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Pharm3 > Ethyl Alcohol > Flashcards

Ethyl Alcohol Flashcards

1
Q

Ethyl Alcohol

A

usually never prescribed unless for waning off an extreme alcoholic who will have seizures without it

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2
Q

what is alcohol

A

we drink ethanol

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3
Q

Primarily METHANOL (isopropanol mentioned too) cause what

A
  • Methanol and isopropanol metabolized into formic acid and formaldehyde which are toxic
  • Drinking them can result in vomiting blindness coma and death
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4
Q

what is BAC

A

BAC = mg alcohol/100 ml of whole blood

ex BAX .05 = .05mg of alcohol per 100 ml

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5
Q

Absorption of alcohol
Females vs Males

A
  • 20% absorbed in stomach and affected by food volume
    -80% absorbed in small intestine
    Males have 50% more alcohol dehydrogenase so female of same body weight and composition will have a 7% higher BAC
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6
Q

Alcohol distribution

A

-distrubutes freely throughout body
-readily crosses BBB warm fuzzy feeling
- freely to fets so FETAL BAC = Maternal BAC

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7
Q

Alcohol metabolism

A

-5% excreted unchanged in lungs
-liver metabolizes 95%

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8
Q

CYP2E1, Catalase, and alcohol dehydrogenase play a role

A

in acetylaldehyde formation which Is carcinogenic
- people who consume large quantities have sour smell due to acetalaldehyde conversion to acetic acid
- CYP2E1 and catalase play role into high dose alcohol
- adults metabolize 1 drink per hour but genotype may affect of alcohol dehydrogenase available and these people show red face and intolerance sometimes

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9
Q

Pharmacodynamic of alcohol

A
  • ethanol increases chloride ion channel by working on gaba similar to benzodiazepines
  • results in sedation, muscle relax, inhibition of cognitive motor skills, antiafxitey
    -feeds dopaminergic reward center making addictive
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10
Q

Alcohol+ caffeien

A

Caffeine can mask some effects of alcohol
- alcohol is 0 order metabolism but caffeine is 1st order metabolism so caffeine will often metabolize and ware off first making you feel super fucked
- caffeine in four loko wears off and you feel OD sauced

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11
Q

Pharmacodynamics alcohol on Glutamate

A
  • inhibits responsiveness of NMDA receptors to glutamnergic neuron causing decreased neuronal firing
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12
Q

Alcohol on Opiod receptors

A

Ethanol and stress interact so drinking becomes more addictive by forcing endogenous release of endorphins and enkephalins (aka opioid dopamine reward circuit)
- Naltrexone is opioid antagonist and has good use in the addiction with the stress and enkephalin shit

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13
Q

Acamprosate and Naltraxone

A

Acomprosate is a structural analog of glutamate used in abstinence of alcohol
Combined with Naltrexone is best in efficacy for abstinence

-usually abstinence drugs are ass but this works

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14
Q

Alcohol on serotonin receptors

A

-chronic use augments serotonergic activity specifically 5HT2 and 5HT3
(located dopaminergic nuerons in nucleus accumbens)

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15
Q

Canabinoid receptors and alcohol

A

-chronic alcohol stimulates formation of endogenous cannabinoid transmitter ANANDAMIDE
- this down regulates cannabinoid receptors
- cessation of drinking results in hyperactive endocnnabinoid rxn stimulating alcohol craving
-** ethanol and cannabinoid agonist activate same reward system and may be useful to quit alcohl (smoking weed does)

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16
Q

Alcohol consumption Large amount vs small ammiunt

A

Large = bad cancer, anemia, cardiomyopathy, cirrhosis, hep

small good = increase insulin sesnitvity/ lower risk of diabetes
reduce risk of silent infarcts
Helps lipid and cell panel

17
Q

Alcohol causes graded depression of?

