Pharm: alcohol use and abuse Flashcards
EtOH metab
ethanol – (alcohol dehydrogenase)–> acetaldehyde – (aldehyde dehydrogenase) –> acetate
disulfiram moa
blocks the action of aldehyde dehydrogenase resulting in the accumulation of acetaldehyde, which causes nausea and flushing
acetaldehyde duel action
unpleasant in periphery: nausea and flushing
central action is pleasurable: effects the pleasure center in the VTA, giving rise to a reinforcement of alcohol seeking behavior
alcohol and acetaminophen use
alcohol induces CYP 2E1, resulting in a greater proportion of acetaminophen is converted to NAPQI (toxic), leading to the depletion of GSH stores, which causes a toxic accumulation of NAPQI in the liver
acetaminophen overdose antidote
n-acetylcysteine
ethanol effects on GABAa system
increase GABA release and increased receptor density
ethanol effects on NMDA system
inhibition of postsynaptic NMDA receptors; with chronic use - upregulation
alcohol effects on dopamine system
increased synaptic dopamine, increased effects on ventral tegmenjtum/nucleus accumbent reward
alcohol effects on ACTH system
increased blood and CNS levels of ACTH
alcohol effects on opioid system
release of beta-endorphins and activation of mu receptors
alcohol effects on 5-HT system
increase in 5-HT synaptic space
alcohol effects on the cannabinoid receptor system
increase CB1 activity leading to changes in DA, GABA, and glutamate activity
acute systemic effects of alcohol
CV depressant, relaxation of smooth muscle - vasodilation, possible hypothermia, increased gastric blood flow; relaxes uterine smooth muscle
effects of body weight on BAL
more weight = larger vol. of distribution = lower BAL
effects of BMI on BAL
more body fat = small volume of distribution = higher BAL
effects of gender on BAL
females = higher BAL
alcohol metab
zero order
chronic effects of ethanol on the liver
decreased gluconeogenesis leading to hypoglycemia
fatty liver leads to hepatitis, cirrhosis, and liver failure
chronic effects of ethanol on the GI system
bleeding and scarring lead to absorptive and nutritional deficiency
chronic effects of ethanol on the CNS
peripheral neuropathy
wernicke-korsakoff syndrome (ataxia, confusion, ocular muscle paralysis)
chronic effects of ethanol on the endocrine system
gynecomastia and testicular atrophy secondary to steroid insufficiency
chronic effects of alcohol on the CV system
HTN, anemia, dilated cardiomyopathy, arrhythmias,
modest alcohol increases HDL and may protect agains CHD
alcohol and neoplasia
GI cancer incidence increased in alcoholics
chronic effects of alcohol on the immune system
enhanced inflammation in liver and pancreas but reduced immune response in other tissues; chronic alcoholics susceptible to infectious pneumonia
