tracking ability
  • decreased motor skills, staggering
  • slurred speech
  • impaired medullary function = loss of balance, nausea, vomiting, decreased respiration
  • decreased sexual performance
  • inhibits REM sleep
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5
Q

Describe alcohol’s effect on cardiovascular system

A

skin vasodilation due to inhibition of reflex vasoconstriction = heat lost

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6
Q

what is alcohol’s effect on GI tract?

A

at low concentrations:
-increased gastrin secretion, HCL acid secretion

at high concentrations:
-directly irritates gastric tissue

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7
Q

what is ethanol’s effect on liver?

A

direct toxic effect on liver - interacts with other liver toxicants

chronic use:

  • fatty liver
  • decreased testosterone synthesis
  • increased testosterone metabolism
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8
Q

what is ethanol’s effect on the kidney?

A
  • weak diuretic
  • inhibits ADH secretion: H2O @ collecting duct not reabsorbed as well
  • decreased uric acid secretion -> gout (deposition of crystals in joints)
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9
Q

Describe the absorption of ethanol

A
  • rapidly absorbed in S.I.
  • slightly absorbed from stomach
  • factors that delay stomach emptying, lower the rate of absorption (food, exercise, anticholinergic agents)

px with gastrectomies have more rapid absorption

carbonation may increase stomach emptying (champagne get you drunk)

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10
Q

describe systemic distribution of ethanol

A
  • rapidly equilibrated with all tissues
  • ethanol can pass placenta
  • newborns can undergo withdrawal - there may be developmental damage aka fetal alcohol syndrome
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11
Q

describe metabolism of ethanol

explain reasoning behind fatty liver side effect

what order reaction is the first enzyme of metabolism?

what is the rate limiting component of ethanol metabolism?

A

primarily metabolic site is liver

CH3-CH2-OH ———-> acetaldehyde via alcohol dehydrogenase, a NAD+ —> NADH as well

–fomepizole acts here to inhibit alc. dehydro

acetaldehyde ———> acetyl CoA via acetaldehyde dehydrogenase, a NAD+ —–> NADH once again

–disulfiram acts here to inhibit acetaldehyde dehydro

fatty liver: NADH goes into fat production, much of which is made

alcohol dehydrogenase is a zero-order rxn = rate of metabolism is constant and independent of ethanol concentration (1 oz / 3 hr)

NAD+ availability is rate-limiting

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12
Q

describe excretion of ethanol

A

lungs (minor) and kidneys

best measure of concentration is blood sample

acetyl CoA —> water and CO2

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13
Q

comment on toxicity of ethanol

A

potency: effect vs. concentration
- alcohol potency is very low

50g of ethanol = 1 mol ethanol
4 avg. drinks = 56 g
for aspirin, 1 mol = 300 tablets

2 drinks = .03% blood conc
6 drinks = 0.1%: 50% decrease in reaction time
12 drinks = 0.2%
18 drinks = 0.3%

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14
Q

What are the three kinds of ethanol tolerance and what are their effects?

A

metabolic: increase in alc. dehydrogenase
tissue: increase in # of excitatory neurons
behavior: trained to be soberz

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15
Q

Effects of ethanol dependence?

A

physical:
-withdrawal: headache, nausea, dizziness, sweating

-severe withdrawal: tremors, seizures, cramps, delirium tremens

psychological effects do present

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16
Q

Can ethanol interact with other drugs?

A

yes, any drug that enters CNS

17
Q

For what is disulfiram used?

A

inhibits aldehyde dehydrogenase = buildup of acetaldehyde

18
Q

for what is acamprosate used?

A

decreased craving for ethanol

19
Q

what are the neurological and mental consequences of ethanol addition?

A
  • brain damage
  • memory loss
  • sleep disturbances
  • family life
  • psychosis
20
Q

what are the nutritional consequences of ethanol addition?

A

alcoholics have the poorest nutrition of any group in U.S.

thiamine deficiencies ->

  • wernicke’s encephalopathy
  • disorientation polyneuritis
  • severe vision changes
21
Q

what are the cardiomyopathy consequences of ethanol addition?

A

more congestive heart failure

22
Q

what are the liver consequences of ethanol addition?

A
  • cirrhosis

- fatty liver

23
Q

what are the fetal consequences of ethanol addition?

A

fetal alcohol syndrome:

  • CNS dysfunction
  • facial abnormalities
  • immune system abnormalities
  • still birth
24
Q

describe metabolism of methyl alcohol

toxicity?

treatment of toxicity?

A

CH3-OH ———> formaldehyde via alcohol dehydrogenase

formaldehyde ——> formic acid via acetaldehyde dehydrogenase

toxicity: metabolic acidosis
- blindness: formic acid kills retinal cells (ganglion cells)

metabolism of methanol is slower than ethanol

so, as treatment, drink ethanol

25
Q

for what is fomepizole used?

A

specific inhibitor of alcohol dehydrogenase