A

depression of CNS in graded manner:
-impairment = .05-.1
-blackout .25
-death = .4
(these are BAC)

18
Q

Alcohol in crime

A
  • causes alcohol myopia: focus on present only, mental deficits
  • Myopia associated with Male violence, homicides and assaults
19
Q

Alcohol Tolerance 3 types

A
  • Metabolic - where liver increases # metbaolizing enzymes
  • Tissue/ functional - neurons adapt to drug presence and you can literally behave normal as if you’re sober. But! ur memory and cognition is still impaired
  • Associative tolerance- your environment affects tolerance
20
Q

Korsakoffs and other side effects

A

-Korsakoff is permanent alcohol induced demtia from lack of Thiamine, mammilary bodies
-> give them thiamine
- normal iq but anterograde amnesia

OTHER:
- reversible drug induced amnesia (being drunk)
- Liver damage: can repair if stopped early but if not causes fatty liver and cirhossis
- paancreatitis
-chronic gastrist
-fetal alcohol
cancer

21
Q

Fetal syndrome

A

mothers drink
- CNS dysfunction mental retardation (Cam???)
- reduction In brain size
- congenital heart defects
- ADHD
- look like monkey (Cam🤨!??!)
🧐😮‍💨
👁️👅👁️ «<—- cam this you bro???
🤰🏿

22
Q

Alcohol Withdrawal Syndrome

A
  • life threatening
  • use benzos for first few days where you have serious symptoms of delirium and tremens
    anxiety insomnia etc..
  • Use anticonvulsants for withdrawal seizures (Carbamazepine)
23
Q

Diazapam chlordiazepoxide

A

-Binds gaba A facilitate chloride channel = hyperpol
- TX for alcohol withdrawal and seizure disorders related
-can exert additive CNS depression when administered with other drugs
-AE: CNS depression, tolerance dependance

24
Q

Carbamazepine valproic acid

A
  • inactivat Na+ channels and prevent withdrawal induced seizures which may induce death **(as mentioned use in alcohol withdrawal syndrome)
  • beware of hepatic metabolism and drug interactions, contraindicated in people who have liver impairment
  • GI discomfort
25
Q

Gabapentin oxycarbazapin

A

-decreases glutamate release and inactivates Na+ channels for prevention of withdrawal induced seizures** (alcohol withdrawal syndrome)
- less hepatic induction and interaction compared to carbamazepine which is good for people who have liver dysfunction
-AE sleepiness, dizziness, fatigue

26
Q

Alcoholism def

A

chronic disease with genetic psychosocial and environmental factors influencing development and manifestation. progressive and fatal

27
Q

Disulfiram (alcohol TX)

A

-Irreversibly inhibits aldehyde dehydrogenase increasing serum acetalaldehyde.
-when you drink it can make you violently ill and throw up a lot and patients will often forcefully drink to make them self vomit out the pill so they can continue drinking
- treats chronic alcoholism
- Do not give to patient intoxicated or currently drinking
-AE seber flushing, headache, nausea and confusion

28
Q

Alcoholism genetic contribution
and Comorbididtes

A

GENETIC
-Alcoholism in all classes of life
-children predisposed to one greater risk
- male children 25-50% more likely to be alcoholic if parents alcoholic (I think specifically dad)
- Female child 3-8% more likely to be alcoholic if parents are (again I think specifically its father)
COMORBIDITITIES
depression, anxiety disorder, impulse control disorder pTSd people more likely to alcohol

29
Q

Fomepizole (alcohol tx) <- by this I mean like works in alcohol pathway

A
  • comp inhibitor of alcohol dehydrogenase prevent break down into formaldehyde and formic acid
  • TX in Methanol and Ethylene Glycol poison
    -beware of patins with hepatic and renal dysfunction
    —* combine with HEMODIALYSIS
  • Headach nausea sleepiness and unsteadiness
30
Q

Acamprosate (TX of alcoholism)

A

Thought to interact on neuronal NMDA (glutamate) receptors and Ca+ channels
- used for abstinence in alcohol patients but these tend to be useless almost
- not metabolized excreted unchanged in kidney which is better for patients with bad liver
- AE diarrhea, nausea, headache, drowsiness

31
Q

Naltrexone (alcohol TX)

A

Blocks endogenous opioid peptides and used to treat opioid and alcohol use disorders in US
- significant first past metabolisms so don’t use in patients with compromised liver
- nausea vomitting headaches drowsiness

Pharm3 (7 decks)

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