alcohol pharm Flashcards

1. Describe the absorption, distribution and metabolism of ethanol and methanol. 2. List the pharmacological and toxic effects of ethanol and methanol and the mechanism of action for each effect. 3. Describe the tolerance and physical dependence that develops following chronic ethanol administration. 4. Describe the pharmacological approaches to the treatment of alcoholism. 5. Describe the pharmacological approaches to the treatment of methanol poisoning and the mechanism of action of the ag

1
Q

kcal yield of EtOH

A

7 kcal/g

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2
Q

effective dose of EtOH

A

1-3 g/kg

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3
Q

mode of EtOH absorption

A

passive diffusion in the SI

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4
Q

delays the absoption of EtOH

A

food in stomach

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5
Q

distribution of EtOH in body

A

in total body water

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6
Q

most EtOH is metaboloized by

A

alcohol dehydrogenase

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7
Q

some EtOH metabolized via

A

P450

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8
Q

end result of EtOH metabolizism

A

acetyl CoA

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9
Q

rate limiting step of EtOH metabolism

A

EtOH to acetaldehyde

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10
Q

rate of EtOH metabolism

A

7-10 gm/hour

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11
Q

% of EtOH metabolized by P450

A

10%

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12
Q

main enzyme in P450 that metabolizes EtOH

A

CYP3A4/5

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13
Q

receptor inhibited by EtOH

A

glu (NDMA and kianate)

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14
Q

recptor enhanced by EtOH

A

GABAA

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15
Q

def: Dispositional tolerance

A

reduced effect and reduced concentration in plasma

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16
Q

def: pharmacodynamic tolerance

A

reduced effect at SAME concntration in plasma

17
Q

def: mellanby effect

A

impairment is worse at the same BAC level as levels increase than as they are on the way down

18
Q

common cause of death in EtOH intox

A

respiratory depression

19
Q

liver effects of EtOH

A

fatty liver –> cirrhosis–> portal hypertension

20
Q

endocrine effects of EtOH

A

gynomastia, testicular atrophy, reduced prolactin, GH, and ADH

21
Q

ddx of actute EtOH intox

A

diabetic coma

22
Q

drugs that can cause same reaction to EtOH as disulfram

A

cephlasporins, griseofulvin, metrinidazole, procarbazine

23
Q

drug that reduces EtOH craving

A

naltrexone

24
Q

contraindication of acamprosate

A

kidney pts

25
Q

MOA of acamprosate

A

glutamatergic NMDA antagonist/GABAA agonist

26
Q

alcohol found in moonshine

A

methanol

27
Q

mech of methanol poisoning

A

metabolites are more toxic - causes retinal damage and metabolic acidosis

28
Q

toxic metabolite of methanol

A

formic acid

29
Q

treatment for methanol poisoning

A

high dose ethanol or fomepizole

30
Q

MOA of ethanol for methanol poisoning

A

competes for Alcohol dehydrogenase, reventing metabolism of methanol to toxic metabolites

31
Q

non alcohol methanol and ethylene glycol antidote

A

fomrpizole

32
Q

MOA of fomepizole

A

competitive alcohol dehydrogenase inhibitor

33
Q

tx for methanol poisoning

A

ABC, bicarb, large doses of EtOH, hemodialysis in severe cases, emesis in conciious pts if presented early