Pharmacology of Alcohol Flashcards
When do symptoms of severe alcohol withdrawal typically peak?
24-48 hours after last drink
This drug treats chronic alcoholism by causing severe nausea in response to alcohol.
Disulfiram
What physical defects may present in a baby born with Fetal Alcohol Syndrome?
Hypoplasia of the maxilla, short palpebral fissures, atrial septal defect
When do mild symptoms of alcohol withdrawal begin?
6-8 hours after last drink
Females require less alcohol to achieve the same effects in males. What factors account for this?
Decreased first-pass metabolism, decreased alcohol dehydrogenase activity (quicker buildup of alcohol)
This drug to treat alcohol withdrawal symptoms is contraindicated in patients with renal impairment.
Acamprosate - drug is not biotransformed and excreted renally
What is the rate-limiting step of alcohol metabolism?
Ethanol –> acetaldehyde by the alcohol dehydrogenase
This drug reduces the symptoms of protracted alcohol withdrawal.
Acamprosate
What is the MOA of disulfiram?
Inhibits the aldehyde dehydrogenase
What are the effects of alcohol on the CNS?
Reduction of cortical inhibition and signaling in RAS
True/False. Delirium, hallucinations, and seizures are potential symptoms of severe alcohol withdrawal.
True, along with autonomic symptoms
What is the recommended treatment for alcohol overdose?
Symptom management and prophylactic administration of an anti-convulsant
At high concentrations, alcohol causes nausea and vomiting. What are the effects of alcohol on the GI tract at low concentrations?
Increased appetite and gastrin secretion
True/False. A hangover is a mild form of alcohol withdrawal.
True - the brain adjusts even during acute use
What are the effects of alcohol on the cardiovascular system?
Decreased myocardial contractility and vasodilation
This disorder may present in patients with chronic alcohol use due to thiamine deficiency.
Wernicke-Korsakoff (ataxia, confusion, neuropathy)
What is the MOA of acamprosate?
Decreases glutamate levels in the CNS
What ADRs are associated with methanol OD?
Nonspecific inebriation, visual disturbances, blindness, cessation of respiration
Portal cirrhosis is an irreversible effect of chronic alcohol use. What reversible liver disorders present before this stage due to chronic use?
Alcoholic fatty liver and alcohol hepatitis
What is the effect of acute alcohol use on liver function?
Increase in liver functioning
Fomepizole can be used to treat methanol and ethylene glycol poisoning. What is the MOA of the drug?
Inhibits the alcohol dehydrogenase that produces the toxic metabolites
Alcohol use causes frequent urination. Why is this?
Alcohol causes decreased release of ADH by the posterior pituitary, thus leading to more frequent urination.
When does severe alcohol withdrawal typically begin?
24 hours after last drink
This drug is a mu receptor antagonist that reduces alcohol-induced euphoria to prevent relapse.
Naltrexone
What nutritional deficiencies may present due to chronic alcohol use?
Folic Acid/B9 (megaloblastic anemia)
Iron
Niacin/B3 (pellagra)
Thiamine/B1 (Wernicke-Korsakoff)
Chronic alcohol use causes (hypo/hyper-tension)
Hypertension
Disulfiram is contraindicated in this patient population.
Patients with severe myocardial disease or coronary occlusion
A teenager is brought to the ED by EMS. Friends of the teen report they were drinking windshield wiper fluid to get drunk and their friend “passed out.” What is the likely diagnosis and treatment?
Methanol OD - support respiration and administer fomepizole
Alcohol exhibits this type of biotransformation.
Zero-order
This compound is known to be sweet-tasting. It is generally non-toxic, but is metabolized to toxic compounds by the alcohol dehydrogenase. What life-threatening ADR is associated with this compound?
Ethylene Glycol - deposition of oxalate crystals in the renal tubules
True/False. Alcohol use causes hyperglycemia due to energy production from metabolism.
False. Alcohol use causes hypoglycemia.
