alcohol

Question 1

abuse

Answer 1

unable to limit consumption

Question 2

when does the peak effect occur?

Answer 2

30 minutes after consumption

Question 3

Role of food?

Answer 3

delays absorption onset., s absorbed more slowyly but not less

Question 4

why do women have higher BACs?

Answer 4

more totaly boy water/kg and more fat/kg

Question 5

which organs excrete ETOH?

Answer 5

Kidney and lung

Question 6

What is ETOH converted to?

Answer 6

acetaldhyde

Question 7

what is acetaldehyde converted to?

Answer 7

acetate

Question 8

which chemical is responsible for hangovers?

Answer 8

acetaldehyde

Question 9

which enzyme is used in the liver to break down alcohol?

Answer 9

alcohol dehydrogenase

Question 10

what percentage is excreted by the lungs?

Answer 10

2%

Question 11

how many drinks /hr= .08-.1 %?

Answer 11

2-4 /

Question 12

ethanal protentiates action of which molecule?

Answer 12

GABA, increase dopamine

Question 13

Alcohol limits which moleceuls release?

Answer 13

acetylcholine (sedation) and antiduiretic hormone

Question 14

Alcohol effect on smooth muscle is

Answer 14

relaxes/dilates, hypothermia in overdoses, acute pancreatitis

Question 15

What is the progression of the diseased liver from alcohol?

Answer 15

alcoholic hepatitis -> fibrosis -> cirrhosis and liver failure

Question 16

3 GI effects of alcohol

Answer 16

1) chronic pancreatitis- uncommon
2) protein malnutrition
3) vitamin deficiency

Question 17

4 CNS effects of ETOH

Answer 17

1) Peripheral neuropathy (Thiamine deficiency)
Chronic ETOH is toxic to peripheral nerves and causes impaired conduction.

2) CNS- ataxia and dementia
3) wernicke- Korsakoff syndrome
4) Visual Changes

Question 18

Wernicke- Korsakoff Syndrome; 2 parts

Answer 18

• uncommon but leads to death

-1) Wernicke’s encephalopathy: paralysis of eye muscles, ataxia, confusion occurring acutely after ETOH ingestion
It’s due to thiamine (vitamin B1) deficiency

2)Korsakoff’s psychosis: if survive the acute Wernicke’s encephalopathy often left with Korsakoff psychosis. Korsakoff is a form of dementia with impaired memory & confusion

Question 19

3 effects of ETOH on CVS

Answer 19

1) dilated cardiomyopathy- toxic to hear cells, CHf symptoms
2) Arrhythmias- develop atrial or ventricular arrhytmias
3) HTN- greater than 3 drinks/ day

Question 20

2 effects of ETOH on marrow

Answer 20

1) anemia- folic acid deficiency, iron deficiency, GI bleeding
2) thrombocytopenia- direct platelet toxicity

Question 21

3 Endocrine Effects of ETOH

Answer 21

1) Geynecomastia
2) testicular atrophy
3) hypoglycemia

Question 22

Cancers associated with ETOH

Answer 22

-mouth, pharynx, larync, esophagus, liver

Question 23

Drug related interactions

Answer 23

• increases liver enzyme activity

Question 24

etoh effects of sedative hypnotics

Answer 24

inhibits metabolism

Question 25

etoh effects of vasodilators and hypoglycemics

Answer 25

increases effects

Question 26

etoh effects on CNS depressents

Answer 26

additional sedation

Question 27

ETOH and Tylenol

Answer 27

- decrease liver ability to break down tylenol - atcepominophrin broken down into toxic compound - 3 or more drink a day increases hepatotoxicity - if a drink 2 gm/ day is tylenol limit

Question 28

Benzodiazapine

Answer 28

-eliminated withdrawl maifestations

Question 29

benzodiazapine dosing for withdrawl 3)

Answer 29

1) intermittend- adjusted to severity of symptoms 2) scheduled- given on admission and then tappered 3) loading- newer, Diazepam- 10-20 mg every 1-2 hrs until no symtoms; loarazepam- 1-2 mg

Question 30

Nutrition consideration

Answer 30

- thiamine - Mg - Electrolytes - potassium

Question 31

Fluid therapy

Answer 31

5% dextrose in 1/2 normal saline

Question 32

drug for hallucinations

Answer 32

haloperidol

Question 33

drug for seizures

Answer 33

benzos

Question 34

drug for BP

Answer 34

beta blockers

Question 35

alpha agonists (clonidine)

Answer 35

help with some withdrawl symptoms

Question 36

Chronic therapy

Answer 36

Disulfiram- blocks dehydrogenase- negative symptoms immediately naltexone- opiod receptor antagonist- decrease ETOH craving Acamprosate- antagnozies neurotrnasmiters stimulated by ETOH- reduces cravings