Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

Pharm II Exam 1 > Lecture 4: Alcohol > Flashcards

Lecture 4: Alcohol Flashcards

1
Q

What type of drug is ethanol?

A

Sedative hypnotic/CNS depressant

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

What is the speed and distribution of absorption of ethanol?

A

Rapidly/almost completely absorbed and distributed to ALL tissues (crosses the placenta)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

What are the two enzymes responsible for ethanol metabolism?

A
  1. Alcohol Dehydrogenase

2. MEOS (Microsomal Ethanol Oxidizing System)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

What type of enzyme is alcohol dehydrogenase/where located? What levels of ethanol does it work at?

A
  1. NAD dependent –> limited NAD –> zero order kinetics –> limited capacity to absorb EtOH
  2. works at lower levels of EtOH
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

What is MEOS thought to be responsible for? What levels of ethanol does it work at?

A
  1. thought to be responsible for metabolic tolerance

2. works at higher levels of EtOH

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

What types of drugs can lead to supra-additive CNS depression when give w/ EtOH (acute drug interaction)?

A

CNS depressants and substrates for P450 Enzymes

TCAs, H1-antihist, narcotics, BZs

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

What is the conseq of chronic drug interactions w/P450 Enzymes (esp CYP2E1) and ethanol?

A

Reduce the effect of the that drug

High levels of CYP2E1 –> incr formation of toxic metabolites

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

What is the risk a/w acetaminophen (Tylenol) and chronic alcoholics? What could be the permanent result? Tx?

A

up-regulate CYP enzymes-> incr formation of toxic metabolites –> may cause hepatotoxicity in alcoholics

Could cause irrev liver damage

Tx: N-acetylcesteine

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MOA for N-acetylcesteine?

A

Neutralizes metabolites formed by the metabolism of acetaminophen by P450 enzymes

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

What drinks contain the same amount of ethanol (12-15 g)?

When a 70 lb man consumes these what will his peak BAC be? How long does it take for the liver to oxidize it?

A

can of beer (12 oz), shot of whiskey (1.5 oz), glass of wine (4 oz)

Peak BAC = 0.02%

Liver oxidizes 1 typical drink in 1 hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

MOA for ethanol’s CNS effects for GABA and NMDA receptors?

Note: it also incr conc of DA, Serotonin, and endogenous opioids

A

Enhances GABA actions at GABA-A receptor

Inhibits glutamate actions at NMD receptor

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

What is functional tolerance?

A

reduction of CNS sensitivity to ethanol due to adaptive changes in neurons (up/down regulation of receptors)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Alcohol induces excitation of the 5-HT3 receptor for serotonin, which is involved in what response? Tx?

A

emetic response

Tx = Ondansetron (inhibits 5-HT3 rec)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

What is the major chronic effect of ethanol?

A

Metabolic and functional tolerance

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

What is the MC neurologic abnormality a/w chronic alcoholism?

A

Peripheral Neuropathies

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

What does thiamine deficiency in alcoholics lead to? Tx?

A

thiamine defic –> wernicke korsakoff syndrome

Tx: IV thiamine (banana bag) –> prev permanent brain damage

17
Q

What are the 5 peripheral organs/systems affected by chronic alcohol use?

Note: extra info included for reference

A
  1. Liver (decr gluconeogenesis, hypoglycemia, NAD depletion, fat acculm in liver –> hepatitis and cirrhosis)
  2. GI (inflam, bleeding, scaring –> abs defects)
  3. Endocrine (gynecomastia, testicuar atrophy, salt retention)
  4. CV (HTN, anemia, MI)
  5. Neoplasia (breast, esophagus, mouth, ovarian, colorectal carcinoma)
18
Q

What can occur if ethanol is consumed during pregnancy? Effects on baby?

A

Fetal Alcohol Syndrome

Mental retardation, growth defic, microcephaly, underdeveloped mid face

19
Q

What is the Tx for severe alcohol intoxication?

A

IV dextrose

+/- thiamine admin, correction of electrolyte balance

20
Q

What is the Tx for severe alcohol withdrawal syndrome?

A

Gradually tapering dose of long acting BZs

diazepam

21
Q

Drug used to prevent alcohol relapse?

S/Es?

A

Disulfiram

resp depression, CV collapse, arrhythmias, MI, convulsion, unconsciousness, sudden death

22
Q

Main drug used alone for preventing alcohol craving?

What must be done before this drug is prescribed?

A

Naltrexone (opioid antagonist)

Must do Narcan/Naloxone challenge before prescribing

23
Q

Other anti-craving meds?

Other use?

A

Topiramate, Acamprosate

anti-convulsants

24
Q

How does 1-2 drinks of alcohol per day increase life expectancy?

A

Protects you from CHD

25
Q

3 Tx options for methanol or ethylene glycol intoxication?

A
  1. IV ethanol
  2. Fomepizole (antidote)
  3. dialysis
26
Q

What is the Tx for mild-mod alcohol withdrawal syndrome?

A

Clonidine or propanolol

27
Q

what combination of drugs is best for reducing alcohol cravings?

A

Disulfiram + acamprosate

28
Q

What can acamprosate and topiramate not treat?

A

alcohol withdrawal syndrome (seizures!)

Pharm II Exam 1 (6 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions