Ethanol and Methanol Flashcards

1
Q

What is the drug class of ethanol?

A

CNS depressant

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2
Q

What is the mechanism of action of ethanol?

A

General suppressant effct on most cells. Can inhibit excitatory (glutaminergic pathways) or activate inhibitory (GABAergic) pathways

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3
Q

What does GABA stand for?

A

Gamma Amino Butyric Acid

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4
Q

How does ethanol cause a mild diuretic effect?

A

Inhibition of ADH secretion

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5
Q

From where is ethanol absorbed?

A

The small intestine (less so from intestine)

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6
Q

What is carbonation’s effect on ethanol absorption?

A

Increases rate of gastric emptying so more rapid absorption.

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7
Q

What does alcohol dehydrogenase do?

A

Converts ethanol to acetaldehyde

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8
Q

What does acetaldehyde dehydrogenase do?

A

Converts acetaldehyde to acetyl CoA

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9
Q

What builds up in the body when ethanol is metabolized?

A

NADH (from alcohol dehydrogenase and acetaldehyde dehydrogenase)

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10
Q

What drug is given to discourage patients from drinking? (makes them feel ill when they drink alcohol?)

A

Disulfiram

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11
Q

What is disulfiram’s mechanism of action?

A

Inhibits acetaldehyde Dehydrogenase leading to an increase in acetaldehyde causing headache, severe nausea, and convulsions

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12
Q

What is a drug that can reduce ethanol craving during withdrawal?

A

Acamprosate - somehow alters GABA activity

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13
Q

What drug is given to inhibit alcohol dehydrogenase?

A

Fomepizol

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14
Q

What is the mechanism of action of inhaled general anesthetics?

A

Potentiation of inhibitory GABAergic neurons or blockade of glutamate (excitatory) neurons

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15
Q

How does lipid solubility affect potency of general anesthetics?

A

The higher the lipid solubility the more potent the general anesthetic

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16
Q

What is MAC?

A

Minimal alveolar concentration (ED50 of inhaled general anesthetics) The lower the MAC the more potent the drug

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17
Q

What effect does the Blood/Gas coefficient of an inhaled general anesthetic have?

A

High B/G coefficient = slower onset (need a lot more in blood before it becomes saturate enough to act)

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18
Q

What are the anesthetic effects of NO?

A

Good analgesic (pain killer), no amnesia

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19
Q

What are the halogenated hydrocarbons?

A

(FLURANEs) isoflurane, desflurane, sevoflurane

20
Q

What is a side effect of the halogenated hydrocarbons?

A

Malignant hyperthermia

21
Q

What is used to treat malignant hyperthermia from halogenated hydrocarbons?

A

Dantrolene

22
Q

What are the intravenous general anesthetics?

A

Thiopental, propofol, etomidate (Barbiturates), midazolam

23
Q

What is the mechanism of action of Thiopental?

A

Activates GABAergic pathway (rapid induction/recovery)

24
Q

What is the mechanism of action of Propofol?

A

Activates GABA pathway

25
Q

What is the mechanism of Ketamine?

A

Analog of phencyclidine. Binds to and activates a receptor which then blocks glutamate activity.

26
Q

What is the mechanism of action of Etomidate?

A

Activates GABA receptors

27
Q

What is the mechanism of action of Midazolam?

A

Activates GABAnergic neurons

28
Q

To what drug class does thiopental belong?

A

Barbiturates I.V. general anesthetic

29
Q

To what drug class does propofol belong?

A

Barbiturates I.V. general anesthetic

30
Q

To what drug class does Ketamine belong?

A

Barbiturates I.V. general anesthetic

31
Q

What is the structure of the local anesthetics?

A

Aromatic site connected by either an ester or amide linkage to an amino site

32
Q

What are the local anesthetics that are linked by an ester?

A

Cocaine, benzocaine, procaine, benoximate and proparacaine (BBC PP)

33
Q

What are the local anesthetics that are linked by an amide?

A

Lidocaine, articaine, mepivacaine, bupivacain, prilocaine, ropivacaine, etidocaine (P-MARBLE)

34
Q

What is the mechanism of action of the local anesthetics?

A

They are weak bases which act on the Na+ channels of excitable tissue. Decrease neuronal conduction, repolarization rate, and increase refractory period

35
Q

What kind of neurons are affected by local anesthetics?

A

More rapidly firing neurons are more sensitive, smaller fibers are more sensitive, myelinated fibers are more sensitive; pain>cold>warmth>touch>motor neurons

36
Q

Do ester linked or amide linked local anesthetics have a longer duration?

A

Amide linkage last longer (metabolized in liver by P450) than ester bonded (hydrolyzed by a circulating plasma cholinesterase)

37
Q

What are the side effects of the local anesthetics?

A

Blurred vision, tinnitus (ringing of ears), convulsions, comas, death, arrhythmias, tachycardia, allergic reactions

38
Q

What is tetrodotoxin?

A

Found in liver and ovaries of pufferfish - irreversibly block Na+ channels causing repiratory paralysis and death

39
Q

What is saxitoxin?

A

Found in shellfish “red tide” - cause respiratory paralysis and death

40
Q

To what drug class does baclofen belong?

A

Neuronal treatment of spasticity

41
Q

What is the mechanism of action of baclofen?

A

GABA agonist

42
Q

What does diazepam and other benzodiazepines do? (mechanism of action)

A

Activate GABA receptors - used to treat spasticity

43
Q

What is tizanidine used for?

A

Neuronal treatment of spasticity

44
Q

What is the mechanism of action of tizanidine?

A

Alpha2 agonist

45
Q

What drug is used to treat spasticity on the muscular level?

A

Dantrolene (orally administered)

46
Q

What is the mechanism of action of dantrolene?

A

Inhibits stimulus induced release of Ca2+ from muscle sarcoplasmic reticulum