Alcohol and Adverse Drug Reactions (9)

Question 1

What claims more lives than drugs?

Answer 1

Alcohol

Question 2

EtOH

Answer 2

Alcohol

Question 3

Impaired ability to control alcohol use despite adverse effects

Answer 3

Alcohol Abuse Disorder

Question 4

How does alcohol get digested?

Answer 4

It is absorbed into the blood stream UNALTERED

Question 5

Due to alcohol being unaltered in the blood stream, the amount exhaled is?

Answer 5

Proportional to the blood level

Question 6

Drunk driving blood alcohol level and drink number

Answer 6

80 mg/dl

= 3 drinks

Question 7

A blood alcohol content of 300 mg/dl will cause?

Answer 7

Coma

Question 8

Alcohol tolerance

Answer 8

Alcoholics metabolize alcohol at a HIGHER rate, thus they have lower alcohol levels in blood even after same number of drinks

Question 9

What enzyme breaks down alcohol?

Answer 9

Alcohol Dehydrogenase

Question 10

Alcohol is taken to ______ by alcohol dehydrogenase

Answer 10

Acetaldehyde -> Acetate

Question 11

What ethnicity has decreased ability to metabolize alcohol because they have decreased levels of alcohol dehydrogenase?

Answer 11

Asians

Question 12

Describe how alcohol causes liver injury

Answer 12

• Alcohol causes Endotoxin release from Gram (-) bacteria
• Endotoxins cause release of TNF from macrophages
  = Hepatic injury

Question 13

Acute Alcoholism effects can be reversed if consumption is stopped. What are those effects?

Answer 13

CNS depressant effects

Steatosis of liver

Question 14

Chronic Alcoholism effects on the liver?

Answer 14

Steatosis

Cirrhosis (nodules)

Question 15

Chronic Alcoholism causes a deficiency in what vitamin?

Answer 15

Thiamine (B1)

– Wernicke-Korsakoff Syndrome

Question 16

How does Chronic Alcoholism increase risk of coronary artery disease?

Answer 16

Lowers HDL

Question 17

Fetal Alcohol syndrome findings?

Answer 17

Microcephaly
Facial anomalies
Decreased mental functions

Question 18

Drinking alcohol at what point in pregnancy is the most harmful?

Answer 18

1st trimester

Question 19

Wernicke Encephalopathy

Answer 19

Reversible Thiamine (B1) deficiency

Question 20

Wernicke Encephalopathy symptoms and physical findings?

Answer 20

Psych symptoms and opthalmoplegia

- Hemorrhage and necrosis of mammillary bodies

Question 21

If Wernicke Encephalopathy goes untreated, what will result?

Answer 21

Korsakoff Syndrome

Question 22

What symptoms are seen with Korsakoff Syndrome?

Answer 22

Memory loss and confabulation

Question 23

Chronic alcohol use can also affect the brain. Describe what it does.

Answer 23

Atrophy of ANTERIOR Vermis

- Causes unsteady gait and ataxia

Question 24

Untoward effects of drugs that are given in therapeutic settings

Answer 24

Adverse Drug Reactions

Question 25

What antibiotic causes discoloration of the skin?

Answer 25

Minocycline

Question 26

Minocycline causes?

Answer 26

Discoloration of the skin

Question 27

Most common physical exam finding with hypersensitivity reactions?

Answer 27

Skin rashes

Question 28

What age population is more likely to suffer an Adverse Drug Reactions?

Answer 28

Older people

Question 29

Anticoagulants such as warfarin and pradaxa cause what adverse effect?

Answer 29

BLEEDING or thrombosis due to insufficient dosage

Question 30

Warfarin

Answer 30

Inhibits vitamin K | - Anti-clot

Question 31

Pradaxa

Answer 31

Inhibits Thrombin | - Anti-clot

Question 32

What is menopausal hormone therapy?

Answer 32

Giving menopausal women estrogen and progestons

Question 33

Good and Bad effects of menopausal hormone therapy?

Answer 33

Good - may protect against CAD | Bad - Increases risk of breast cancer and stroke

Question 34

Oral contraceptives protect against what cancers?

Answer 34

Ovarian and Endometrial

Question 35

Bad effects of oral contraceptives?

Answer 35

Increase cervical cancer risk and DVT risk

Question 36

If you smoke and take oral contraceptives, what are you at risk for?

Answer 36

DVT

Question 37

Prolonged Oral contraceptive use may cause what cancer?

Answer 37

Hepatic Adenoma

Question 38

These cause stunted growth, acne, testicular atrophy, facial hair in females, increased MI risk

Answer 38

Anabolic steroids

Question 39

Acetomenophin toxic agent created?

Answer 39

NAPQ1

Question 40

Acetomenophin can be toxic to what organ?

Answer 40

Liver

Question 41

Chronic Aspirin (salicyclate) poisoning exam findings?

Answer 41

Tinnitus (ringing), dizziness, bleeding, coma

Question 42

What is the inactive form of Alcohol Dehydrogenase seen in some Asian populations?

Answer 42

ALD*2 - Aldehyde dehydrogenase

Question 43

What are the symptoms of having the inactive version of alcohol dehydrogenase (ALD*2)?

Answer 43

Flushing, nausea, Increased HR with alcohol consumption

Question 44

How does alcohol increase the effect of other drugs?

Answer 44

It DELAYS their catabolism by competing for the CYP2E1 substrate