PPW2 Alcohols

Question 1

What is ethanol antidote for?

Answer 1

It is antidote for methanol and ethylene glycol

Question 2

How is ethanol eliminated

Answer 2

2-8% by urine, sweat, or breath

92-98% metabolized by liver

Question 3

What are the three enzymes that can convert alcohol to acetaldehyde?

Answer 3

• Alcohol dehydrogenase
• CYP 450
• Catalase

Question 4

What is responsible for ethanol addiction

Answer 4

Catalase metabolized ethanol in the brain to acetaldehyde which combines with neurotransmitters to form THIQs which responsible for addiction

Question 5

What types of people tolerate alcohol more and why? And what syndrome do they get?

Answer 5

Most individuals use acetaldehyde dehydrogenase called ALD2, while some East Asians and American Indians use ALD2*2 which is far less efficient in breaking down acetaldehyde.
-They get flush syndrome

Question 6

What is reverse tolerance?

Answer 6

It means that people with liver damage produce less alcohol dehydrogenase than those with healthy liver and become more intoxicated at smaller doses of alcohol

Question 7

What is Antabuse reaction and how can we treat it?

Answer 7

It is the drug that makes people sick if taken with alcohol because it binds and inhibits acetaldehyde dehydrogenase.
-Symptoms include; Facial flushing, headaches, nausea, vomiting and heart palpitations
We can treat it with 500-1000 mg iv of vitamin C and 40-100mg ferry iv

Question 8

Which formula is used to estimate peak blood alcohol concentration?

Answer 8

Widmark formula

Question 9

Drinking small amount of alcohol decreases risk of?

Answer 9

Heart disease, stroke, diabetes mellitus and early death

Question 10

Drinking high amounts of alcohol increases risk of?

Answer 10

Heart disease, stroke, hypertension, and atrial fibrillation

Question 11

What tests do we use for alcohol intoxication?

Answer 11

Breath test, saliva test and blood test

Question 12

What are the metabolic effects of ethanol poisoning?

Answer 12

• Hypoglycemia
• Electrolyte imbalance (hypokalemia, hypocalcemia, hypophosphatemia and hypomagnesemia)
• Alcoholic ketoacidosis

Question 13

What does the treatment of ethanol depend on and how do we treat it?

Answer 13

• It depend on the patients condition, not the ethanol level in serum
• Oxygen therapy, funds Iv, sedatives or antipsychotics, and symptomatic treatment (hypoglycemia treatment, electrolyte imbalance treatment, and liver failure treatment). We may also give physostigmine and naloxone

Question 14

When do symptoms of alcohol withdrawal begin, and when are they worst?

Answer 14

They begin around six hours following last drink, are worst at 24-72 hours and improve by seven days

Question 15

How do we treat withdrawal symptoms of alcohol?

Answer 15

Fluids iv, sedatives, beta blockers and haloperidol

Question 16

What is the metabolite of methanol and what does it cause?

Answer 16

The metabolite is called formic acid and it causes permanent blindness by destructing optic nerve

Question 17

How does the symptoms of methanol poisoning progress?

Answer 17

• First symptoms are seen after 12-24 hours from ingestion because of slow metabolism and these are similar to alcohol
• Then we see CNS depression and metabolic acidosis

Question 18

What organs are involved in methanol intoxication?

Answer 18

Optic nerve, CNS, kidneys, Liver and heart

Question 19

When do you correct metabolic acidosis and what do you give?

Answer 19

You correct it when pH is less than 7 and you give sodium bicarbonate

Question 20

What are the antidotes of methanol?

Answer 20

Ethanol and fomepizole (competitive inhibitor of alcohol dehydrogenase)

Question 21

What is ethylene glycol used for?

Answer 21

• raw material in the manufacture of polyester fibers

- Antifreeze formulations

Question 22

What are the antidotes for ethylene glycol?

Answer 22

Ethanol and fomepizole (competitive inhibitor of alcohol dehydrogenase)