Pharmacology of alcohol use and misuse Flashcards
Describe the clinical implications of the dose dependent disposition of alcohol
small increases in dose can cause disproportionate increases in concentration
Describe the mechanisms of action of ethanol on the CNS
Binding site on GABA unknown enhances the effects of GABA which enhances neuronal inhibition
Binds to NMDA receptor inhibits the effect of glutamate reducing excitatory effect
What enzyme is responsible for turning ethanol into acetaldehyde
Alcohol dehydrogenase
NAD–> NADH
What enzyme is responsible for turning acetaldehyde to acetyl CoA
Aldehyde Dehydrogenase (ALDH)
NAD, COA–> NADH
what enzyme is responsible for turning ethanol into acetaldehyde in high alcohol consumption
MEOS(microsomal ethanol oxidizing system)
NADPH + H–> NADP
T or F: Fomepizole is used in the tx of methanol and ethylene glycol poisoning
T (inhibits ADH)
T or F: by slowing gastric emptying food will increase the rate of ethanol absorption and reduce the saturation of metabolism
False: food will reduce the rate of ethanol absorption
What are the minor symptoms of alcohol withdrawal syndrome
Anxiety, insomnia,GI upset, headache,palpitations,anorexia
What are the symptoms of alcoholic hallucinosis
most commonly visual also auditory or tactile usually resolves within 48 hours
What are the withdrawal seizures in alcohol withdrawal syndrome
generalized tonic clonic convulsions
may occur as early as 2 hours after alcohol cessation
What are delerium tremens
agitation hallucinations disorientation tachycardia HTN fever diaphoresis
What are the three stages of AUD
binge/intoxication, withdrawal/negative affect
preoccupation/anticipation
What is the superstructure for the binge intoxication stage
A.basal ganglia
B. extended amygdala
C. prefrontal cortex
A
What is the superstructure for the withdrawal/negative affect stage
A.basal ganglia
B. extended amygdala
C. prefrontal cortex
B
What is the superstructure for the preoccupation/anticipation stage
A.basal ganglia
B. extended amygdala
C. prefrontal cortex
C
T or F: AUD is very complex and involves many neurochemical and molecular targets
T
What drugs are approved for AUD
disulfiram
Naltrexone
Acamprosate
What does disulfiram inhibit
aldehyde dehydrogenase (ALDH)
focuses on metabolism causes aversive reaction to alcohol (N/V) due to acetaldehyde build up
Naltrexone targets
opioid system
Acamprosate targets
glutaminergic system
Alcohol poisoning signs
CUSP
cold clammy pale or bluish skin
Unconscious or unable to be roused
Slow or irregular breathing
Puking repeatedly or uncontrollably
