Pharmacology - Non-medical drug use

Question 1

Where is most alcohol metabolized?

Answer 1

Liver although some metabolism occurs in stomach

With a big meal more stomach metabolism takes place because absorption is slower

Question 2

T/F On empty stomach, peak alcohol concentration in blood arrives earlier, peak concentration is higher, and total absorption is greater

Answer 2

True

Question 3

How can you measure absorption?

Answer 3

area under curve on a plasma concentration vs time graph

Question 4

What are the two liver enzymes involved in alcohol metabolism?

Answer 4

alcohol dehydrogenase

acetaldehyde dehydrogenase

Question 5

where are alcohol dehydrogenase and acetaldehyde dehydrogenase found within the cell?

Answer 5

alcohol dehydrogenase (cytoplasm)
acetaldehyde dehydrogenase I (cytoplasm - MINOR)
acetaldehyde dehydrogenase II (mitochondria - MAJOR)

Question 6

enhanced toxicity from alcohol in certain susceptible individuals is due to

Answer 6

rapid metabolizing alcohol dehydrogenase (producing high levels of acetaldehyde) or defective mitochondrial acetaldehyde dehydrogenase

Question 7

what is disulfiram?

Answer 7

(anabuse) acetaldehyde dehydrogenase inhibitor ==> acetaldehyde builds up and causes toxicity (nausea, vomiting)

Question 8

T/F oxidation of ethanol via ADH or ALDH both utilize NAD+ as electron acceptor

Answer 8

true

Question 9

Under what conditions is the P450 system utilized to metabolize alcohol?

Answer 9

Heavy or chronic drinking

Question 10

Alcohol metabolism exhibits 1st order or zero order elimination kinetics?

Answer 10

Zero order (saturation) kinetics untill very very low levels (.005%) becomes 1st order kinetics (100 mg/kg/hr - at levels this low rate is not dependent on concentration, dependent on body weight)

NAD+ is limiting (saturatable) factor

Question 11

Microsomal ethanol oxidizing system (MEOS) utilizes which CYP450 enzyme to metabolize alcohol?

Answer 11

CYP2E1

Question 12

T/F stomach is greatest site of absorption for alcohol

Answer 12

FALSE - small intestine!

Question 13

Which allele of ADH is responsible for enhanced sensitivity to alcohol in Asians?

Answer 13

ß2 allele

Question 14

Which neurotransmitter system do LSD, mescaline, psilocybin, MDMA primarily influence?

Answer 14

serotonin

Question 15

Metabolic symptoms of excessive alcohol intake

Answer 15

hypoglycemia
lactic acidosis
ketoacidosis
hypertriglyceremia

Question 16

What else does CYP2E1 metabolize?

Answer 16

acetaminophen, theophylline, halogenated anesthetics

Question 17

T/F signs of cerebellar dysfunction from alcohol include diplopia, nystagmus, dysarthria, ataxia

Answer 17

True

Question 18

Alcohol increases or decreases HDL levels?

Answer 18

increases (1-6 drinks/week)

Question 19

Alcohol increases or decreases risk coronary heart failure?

Answer 19

decreases (1-6 drinks/week)

Question 20

What is considered safe level of alcohol consumption?

Answer 20

1-2 drinks/day for women

2-3/day for men

Question 21

T/F Acute alcohol use inhibits drug metabolism while chronic use can increase metabolism

Answer 21

True

Question 22

T/F alcohol inhibits activity of adrenal cortex

Answer 22

False - adrenal cortex is stimulated

Question 23

What effect does alcohol have on testosterone synthesis?

Answer 23

Decreased testosterone synthesis: male
alcoholics > hypogonadism & feminization,
gynecomastia

Also suppresses uterine motility & milk ejection

Question 24

T/F alcohol is the most frequent cause of teratogenically induced mental deficiency in the Western world

Answer 24

True

Question 25

Effects of alcohol on fetus include?

Answer 25

decreased pre and postnatal body length and below mean weight Facial/limb deformaties microcephaly, tremor, seizures, slow development, hyperactivity, learning problems, memory problems

Question 26

Methyl-alcohol causes acidosis visual disturbances and blindness. What is treatment?

Answer 26

ethanol + bicarbinate

Question 27

What is major symptom of ethylene glycol toxicity?

Answer 27

Nephrotoxicity acidosis CNS excitement ---> depression

Question 28

What is major symptom of methanol toxicity?

Answer 28

retinal damage | acidosis

Question 29

What is major symptom of methanol toxicity?

Answer 29

Nausea, vomiting, headache, HYPOtension

Question 30

What is major symptom of isopropyl alcohol toxicity?

Answer 30

gastritis, acidosis, CNS symptoms

Question 31

T/F Treatment for isopropyl alcohol toxicity is ethanol + bicarb

Answer 31

FALSE (this is for methanol) there is no antedote for isopropyl alcohol toxicity

Question 32

What are roofies? What type of drug?

Answer 32

flunitrazepam - Rohypnol | Benzo

Question 33

How is cocaine metabolized?

Answer 33

Mostly by plasma cholinesterase but some P450 metabolism byproduct detected in urine tests is benzoylecgonine

Question 34

What is current use of cocaine?

Answer 34

topical anesthetic for upper respiratory tract (vasocontrictor and local anesthesia ==> shrinks mucosa)

Question 35

T/F hallucinogens are schedule I drugs

Answer 35

true

Question 36

What is MPTP?

Answer 36

failed attempt at making fentanyl that resulted in death of substantia nigra neurons and drug induced parkinsons

Question 37

LSD is agonist or antagonist of 5HT2A receptors?

Answer 37

agonist - inhibits firing at Raphe nucleus (which is inhibitory) thus agonism disinhibits post-synaptic neurons

Question 38

What is anandamide?

Answer 38

natral ligand for canbabanoid receptors

Question 39

MDMA side effects

Answer 39

Possible hypertensive crisis with spontaneous intracerebral hemorrhage paranoid psychosis, cardiac arrhythmias, death