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Therapeutics III > Exam 5 (final) - Watts AUD > Flashcards

Exam 5 (final) - Watts AUD Flashcards

1
Q

ADME: absorption

A

peak 30-90 minutes
-food slows absorption
alcohol increases acid release
-may induce ulcers/GERD

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2
Q

alcoholism affects _____% of population

A

10

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3
Q

ADME: distribution

A

alcohol is distributed throughout TBW
-men have more TBW (58%) than women (48%)

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4
Q

ADME: metabolism

A

90% in liver in 2 steps:
-by alcohol dehydrogenase —> acetaldehyde then by aldehyde dehydrogenase —> acetate
microsomal ethanol oxidizing system (MEOS)
-only at high alcohol conc., involves CYP2E1

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5
Q

ADME: elimination

A

follows zero order kinetics
-20 beers=20 hours before it is all eliminated

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6
Q

fomepizole (Antizol) use

A

-ADH inhibitor for alcohol OD
-slows formation of formaldehyde and toxic metabolites
-gives liver more time to further metabolize toxic metabolites

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7
Q

disulfiram (Antabuse) use

A

-used to treat alcohol abuse/dependance
-effects last up to 14 days
-not very effective bc patient must be very motivated to quit before starting, otherwise they just won’t take it

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8
Q

SNP in ALDH2 _______ activity (reduces or increases)

A

reduces

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9
Q

heterogygous ALDH2*2 can _____ consume alcohol (still or not)

A

still

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10
Q

homozygous ALDH2*2 can _____ consume alcohol (still or not)

A

not

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11
Q

what does alcohol do at GABA-A (chloride channels) receptors?

A

it is an allosteric activator of inhibitory neurotransmitters

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12
Q

what does alcohol do at NMDA receptors?

A

inhibitor

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13
Q

what does alcohol cause a release of?

A

opioids (enkephalins)
serotonin, NE, DA
Ach

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14
Q

low levels of alcohol cause what behaviors?

A

euphoria, disinhibition (talkative) at 30-60
analgesia at 60-90

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15
Q

intermediate levels of alcohol cause what behaviors?

A

CNS stimulation (mood swings, aggression) at 80-120
CNS depression (slurred speech, ataxia, sedation) at 100-200

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16
Q

high levels of alcohol cause what behaviors?

A

coma/death at 300-500

17
Q

CV effects: acute

A

vasodilation
-flushing
-lowered BP
-increased HR

18
Q

CV effects: moderate

A

reduced risk of coronary disease

19
Q

CV effects: heavy/chronic use

A

cardiomyopathy
arrhythmias (binge drinking)
HTN
hemostatis

20
Q

high doses of alcohol may cause ____thermia (hypo or hyper) especially in cold temp

A

hypo

21
Q

alcohol is a __________, appetite _______ (at low doses) and appetite _______ (at high doses)

A

secretagogue, stimulant, suppressant
-increase HCl secretion

22
Q

alcohol can cause what to happen to the liver?

A

fatty liver
cirrhotic liver
cancer (of liver or anywhere along site of ingestion)
edema

23
Q

drug-drug interactions to watch for with alcohol

A

CNS depressants
aldehyde dehydrogenase inhibitors
acetaminophen (bc it increases amt of toxic metabolite NAPQI)
aspirin

24
Q

alcohol toxicology acute management

A

prevent respiratory depression
prevent aspiration of vomit

25
Q

alcohol toxicology taratogen

A

fetal alcohol syndrome
lower testosterone and sperm quality

26
Q

alcohol withdrawal sx

A

anxiety
seizures/tonic clonic convulsions
delirium tremes
N/V

27
Q

alcohol withdrawal tx

A

benzos
phenytoin for seizures
electrolytes
alpha 2 adrenergic partial agonists
-clonidine, gaunfacine

28
Q

alcohol relapse is normally _____ triggered

A

cue
-seeing glass of alcohol, fav bar
-mood related

29
Q

3 FDA approved drugs for alcoholism

A

disulfiram (Antabuse)
acamprosate (Campral)
naltrexone (Revia)

30
Q

disulfiram (Antabuse) MOA

A

aldehyde dehydrogenase inhibitor

31
Q

acamprosate (Campral) MOA

A

NMDA receptor antagonist/GABA agonist

32
Q

naltrexone (Revia) MOA

A

opioid receptor antagonist

33
Q

patients who have alanine118glycine mutation at mu receptor respond better to what drug for alcoholism

A

naltrexone

34
Q

drugs used off label for alcoholism:MOA

A

topiramate (Topamax): inhibits glutamate signaling, enhances GABA signaling
baclofen: GABA-B receptors
varenicline (Chantix): nicotinic receptors

Therapeutics III (22 decks)

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