L 84 - Watts alcohol abuse

Question 1

absorption of alcohol:
- __% from stomach, remainder from intestine
- peak __ - __ minutes
- limited by ______ ______
- alcohol increases ____ release

Answer 1

10
30-90
gastric emptying
acid

Question 2

men dilute alcohol more than women because?

Answer 2

they have more total body water

Question 3

elimination of alcohol is _____ order at or above 10-20 mg/dl

Answer 3

zero (looks like a straight line)

Question 4

Metabolism of alcohol:
-__% in the liver
- microsomal ethanol oxidizing system (MEOS)
- only at ____ alcohol concentration
- involves CYP___

Answer 4

90
high
CYP2E1

Question 5

what is the test used to monitor alcohol consumption?

Answer 5

Glucuronidation (0.5%-EtG test)

Question 6

what is alcohol metabolized by?

Answer 6

alcohol dehydrogenase (ADH)

Question 7

where is the enzyme alcohol dehydrogenase found? (3)

Answer 7

liver, brain, stomach

Question 8

T or F: Women express higher levels of gastric ADH

Answer 8

False, men do

Question 9

what is the drug called that is an ADH inhibitor?

Answer 9

fomepizole (antizol)

Question 10

what does the act of inhibiting ADH do after taking fomepizole?

Answer 10

slows formation of formaldehyde and toxic metabolites -> gives the body a better chance to handle them

Question 11

what is acetaldehyde metabolized by?

Answer 11

aldehyde dehydrogenase

Question 12

an SNP in which enzyme reduces activity of it

Answer 12

ALDH2, this causes a buildup of the shit that makes you feel drunk

Question 13

T or F: Disulfiram (antabuse) is a reversible inhibitor

Answer 13

false, irreversible

Question 14

Flushing
A. hetero ALDH2
B. homo ALDH2

Answer 14

A

Question 15

Can still consume alcohol
A. hetero ALDH2
B. homo ALDH2

Answer 15

A

Question 15

Neurotoxic
A. hetero ALDH2
B. homo ALDH2

Answer 15

B

Question 16

Strong hangover
A. hetero ALDH2
B. homo ALDH2

Answer 16

B

Question 17

cannot consume alcohol
A. hetero ALDH2
B. homo ALDH2

Answer 17

b

Question 18

two important ligand-gated ion channels that alcohol targets according to watts

Answer 18

GABA-A and NMDA

Question 19

at what concentration of alcohol is someone experiencing euphoria, disinhibition, being talkative

Answer 19

30-60 mgdl

Question 20

at what concentration of alcohol is someone experiencing analgesia

Answer 20

60-90 mg/dl

Question 21

at what concentration of alcohol is someone experiencing CNS stimulation such as mood swings and aggression

Answer 21

80-120 mg/dl

Question 22

at what concentration of alcohol is someone experiencing CNS depression such as slurred speech, ataxia, sedation

Answer 22

100-200 mg/dl

Question 23

at what concentration of alcohol is coma-death possible

Answer 23

300-500 mg/dl

Question 24

Cardiovascular effects induced by alcohol:
Acute

Answer 24

vasodilation

Question 25

Cardiovascular effects induced by alcohol:
moderate use

Answer 25

reduced risk of coronary diseasee

Question 26

Cardiovascular effects induced by alcohol:
heavy/chronic use

Answer 26

cardiomyopathy

Question 27

physiological effects of alcohol consumption:
thermoregulation

Answer 27

hypothermia

Question 28

physiological effects of alcohol consumption:
gastrointestinal

Answer 28

etoh is a secretagogue which increases HCl secretion, low dose is appetite stimulant, high dose is appetite depressant

Question 29

long term alcohol adverse effects:
liver (2)

Answer 29

fatty liver leads to cirrhosis
can cause edema

Question 30

acute intoxication management:
prevent ________ __________

Answer 30

respiratory depression

Question 31

red highlighted things under alcohol withdrawal (3)

Answer 31

anxiety
seizures
delirium tremens

Question 32

3 tx options for alcohol withdrawal

Answer 32

benzos
phenytoin if seizures
electrolytes

+ can also use clon/guan

Question 33

3 FDA approved txs for alcoholism

Answer 33

Disulfiram (antabuse)
Acamprosate (Campral)
Naltrexone (revia)

Question 34

Acamprosate MOA

Answer 34

NMDA receptor antagonist/GABA agonist -> reduces relapse and prolong abstinence

Question 35

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

Answer 35

118G

Question 36

3 off label drugs for alcoholism treatment

Answer 36

topiramate -> enhance GABA signaling
baclofen -> stimulates GABA-B receptors
varenicline -> human tests underway for alcoholism