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Year 2 Psych exam2 > Pharm, Alcohol part I > Flashcards

Pharm, Alcohol part I Flashcards

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1
Q

Drugs for Tx of acute alcohol withdrawal

A

diazepam
lorazepam
oxazepam
thiamine

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2
Q

drugs for prevention alcohol abuse

A

acamprosate
disulfiram
naltrexone

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3
Q

what drugs are used for Tx acute methanol or ethylene glycol poisoning

A

ethanol

fomepizole

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4
Q

defintion alcohol abuse

A

use of alcohol in dangerous situtation like drinking.driving or combination with other meds

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5
Q

alcohol dependence

A

alcohol abuse plus physical dependence on alcohol like tolerance to alcohol and signs and Sx upon withdrawal

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6
Q

peak blood levels alcohol

A

30 min after ingestion if empty stomach

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7
Q

typical 70 kg adult can metabolize

A

7-10 g alcohol per hour

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8
Q

what is required to convert ethanol to acetaldehyde

A

NAD+

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9
Q

aspirin interaction with ADH

A

inhibits gastric ADH and increase ethanol bioavailability

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10
Q

MOA fomepizole

A

inhibits ADH and used in Tx of acute methanol or ethylene glycol poisoning

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11
Q

what is produced when acetaldehyde converted to acetic acid

A

NADH

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12
Q

what drug inhibits ALDH

A

disulfiram

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13
Q

what population has low activity level mitochondrial ALDH

A

asian

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14
Q

if have low activity level mitochondrial ALDH what happens when drink alcohol

A 
facial flushing
light headedness
palpitations
nausea
general hangover
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15
Q

how to cytochrome P450s metabolize ehtanol

A

use NADPH as cofactor in metabolism of ethanol to acetaldehyde

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16
Q

chronic alcohol consumption induces microsomal ethanol oxidizing system and results in what

A

activation of toxins, free radicals and hydrogen peroxide

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17
Q

alcohol effects on glutamate

A

inhibits ability of glutamate to activate and open NMDA R
leads to inc depression of CNS
memory loss can occur as a result (blackout)

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18
Q

Alcohol effects on GABA

A

enhances GABA on GABA a R and leads to increased depression of CNS

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19
Q

depression of myocardial contractility observed when drinking what amount

A

people who acutely drink moderate amounts

BAC >100

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20
Q

alcohol effects on smooth muscle

A

vasodilation and smooth muscle relaxation
can cause hypothermia in severe overdose
cause uterine mm relaxation

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21
Q

chronic alcohol use and esophagus

A

esophageal dysfunciton, barretts, traumatic rupture
mallory weiss tears
cancer
at high BAD dec peristalsis and de LES tone

22
Q

Tx for alcohol effects on esophagus

A

PPI and stop drinking

23
Q

chronic alcohol and sotmach

A

distrupte mucosal barrier leading to acute and chronic gastritis
clinical Sx of acute epigastric pain

24
Q

Tx gastritis from alcohol

A

antacids, histamine H2 R blockers

25
Q

chronic alcohol and intestines

A

chronic diarrhea from malabsorption

reversible damage can result in weight loss and vitamine deficiencies

26
Q

what vitamin deficiencies occur in chronic alcoholism

A

vit B like thiamine, retinoids and carotenoids

lower serum and brain levels of Mg

27
Q

chronic alcohol and pancreas

A

most common cause acute and chronic pancreatitis in US
direct effect on pancreatic acinar cells and epithelial permeability
promotes Ca carbonate stone formation

28
Q

chronic alcohol and liver

A

leading cause of liver cirrhosis and need for transplantation

29
Q

primary effects of alcohol

A

progressive fatty infiltration
hepatitis
cirrhosis

30
Q

accumulation fat in liver leads to

A

inhibition TCA cycle and oxidation of fat

excess NADH produced

31
Q

Sx alcohol withdrawal

A

delirium, hallucinations, fever and tachycardia

32
Q

Expression of ion channels in chronic alcoholism

A

NMDA R and vCaCh upregulated

GABAa down regulated

33
Q

neurotoxicity seen with chronic alcohol abuse

A

symmetric peripheral nerve injury with distal parathesias of hands and feet
gait disturbance and ataxia
dementia and demyelinating

34
Q

Wernicke Korsakoff syndrome

A

paralysis of external eye mm, ataxia and confused state that can progress to coma and death
assoc with thiamine def

35
Q

korsakoffs psychosis

A

chronic disabling memory disorder

36
Q

CV effects alcohol

A 
cardiomyopathy HF
arrhythmias
HTN
CHD
stroke
37
Q

cardiomyopathy and alcohol

A

dilated with ventricular hypertrophy and fibrosis

38
Q

alcohol induces what changes in heart cells

A

membrane disruption,
depressed function mitochondria and SR
intracell accumulation phospholipids and fatty acids
up regulation vCaCh

39
Q

arrhtyhmias and alcohol

A

atrial and ventricular

40
Q

ethanol raises serum levels of what in heart

A

cardioprotective HDL cholesterol that inhibits process involved in atherosclerosis

41
Q

increased incidence of hemorrhagic and ischemic stroke if drink what

A

> 40-60g alcohol/day

42
Q

what causes mild anemia in chronic drinkers

A

alcohol related folic acid deficiency

or Fe deficiency from GI bleed

43
Q

What hormones get messed up in chronic alcoholism

A

unbalance steroid hormones that cause gynecomastia and testicular atrophy
K alterations and hypoglycemia and ketosis

44
Q

what occurs to immune system in chronic alcohol use

A

inhibited in lung (predispose to infection- pneumonia )

hyperactive in liver and pancreas

45
Q

skel mm effects alcohol

A

dec mm strength and increased activity CK in plasma

46
Q

body temp in chronic alcohol

A

increased cutaneous and gastric blood flow, sweating may occur while internal body temp falls

47
Q

diuresis with chronic alcohol

A

alcohol inhibits release of vasopression from posterior piruitary gland

48
Q

what causes hyponatremia in alcohol withdrawal

A

vasopressin release

dilutional hyponatremia

49
Q

sexual function with alcohol use

A

disinhibiting effects

increased libido but can lead to deterioration of sexual function

50
Q

Fetal Alcohol Syndrome

A

chronic alcohol abuse during pregnancy can have teratogenic effects
alcohol is a leading cause of mental retardation and congenital malformation

51
Q

signs FAS

A 
intrauterine growth retardation
microcephaly
poor coordination
underdevelopment of midfacial region
minor joint abnormalities
52
Q

ethanol elimination in fetus

A

fetal liver has no or little ADH so rely on mother’s liver for elimination

Year 2 Psych exam2 (13 decks)

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