L 84 - Watts alcohol abuse Flashcards
absorption of alcohol:
- __% from stomach, remainder from intestine
- peak __ - __ minutes
- limited by ______ ______
- alcohol increases ____ release
10
30-90
gastric emptying
acid
men dilute alcohol more than women because?
they have more total body water
elimination of alcohol is _____ order at or above 10-20 mg/dl
zero (looks like a straight line)
Metabolism of alcohol:
-__% in the liver
- microsomal ethanol oxidizing system (MEOS)
- only at ____ alcohol concentration
- involves CYP___
90
high
CYP2E1
what is the test used to monitor alcohol consumption?
Glucuronidation (0.5%-EtG test)
what is alcohol metabolized by?
alcohol dehydrogenase (ADH)
where is the enzyme alcohol dehydrogenase found? (3)
liver, brain, stomach
T or F: Women express higher levels of gastric ADH
False, men do
what is the drug called that is an ADH inhibitor?
fomepizole (antizol)
what does the act of inhibiting ADH do after taking fomepizole?
slows formation of formaldehyde and toxic metabolites -> gives the body a better chance to handle them
what is acetaldehyde metabolized by?
aldehyde dehydrogenase
an SNP in which enzyme reduces activity of it
ALDH2, this causes a buildup of the shit that makes you feel drunk
T or F: Disulfiram (antabuse) is a reversible inhibitor
false, irreversible
Flushing
A. hetero ALDH2
B. homo ALDH2
A
Can still consume alcohol
A. hetero ALDH2
B. homo ALDH2
A
Neurotoxic
A. hetero ALDH2
B. homo ALDH2
B
Strong hangover
A. hetero ALDH2
B. homo ALDH2
B
cannot consume alcohol
A. hetero ALDH2
B. homo ALDH2
b
two important ligand-gated ion channels that alcohol targets according to watts
GABA-A and NMDA
at what concentration of alcohol is someone experiencing euphoria, disinhibition, being talkative
30-60 mgdl
at what concentration of alcohol is someone experiencing analgesia
60-90 mg/dl
at what concentration of alcohol is someone experiencing CNS stimulation such as mood swings and aggression
80-120 mg/dl
at what concentration of alcohol is someone experiencing CNS depression such as slurred speech, ataxia, sedation
100-200 mg/dl
at what concentration of alcohol is coma-death possible
300-500 mg/dl
Cardiovascular effects induced by alcohol:
Acute
vasodilation
Cardiovascular effects induced by alcohol:
moderate use
reduced risk of coronary diseasee
Cardiovascular effects induced by alcohol:
heavy/chronic use
cardiomyopathy
physiological effects of alcohol consumption:
thermoregulation
hypothermia
physiological effects of alcohol consumption:
gastrointestinal
etoh is a secretagogue which increases HCl secretion, low dose is appetite stimulant, high dose is appetite depressant
long term alcohol adverse effects:
liver (2)
fatty liver leads to cirrhosis
can cause edema
acute intoxication management:
prevent ________ __________
respiratory depression
red highlighted things under alcohol withdrawal (3)
anxiety
seizures
delirium tremens
3 tx options for alcohol withdrawal
benzos
phenytoin if seizures
electrolytes
+ can also use clon/guan
3 FDA approved txs for alcoholism
Disulfiram (antabuse)
Acamprosate (Campral)
Naltrexone (revia)
Acamprosate MOA
NMDA receptor antagonist/GABA agonist -> reduces relapse and prolong abstinence
Naltrexone is more effective in patients with an SNP in the mu opioid receptor gene, what weird ass numberletter combo should you look for when thinking about this
118G
3 off label drugs for alcoholism treatment
topiramate -> enhance GABA signaling
baclofen -> stimulates GABA-B receptors
varenicline -> human tests underway for alcoholism
