Ethyl Alcohol Flashcards
Ethyl Alcohol
usually never prescribed unless for waning off an extreme alcoholic who will have seizures without it
what is alcohol
we drink ethanol
Primarily METHANOL (isopropanol mentioned too) cause what
- Methanol and isopropanol metabolized into formic acid and formaldehyde which are toxic
- Drinking them can result in vomiting blindness coma and death
what is BAC
BAC = mg alcohol/100 ml of whole blood
ex BAX .05 = .05mg of alcohol per 100 ml
Absorption of alcohol
Females vs Males
- 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
Alcohol distribution
-distrubutes freely throughout body
-readily crosses BBB warm fuzzy feeling
- freely to fets so FETAL BAC = Maternal BAC
Alcohol metabolism
-5% excreted unchanged in lungs
-liver metabolizes 95%
CYP2E1, Catalase, and alcohol dehydrogenase play a role
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
Pharmacodynamic of alcohol
- 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
Alcohol+ caffeien
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
Pharmacodynamics alcohol on Glutamate
- inhibits responsiveness of NMDA receptors to glutamnergic neuron causing decreased neuronal firing
Alcohol on Opiod receptors
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
Acamprosate and Naltraxone
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
Alcohol on serotonin receptors
-chronic use augments serotonergic activity specifically 5HT2 and 5HT3
(located dopaminergic nuerons in nucleus accumbens)
Canabinoid receptors and alcohol
-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)
Alcohol consumption Large amount vs small ammiunt
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
Alcohol causes graded depression of?
depression of CNS in graded manner:
-impairment = .05-.1
-blackout .25
-death = .4
(these are BAC)
Alcohol in crime
- causes alcohol myopia: focus on present only, mental deficits
- Myopia associated with Male violence, homicides and assaults
Alcohol Tolerance 3 types
- 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
Korsakoffs and other side effects
-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
Fetal syndrome
mothers drink
- CNS dysfunction mental retardation (Cam???)
- reduction In brain size
- congenital heart defects
- ADHD
- look like monkey (Cam🤨!??!)
🧐😮💨
👁️👅👁️ «<—- cam this you bro???
🤰🏿
Alcohol Withdrawal Syndrome
- 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)
Diazapam chlordiazepoxide
-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
Carbamazepine valproic acid
- 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
