Lecture 72 - Alcohol and Benzodiazepines

Question 1

How many drinks is considered too much for men and for women?

Answer 1

For men: > 5 standard drinks in one sitting OR > 15 in a week

For Women: > 4 standard drinks in one sitting OR > 8 drinks in a week

Question 2

On a genetic basis, who is more likely to become an alcoholic, someone who has a high tolerance or some who has a low tolerance?

Answer 2

Someone who has a high tolerance

Question 3

Each standard drink adds about _____mg/dL to Blood Alcohol Level (BAL), and it takes about ____-____mins to metabolize 20mg/dL.

Answer 3

20mg/dL

60-90min

“Rule of 20’s”

Question 4

Brief Intervention is the most useful for Alcohol use disorders, as opposed to other drug use disorders.

These are the steps:

1. Be empathic and curious
2. State your ________ _______
3. _______ your patient about alcohol use disorders
4. _______
5. Follow up
6. Refer, if absolutely necessary

Answer 4

1. Be empathic and curious
2. State your medical findings
3. Educate your patient about alcohol use disorders
4. Advise
5. Follow up
6. Refer, if absolutely necessary

Question 5

At low levels, alcohol preferentially depresses CNS activity in the _____ lobe.

Answer 5

Frontal

Question 6

What is the main triad of symptoms in Wernicke’s Encephalopathy (Thiamine deficiency)?

Keep in mind Wernicke’s encephalopathy is Reversible while Korsakoff’s dementia is NOT.

Answer 6

1. Confusion
2. Ataxia
3. Ophalmoplegia (especially the Lateral rectus, so CN IV - Abducens)

Question 7

What are the treatments for the following severities of Alcohol Withdrawal:

Mild –>

Moderate –>

Severe –>

Answer 7

Mild –> rest and hydration

Moderate –> Oral Chlordiazepoxide

Severe –> IV Chlordiazepoxide

Question 8

While Alcohol stimulates GABAa receptors, it Inhibits ______ activity. Therefore, it has a synergystic effect on depressing the CNS.

Answer 8

Glutamate

Question 9

In the metabolism of Alcohol, ________ ________ (enzyme) breaks down Acetaldehyde into Acetate. Acetate is benign, but Acetaldehyde causes an intense Hangover feeling.

_______ is a drug that Irreversibly binds and inhibits this enzyme.

Answer 9

Acetaldehyde dehydrogenase (ALDH)

Disulfiram

Question 10

_______ is particularly useful in treating Alcohol relapses. It prevents the full Euphorogenic/reinforcing effects of alcohol (reduces positive reinforcement reward craving).

Answer 10

Naltrexone

Question 11

_______ works to decrease Abstinence cravings for alcohol by interfering with the Glutamatergic system. Bc Alcohol inhibits Glutamate, the body tries to compensate by upregulating it. When alcohol use stops, the body is left in a protracted withdrawal state bc of very high Glutamate activity. ______ decreases that activity, and thus decreases Abstinence cravings.

Answer 11

Acamprosate

Acamprosate