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psych > Pharm: alcohol use and abuse > Flashcards

Pharm: alcohol use and abuse Flashcards

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1
Q

EtOH metab

A

ethanol – (alcohol dehydrogenase)–> acetaldehyde – (aldehyde dehydrogenase) –> acetate

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2
Q

disulfiram moa

A

blocks the action of aldehyde dehydrogenase resulting in the accumulation of acetaldehyde, which causes nausea and flushing

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3
Q

acetaldehyde duel action

A

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

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4
Q

alcohol and acetaminophen use

A

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

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5
Q

acetaminophen overdose antidote

A

n-acetylcysteine

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6
Q

ethanol effects on GABAa system

A

increase GABA release and increased receptor density

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7
Q

ethanol effects on NMDA system

A

inhibition of postsynaptic NMDA receptors; with chronic use - upregulation

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8
Q

alcohol effects on dopamine system

A

increased synaptic dopamine, increased effects on ventral tegmenjtum/nucleus accumbent reward

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9
Q

alcohol effects on ACTH system

A

increased blood and CNS levels of ACTH

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10
Q

alcohol effects on opioid system

A

release of beta-endorphins and activation of mu receptors

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11
Q

alcohol effects on 5-HT system

A

increase in 5-HT synaptic space

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12
Q

alcohol effects on the cannabinoid receptor system

A

increase CB1 activity leading to changes in DA, GABA, and glutamate activity

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13
Q

acute systemic effects of alcohol

A

CV depressant, relaxation of smooth muscle - vasodilation, possible hypothermia, increased gastric blood flow; relaxes uterine smooth muscle

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14
Q

effects of body weight on BAL

A

more weight = larger vol. of distribution = lower BAL

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15
Q

effects of BMI on BAL

A

more body fat = small volume of distribution = higher BAL

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16
Q

effects of gender on BAL

A

females = higher BAL

17
Q

alcohol metab

A

zero order

18
Q

chronic effects of ethanol on the liver

A

decreased gluconeogenesis leading to hypoglycemia

fatty liver leads to hepatitis, cirrhosis, and liver failure

19
Q

chronic effects of ethanol on the GI system

A

bleeding and scarring lead to absorptive and nutritional deficiency

20
Q

chronic effects of ethanol on the CNS

A

peripheral neuropathy

wernicke-korsakoff syndrome (ataxia, confusion, ocular muscle paralysis)

21
Q

chronic effects of ethanol on the endocrine system

A

gynecomastia and testicular atrophy secondary to steroid insufficiency

22
Q

chronic effects of alcohol on the CV system

A

HTN, anemia, dilated cardiomyopathy, arrhythmias,

modest alcohol increases HDL and may protect agains CHD

23
Q

alcohol and neoplasia

A

GI cancer incidence increased in alcoholics

24
Q

chronic effects of alcohol on the immune system

A

enhanced inflammation in liver and pancreas but reduced immune response in other tissues; chronic alcoholics susceptible to infectious pneumonia

25
Q

fetal alcohol syndrome

A

intrauterine growth restriction, microcephaly, poor coordination, mid facial underdevelopment, minor joint abnormalities

26
Q

naltrexone moa

A

mu opoid antagonist; felt to decrease drinking through decreasing feelings of reward with alcohol and/or decreased craving

27
Q

acamprosate moa

A

weak NMDA antagnoist, activator of GABAa receptors; may decrease mild protracted abstinence syndromes with decreased feeling of “need” for alcohol

28
Q

fomeprazole moa

A

blocks the action of alcohol dehydrogenase preventing the conversion of ethylene glycol and methanol into toxic metabolites

29
Q

ethylene glycol metab and toxicity

A

converted by ADH to oxalic acid which causes acidosis and nephrotoxicity

30
Q

methanol metab and toxicity

A

converted by ADH to formaldehyde and formic acid which cause every acidosis and retinal damage

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