Pharmacology of Ethanol

Question 1

Ethanol Absorption is rapid throughout entire GI tract; and extremely rapid in the ________.
•

Answer 1

small intestine

Question 2

The more rapid the ethanol _______ , the more rapid the absorption (dependent on concentration gradient)

Answer 2

ingestion

Question 3

Ethanol is water soluble and distributed in ________

Answer 3

total body water (will also cross the placenta)

Question 4

Distribution / equilibration is most rapid in areas of high ________. Initial CNS effects within 5 min; peak effects within 15-60 min.

Answer 4

blood flow (brain, liver, kidney, lung)

Question 5

Fat contains less water and thus less alcohol._______ is a factor that corrects for the volume of distribution of alcohol

Answer 5

[r]

Question 6

r = \_\_\_\_\_\_ for men, 
r =  \_\_\_\_\_\_ for women.

Answer 6

0. 68,

0. 55

Question 7

Women given the same g/kg dose of ethanol as a man of equal weight will have a _______ blood alcohol concentration

Answer 7

higher

Question 8

Metabolism is responsible for _______ of disappearance of alcohol from body.

Answer 8

90-98%

Question 9

First pass metabolism in _________ may be important in sex differences in BAC

Answer 9

gastric mucosa

Question 10

Metabolism occurs at a __________ of 7-10 grams of alcohol per hour

Answer 10

constant rate (zero order kinetics)

Question 11

which enzyme is the main metabolizer of ethanol in the liver

Answer 11

Alcohol dehydrogenase

Question 12

________ accounts for 10-25% of ethanol metabolism at higher BACs

Answer 12

CYP2E1 (previously known as Microsomal Ethanol Oxidizing System [MEOS]);

Question 13

Aldehyde dehydrogenase is inhibited by ________

Answer 13

disulfiram

Question 14

__________ converts acetaldehyde to acetate.

Answer 14

Aldehyde dehydrogenase

Question 15

acetate is converted to ______. then metabolized into fatty acids and cholesterol, CO2, H2O, and energy

Answer 15

Acetyl CoA

Question 16

what are the adverse effects of increased acetaldehyde levels

Answer 16

nausea/vomiting,
respiratory and cardiovascular collapse,
convulsions

Question 17

Mitochondrial oxidation of NADH to NAD is insufficient with the increased levels of _______, caused by alcohol

Answer 17

NADH

Question 18

increased levels of NADH leads to disruptions in hepatic metabolic pathways:
Increased Blood lactate =________

Answer 18

acidosis -> behavioral disturbances

Question 19

Increased levels of NADH leads to disruptions in hepatic metabolic pathways:
Increased Mg++ excretion can lead to _______
Decreased Uric acid excretion may precipitate ______

Answer 19

convulsions,

gout attacks

Question 20

Increased levels of NADH leads to disruptions in hepatic metabolic pathways:
Increased Acetyl CoA leads to _________ fatty acid synthesis combined with decreased fat breakdown leads to fatty liver.
Increased NADH leads to Decreased Krebs cycle activity, -> Decreased gluconeogenesis -> ______

Answer 20

Increased,

hypoglycemia

Question 21

Alcohol produces a dose-dependent __________ effect similar to ________

Answer 21

CNS depressant

barbiturates

Question 22

Ethanol is not a stimulant at any dose, but depression of _________ neurons is seen first, resulting in a relative stimulatory phase prior to depressive actions.

Answer 22

inhibitory cortical

Question 23

The CNS effects of low-to-moderate doses of ethanol (0.05-0.250 g/dl [50-250 mg %]) are mediated via interactions with ______ and _________ receptor coupled ion channels.

Answer 23

GABA (potentiation),
glutamate NMDA (inhibition)

Question 24

alcohol may precipitate convulsions; and is ________ in epilepsy

Answer 24

contraindicated

Question 25

Effects of Alcohol on the Liver

Answer 25

Reversible damage (increased fatty acid / lipid deposition -> hepatitis).
ascites,
esophageal varicosities.
May see decreased synthesis of clotting proteins, thus increased bleeding time.

Question 26

Cirrhosis occurs in ______ of chronic alcoholics (5-25 yrs)

Answer 26

20%

Question 27

High doses of ethanol can decrease absorption of _________.

Answer 27

amino acids, glucose, folic acid, thiamine, B12

Question 28

Alcohol-induced increases in digestive secretions can produce ________.

Answer 28

pancreatitis

Question 29

Prolonged ethanol use may cause serious ulceration of the gastric mucosa, ranging from ______to actual ________.

Answer 29

gastritis,

hemorrhage

Question 30

Alcohol exerts a diuretic effect by ___________.

Answer 30

inhibiting the secretion of antidiuretic hormone

Question 31

Heavy drinkers have increased risk of cancers of the

_____________ .

Answer 31

mouth, pharynx, larynx, esophagus, liver, and lung

Question 32

can get ethanol Cross tolerance with other CNS depressants such as ______ & _____

Answer 32

anesthetics,

benzodiazepines

Question 33

what are early withdrawal Sx’s of ethanol (0-48Hr)

Answer 33

anxiety
tremor,
mild agitation

Question 34

what are some late alcohol withdrawal Sx’s (24-150 Hrs)

Answer 34

extreme overactivity,
disorientation,
confusion

Question 35

In __________. Patients display progressive external ophthalmoplegia, nystagmus, ataxia of gait, pain, loss of sensation, and weakness of the arms and legs. Results from thiamine deficiency that is secondary to alcohol intake; responds quickly to thiamine administration

Answer 35

Wernicke’s Disease

Question 36

___________. Symptoms include severe amnesia and personality alterations. Amnesic syndrome may result from interaction of thiamine deficiency with direct neurotoxic effects of alcohol.

Answer 36

Korsakoff’s psychosis

Question 37

what are the Major effects of ethanol by pregnancy trimester?

Answer 37

1st: Major morphologic abnormality
2nd: Increased risk of spontaneous abortions
3rd: Decreased fetal growth

Question 38

Ethanol can promote ______ if taken with aspirin.

Answer 38

GI bleeding

Question 39

If alcoholic with normal liver function -> faster metabolism (enzyme induction, CYP2E1); may reduce concomitant drug effect and can potentiate ______ toxicity.

Answer 39

acetaminophen

Question 40

•NMDA receptor drugs _________. Produces SOME reduction in alcohol craving and relapse rates in combination with psychotherapy.

Answer 40

Acamprosate

Question 41

Opioid antagonists _______ Shown to reduce alcohol craving, consumption, and relapse rates when used in combination with psychotherapy.

Answer 41

Naltrexone