Pharm: Alcohol/Drugs of Abuse

Question 1

Describe the biochemical steps in the metabolism of alcohol?

Answer 1

Alcohol –> acetaldehyde –> acetic acid –> CO₂ + water and energy

Question 2

Alcohol is metabolized via what type of kinetics?

Answer 2

Zero-order kinetics; rate remains constant and is independent of concentration or amount of chemical

Question 3

Which drug can be used for methanol intoxication by blocking alcohol dehydrogenase and the conversion to formaldehyde?

Answer 3

Fomepizole

Question 4

Which 4 drugs can be used in the tx of acute alcohol withdrawal syndrome?

Answer 4

• Diazepam
• Lorazepam
• Oxazepam
• Thiamine (vitamin B1)

Question 5

What is the MOA of Naltrexone?

Answer 5

• µ-opioid receptor antagonist (long-acting)
• ↓ craving for alcohol and the rate of relapse to either drinking alcohol dependence for the short-term (12 weeks)

Question 6

What is an important consideration before prescribing pt Naltrexone for tx of alcohol and opiate dependence?

Answer 6

Must be opioid-free before initiating therapy because naltrexone can precipitate an acute withdrawal syndrome

Question 7

What is the MOA and use of Acamprosate?

Answer 7

• Weak NMDA-receptor antagonist and GABA_A receptor agonist
• Reduces short-term and long-term relaspse rates (more than 6 months)

Question 8

What is the MOA of Disulfiram?

Answer 8

• Irreversibly inhibits aldehyde dehydrogenase leading to buildup of aldehyde
• Causing extreme discomfort in pt’s who drink alcoholic beverages: flushing, throbing HA, N/V, sweating, hypotension, and confusion

Question 9

What are the sx’s of withdrawl from amphetamines, methylphenidate, and cocaine?

Answer 9

Apathy + irritability + ↑ sleep time + disorientation + depression

Question 10

What are the sx’s of OD from amphetamines, methylphenidate, and cocaine?

Answer 10

Agitation + HTN + Tachycardia + Delusions + Hallucinations + Hyperthermia

Question 11

What are the sx’s of OD from heroin and other strong opioids?

Answer 11

Constricted pupils + clammy skin + nausea + drowsiness + respiratory depression + coma + death

Question 12

What are the sx’s of withdrawl from barbiturates, benzo’s and ethanol?

Answer 12

Anxiety + insomnia + delirium + tremors + seizures + death

Question 13

Which opioid receptor antagonist can be used in the acute setting of an OD?

Answer 13

Naloxone (Narcan)