Alcohol

Question 1

potency of alcohol

Answer 1

low

Question 2

how is absorption of alcohol increased

Answer 2

carbonated beverages

Question 3

how is absorption of alcohol decreased

Answer 3

presence of food

Question 4

distribution of alcohol

Answer 4

in total body water

Question 5

metabolism of ethanol

Answer 5

90-98% metabolized to acetaldehyde

remaining eliminated as ethanol in breath, sweat, saliva

Question 6

where does the significant first pass effect of alcohol occur?

Answer 6

liver, stomach- alcohol dehydrogenases

Question 7

What is the rate limiting step of alcohol metabolism?

Answer 7

alcohol dehydrogenase–zero order kinetics because it’s saturated

Question 8

What are the two methods of metabolizing ethanol?

Answer 8

alcohol dehydrogenase

CYP2E1

Question 9

what byproducts are made in the metabolism of ethanol to acetaldehyde

Answer 9

NADH

Question 10

When does CYP2E1 take action?

Answer 10

chronic users of alcohol or high doses of alcohol

Question 11

What steps convert NAD+ to NADH in the metabolism of ethanol?

Answer 11

ethanol to acetaldehyde

acetaldehyde to acetic acid

Question 12

What is the enzyme that converts acetadehyde to acetic acid?

Answer 12

aldehyde dehydrogenase

Question 13

What is the primary first step in metabolizing ethanol?

Answer 13

alcohol dehydrogenase

Question 14

What is the mixed function oxidase system?

Answer 14

system used to convert ethanol to acetaldehyde via CYP2E1

Question 15

What is the Km of CYP2E1 for alcohol?

Answer 15

high

Question 16

What contributes to the fact that Asians are more likely to get flushing with alcohol consumption

Answer 16

genetic polymorphism in aldehyde dehydrogenase

Question 17

what does acetaldehyde cause

Answer 17

unpleasant feeling, headache

Question 18

what are the consequences of alcohol metabolism?

Answer 18

increased NADH:
inhibits TCA cycle–decreases gluconeogenesis
decreases fatty acid oxidation–deposition of fat

increased acetaldehyde:
makes protein adducts–causes inflammation
inhibits microtubules
decreases glutathione

Question 19

what does induction of CYP2E1 affect?

Answer 19

metabolism of xenobiotics to carcinogens

Question 20

how does ethanol cause hypoglycemia?

Answer 20

induces insulin secretion

Question 21

why does alcohol induce ketoacidosis?

Answer 21

can cause hypoglycemia

Question 22

ethanol in the CNS affects

Answer 22

GABA A receptor ligand gated chloride channel

Question 23

What explains the excitement one gets with alcohol?

Answer 23

inhibits inhibitory neurons

Question 24

Effects of alcohol at 100-200mg%

Answer 24

poor motor function

ataxia

Question 25

chronic ethanol consumption causes what effects on the liver

Answer 25

steatosis-fatty liver hepatitis C-often co-morbid cirrhosis-b/c of liver necrosis/inflammation liver cancer

Question 26

effects of chronic ethanol consumption on GI

Answer 26

``` gastritis pancreatitis malabsorption of vitamins diarrhea esophageal cancers ```

Question 27

effects of chronic ethanol in CNS

Answer 27

tolerance due to: - -neuronal change: chronic alcohol causes upregulation of excitatory transmission as compensation - -metabolic: upregulation of CYP2E1 psychological craving and physical dependence

Question 28

how is alcoholism neurotoxic

Answer 28

neuralgia (firing of pain neurons when there isn't pain) peripheral nerve injury memory impaired poor nutrient absorption/thiamine deficiency can lead to cerebral/cerebellar atrophy, Wericke's encephalopathy, Korsakoff's psychosis

Question 29

symptoms in newborn in mother who uses alcohol chronically

Answer 29

retarded body growth facial abnormalities CNS problems

Question 30

Drugs interactions of alcohol

Answer 30

additive with CNS depressants high doses inhibit CYP metabolism, whereas chronic use induces CYP2E1 and can increase metabolism of other drugs Depletes glutathione so can result in acetaminophen toxicity

Question 31

Clinical treatment of acute intoxciation of ethanol

Answer 31

support respiration | fix metabolic issues--dehydration, hypoglycemia, ketosis, electrolyte imbalance

Question 32

How do you treat alcohol withdrawal

Answer 32

want to prevent seizures and delirium and arrythmias treatment: short acting benzodiazepines-diazepam and chlordiazepoxide, atenolol for prevention of cardiac arrythmia

Question 33

how to treat alcoholism

Answer 33

naltrexone acamprosate disulfiram