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Flashcards in Alcohol Deck (23)
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1

BAC intoxication level in most states

80

2

Name the BAC level:
-Sedation, subjective “high,” slower reaction times
-Impaired motor function, slurred speech, ataxia
-Emesis, stupor
-Coma
-Respiratory depression, death

50-100 - Sedation, subjective “high,” slower reaction times
100-200 - Impaired motor function, slurred speech, ataxia
200-300 - Emesis, stupor
300-400 - Coma
>500 - Respiratory depression, death

3

The two CNS ion channels that ethanol targets.

- NMDA subtype of glutamate receptors
- GABA

4

What are NMDA and GABA receptor functions in the CNS?

NMDA is the primary EXCITATORY NT.
GABA is the primary INHIBITORY NT .

5

Alcohol inhibition of NDMA and GABA results in loss of what normal functions of each?

NMDA - normally implicated in learning/memory. Alcohol inhibits the ability of glutamate to open the cation channel of the NMDA receptor and leads to a depression of the CNS.

GABA is normally implicated in depression of CNS. Alcohol enhances GABA effects.

Tolerance and dependence have opposite effects on NMDA and GABA than alcohol (making you drink more to get same effect).

6

Symptoms of ____ include:

-hyperexcitability/palpitations, **tremors, anxiety, insomnia,** N/V, in mild cases

-seizures, toxic psychosis, and delirium tremens in severe cases

withdrawal syndrome

7

What is characterized by delirium, hallucinations, fever, and tachycardia? How long after alcohol discontinuation does this begin?

Delerium tremens

48-72 hours

8

Associated with thiamine deficiency, symptoms show: Paralysis of the external eye muscles, ataxia, and a confused state that can progress to coma and death.

Treatment of this

Wernicke-Korsakoff

Thiamine to improve ocular problems, ataxia, confusion.

9

Peripheral nerve injury, gait and ataxia, dementia, painless blurring vision. all indicate?

Neurotoxicity from alcohol

10

Ethanol increases levels of ___ enzyme, leading to what drug-drug interaction?

CYP450, leading to acetaminophen-induced hepatotoxicity

11

Drugs for treatment of acute alcohol withdrawl

diazepam (long acting benzos), lorazepam and oxazepam (short acting benzos, good for people with iver dz), and thiamine

12

Drugs for prevention of alcohol abuse/dependence

acamprosate, disulfram, naltrexone

13

Drugs for treatment of acute methanol or ethylene glycol poisoning

ethanol and fomepizole

14

Management of acute alcohol intoxication

glucose, thiamine, potassium (if severe vomiting)

15

MOA of___: µ opioid receptor antagonist (long-acting). reduces craving for alcohol. Used to reduce cravings and relapse. For tx of alcohol and opiate dependence.

Contraindicated in patients with what two conditions

naltrexone

CI in hepatitis and liver failure

16

MOA of ___: weak NMDA-receptor antagonist and GABAA receptor agonist (also affects serotonergic, noradrenergic, and dopaminergic systems). Used to reduce relapse (long+short term).

Contraindicated in what disease?

Acamprosate

CI in renal disease

17

MOA of ___: irreversibly inhibits aldehyde dehydrogenase and causes extreme discomfort in
patients who drink alcoholic beverages (flushing, throbbing headache, nausea, vomiting, sweating, hypotension, confusion due to the accumulation of aldehyde).

Disulfiram

18

Four part treatment of ___ poisoning - when a person comes in with blurred vision "like being in a snowstorm".

Methanol poisoning
Treatment:
(1) Respiratory support
(2) Suppression of metabolism by ADH (**ethanol and fomepizole**)
(3) Hemodialysis to enhance methanol removal
(4) Alkalinization to counteract metabolic acidosis (bicarbonate)
**ETHANOL has a higher affinity than methanol for ADH and is often.**
Fomepizole inhibits ADH and also used for tx.

19

A pet/child ingests antifreeze or an industrial solvent with ethylne glycol. Treatment?

Hemodialysis, ethanol infusion, fomepizole

20

Inhibits alcohol dehydrogenase.

fomepizole

21

Inhibits aldehyde dehydrogenase

disulfiram

22

Ethanol undergoes extensive first-pass metabolism by gastric and liver ___

alcohol dehydrogenase (ADH)

23

Withdrawal symptoms:
First 2 days
48-72 hrs
Months

The signs and symptoms that manifest
-earliest are anxiety, insomnia, tremor, palpitations, nausea, and anorexia as well as (in severe syndromes) hallucinations and seizures.
-48-72 hours Delirium tremens typically develops after alcohol discontinuation. The earliest symptoms (anxiety, insomnia, etc) can persist, in a milder form, for several months after alcohol discontinuation.