Pharm: Alcohol/Drugs of Abuse Flashcards
Describe the biochemical steps in the metabolism of alcohol?
Alcohol –> acetaldehyde –> acetic acid –> CO2 + water and energy
Alcohol is metabolized via what type of kinetics?
Zero-order kinetics; rate remains constant and is independent of concentration or amount of chemical
Which drug can be used for methanol intoxication by blocking alcohol dehydrogenase and the conversion to formaldehyde?
Fomepizole
Which 4 drugs can be used in the tx of acute alcohol withdrawal syndrome?
- Diazepam
- Lorazepam
- Oxazepam
- Thiamine (vitamin B1)
What is the MOA of Naltrexone?
- 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)
What is an important consideration before prescribing pt Naltrexone for tx of alcohol and opiate dependence?
Must be opioid-free before initiating therapy because naltrexone can precipitate an acute withdrawal syndrome
What is the MOA and use of Acamprosate?
- Weak NMDA-receptor antagonist and GABAA receptor agonist
- Reduces short-term and long-term relaspse rates (more than 6 months)
What is the MOA of Disulfiram?
- 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
What are the sx’s of withdrawl from amphetamines, methylphenidate, and cocaine?
Apathy + irritability + ↑ sleep time + disorientation + depression
What are the sx’s of OD from amphetamines, methylphenidate, and cocaine?
Agitation + HTN + Tachycardia + Delusions + Hallucinations + Hyperthermia
What are the sx’s of OD from heroin and other strong opioids?
Constricted pupils + clammy skin + nausea + drowsiness + respiratory depression + coma + death
What are the sx’s of withdrawl from barbiturates, benzo’s and ethanol?
Anxiety + insomnia + delirium + tremors + seizures + death
Which opioid receptor antagonist can be used in the acute setting of an OD?
Naloxone (Narcan)