L18: Ethyl Alcohol Flashcards
How can benzos be helpful when one is no longer drinking excess ETOH?
- Decrease chance of seizure activity
- Reduce withdrawl side effects
True or False: Diazepam and Cholordiazepoxide are benzos
True
Which drug class does Naltrexone, Acamprosate, and Fomepizole belong to?
A. Anti-Convulsants
B. Benzos
C. Treats alcoholism
C. Treats alcoholism
Fomepizole is useful for ____ poisoning
methanol
Why is ETOH able to readily cross BBB?
It is both Lipophilic and Hydrophilic
Where is ETOH absorbed? Which enzymes are involved in normal vs excess levels of ETOH?
Stomach and Small Intestine*
- High ETOH: CYP2E1 and Catalase
- Normally: Alcohol Dehydrogenase
_____ blocks aldehyde dehydrogenase
_____ blocks alcohol dehydrogenase
A. Dilsulfram; Fomepizole
B. Fomepizole; Dilsulfram
A. Dilsulfram; Fomepizole
Alcohol is ____ order kinetics while Caffeine is ___ order
A. First; Second
B. Zero; First
C. Zero; Third
D. First; Third
B. Zero; First
Both ETOH and Benzodiazepines can bind to the _____ receptor, leading to increases in Cl- ion flow
GABA
True or False: ETOH increases responsiveness of NMDA receptors to glutamate, resulting in increased neuronal firing
False - ETOH INHIBITS responsiveness of NMDA receptors to glutamate, resulting in DECREASE neuronal firing
_____ is a structural analog of glutamate used in maintaining alcohol abstinence
A. Naltrexone
B. Acamprosate
C. Fomepizole
_____, an opioid antagonist, may reduce ETOH cravings
B. Acamprosate (glutamate analog)
A. Naltrexone (reduce cravings)
True or False: Hypo-glutamatergic state contributes to ETOH withdrawl
True
True or False: In addition to acting on GABA-R, ethanol can activate opioid receptors as well–making it more addictive, as it can trigged endogenous opioid release and trigger dopamine response–and cannabinoid-R
True
True or False: Chronic ETOH use augments serotonergic activity
True
Chronic ETOH use stimulates formation of endogenous cannabinoid transmitter ___, which leads to downregulation of cannabinoid receptors and disinhibition of nucleus accumbens
anadamide
True or False: When one ceases drinking, it results in hypoactive endocannabinoid reaction, which stimulates cravings for ETOH
False - HYPERACTIVE
True or False: Alcohol myopia causes a focus on present without thinking about consequences, plays large role in crime
True
What are the three types of ETOH tolerance?
1) Metabolic: liver increases metabolizing enzymes
2) Tissue/Functional: Neurons adapt to drug – behavior only
3) Associative: Environmental
With Korsakoff’s Syndrome, it is important to treat aggressively with ___ to prevent permanent damage
Thiamine
What causes brain damage in Korsakoff’s Syndrome?
Mammillary Body damage
Which disease is characterized by permanent anterograde amnesia where one has no new learning or membrane, but still has normal IQ?
A. Korsakoff’s Syndrome
B. Fetal Alcohol Syndrome
C. Alcohol Withdrawal Syndrome
D. Alcoholism
A. Korsakoff’s Syndrome
True or False: Patients with Korsakoff’s Syndrome may confabulate
True
Which of the following disorders is associated with: CNS dysfunction, reduced brain size and growth rate, and behavioral abnormalities?
A. Korsakoff’s Syndrome
B. Fetal Alcohol Syndrome
C. Alcohol Withdrawal Syndrome
D. Alcoholism
B. Fetal Alcohol Syndrome
True or False: Signs and symptoms of ETOH withdrawal that manifest earliest are: anxiety, insomnia, tremor, palpitations, nausea, and anorexia as well as (in severe syndromes) hallucinations and seizures.
Delirium tremens typically develops 48–72 hours after alcohol
discontinuation. The earliest symptoms (anxiety, insomnia, etc.) can persist, in a milder form, for several months after alcohol discontinuation
True
Diazepam and Chlordiazepoxide can be used to treat/prevent…
A. Alcohol withdrawal
B. Prevention of
withdrawal-induced
seizures
C. Seizure disorders
A/C
Why is it important for one to not be drinking when taking either Diazepam or Chlordiazepoxide?
Can tolerance or dependence develop?
Additive effect
Yes!
Which drugs inactivate Na+
channels, which prevent
withdrawal-induced seizures, and induces hepatic metabolism (therefore: many DDI)?
A. Carbamazepine/Valproic acid
B. Gabapentin/ Oxcarbazepine
A. Carbamazepine/Valproic acid
Which drugs prevent withdrawal-induced seizures via: decreasing
glutamate release and/or inactivation of Na+ channels?
A. Carbamazepine/Valproic acid
B. Gabapentin/ Oxcarbazepine
B. Gabapentin/ Oxcarbazepine
Which has LESS hepatic induction and interactions than
carbamazepine?
Oxcarbazepine
True or False: SJS is a AE associated with Carbamazepine/Valproic acid
True
____irreversibly inhibits
aldehyde dehydrogenase causing
increased serum acetaldehyde
A. Disulfiram
B. Naltrexone
C. Acamprosate
______ competes for opiate
receptors and displaces opioid
drugs
A. Disulfiram
B. Naltrexone
C. Acamprosate
______ is thought to interact
with NMDA receptors and calcium
channels and is used to maintain
abstinence in alcohol-dependent
patients
A. Disulfiram
B. Naltrexone
C. Acamprosate
A. Disulfiram
B. Naltrexone
C. Acamprosate
True or False: Cocaine dependence
inhibits dopamine beta-
hydroxylase causing an
accumulation of dopamine
True
____ is a competitive inhibitor of alcohol dehydrogenase that treats methanol/ethylene glycol
poisoning – should be used w/caution in patients
with hepatic/renal
dysfunction
Fomepizole
____ blocks conversion of
acetaldehyde to
acetate to treat chronic alcoholism. However, it should NEVER be
administered to a
patient if/when they are in a state of alcohol intoxication
A. Fomepizole
B. Disulfiram
C. Acamprosate
D. Naltrexone
B. Disulfiram
____is thought to interact with neuronal NMDA receptors/Ca channel to maintain maintain abstinence in alcohol-
dependent patients; it is NOT metabolized – it is excreted unchanged from the kidneys
A. Fomepizole
B. Disulfiram
C. Acamprosate
D. Naltrexone
C. Acamprosate
_____i s used to treat opioid use and
alcohol use disorders
is subject to significant
first pass metabolism
Naltrexone
