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Flashcards in Alcohols Deck (38)
1

What is the maximum concentation of ethanol?


12-14%

this is because anything higher than 12% is toxic to the yeast

higher concentrations are attained by distillation

2

For this course, a drink consists of how much of:

beer?

wine?

liquor?


beer - 12 ounces

wine - 5 ounces

liquor - 1.5 ounces (of 80 proof)

3

How much alcohol by percentage does rum have to contain to be 100 proof?


57.15%

4

Alcohol is a generalized CNS _______


depressant

5

If alcohol is a general depressant, why does it initially act like a stimulant?


It depresses inhibitory control, leading to disinhibition euphoria

6

What functions are affected first by ethanol?


basically areas of the brain involved in the most highly integrated functions

so...reticular activating systems and cortical ites

you lose integration control by the cortex so thought an dmotor processes that are most dependent on training and previous experience are first affected

7


Why can't ethanol be used as an anesthetic?


1. it's too long acting to be a clinically useful anesthetic

2. and it only reaches anesthesia at near lethal concentrations

8

Is ethanol a vasodilator or vasoconstrictor? What does this mean for thermoregulation?


It's a vasodilator - due to central vasomotor depression

this means you lose body heart - you get a drop in core temperature

You have a sense of warmth, but the body temp has actually decreased

9


What affect does chronic alcoholism have on the heart?


it's thoguht to be the major cause of cardiomyopathy in the western world

you get conduction defects and rhythm disturbances

10

Although somewhat counterintuitive, there is a strong negative correlation between chronic use of LOW amounts of ethanol and the incidence of CAD. How?


Low amounts of ethanol will increase the concentration of high density lipoproteins (the good ones) and decreasing the concentration of low density lipoproteins (the bad ones)

Low amounts of ethanol will also increase production of endogenous tissue-type plasminogen activator (TPA) so you have changes in the thrombotic potential

11


What are the ACUTE effects of alcohol on the liver?


interferes with the oxidative metabolism of other drugs because it depletes NAD (which is a cofactor necessary for other metabolic reactions)

it also competes for mixed function oxidase

for example, you're more sensitive to sedatives when drunk because they're not metabolized as rapidly

12


What are the CHRONIC effects of alcohol on the liver?


1. it increases oxidative metabolism (an inducer)

this means chronic alcoholics are LESS sensitive to sedatives then wover because they're metabolized more rapidly

2. increases hepatic synthesis and mobilization of fat and secretion of protein from hepatic cells, leading to hepatic disorders

this can be reversible with abstinence, but prolonged exposure may lead to permanent damage

 

13

What is alcohol's effect on the kidney?


it's a diuretic

acts by decreasing the release of ADH from the pituitary

this means you have a decrease in the reabsorption of water in the renal tubules

14

What is the effect of alcohol on the GI tract?


depends on the person

if they like it = psychic stimulation of saliva and gastric acid

10% have increased secretions

20% have depression of secretion and motility, so mucosal irritation

40% have mucosal inflammation and hyperemia leading to erosive gastritis

15

About how many kcal does alcohol have per gram?

7 kcal/g

16

What does ethanol do to cell membranes and what does this mean for receptors?


it has a membrane disordering of "fluidizing" effects

this means it non-specifically alters the characteristics of several NT receptors and enzyme systems

 

17

What receptor complex likely mediates the behavioral effects of alcohol?


likely the GABA receptor

18

What does it mean to say that ethanol is an amphophile?

In terms of absorption?


it's both hydrophilic and lipophilic, so it will dissolve in both water and fat

this means it has complete absorption from the GI tract after oral administration (dependin gon food content)

19

What are two factors of food content that affect ethanol absorption?


fatty foods will retard ethanol absorption (so french fries are good)

carbonation decreases gastric emptying time so you have more rapid absorption of, say, champagne

20

What is the two-step process of ethanol emtabolism?


ethanol to acetaldehyde (catalyzed by alcohol dehydrogenase - rate limiting)

acetaldehyde to acetic acid

21

Chronic use of alcohol may lead to _____ metabolism of ethanol.


more rapid

22


What are the two routes of escretion for ethanol?


some through the kidney (but not much since most ethanol is metabolized)

lung - a constant 0.05% of plasma alcohol levels will be breathed out.

23


What are the therapeutic uses of ethanol?


antiseptic/disinfectant

cools the skin in fever

massaging lotion to prevent ulcerative sores in bedridden

injected in proximity of nerves to relieve pain due to trigeminal neuralgia or an inoperable carcinoma

antidote to methanol intoxication

as a vehicle to dissolve other drugs

24

What are the acute toxicites of alcohol and how is it a "self-limiting" process?


high doses can produce coma

it's self limiting because the person passes out before reaching that lethal concentration usually

(however, rapid ocnsumption of large amount may overcome this process and an unconscious patient can aspirate vomit and suffocate)

25

What are the chronic toxicites for alcohol?


physical dependence and tolerance

cirrhosis

pancreatitis

myocardial rpblems

severe depression and suicide

neuropsychiatric syndromes like wernickes and korsakoff's

26

A hangover is from what aspects of alcohol use?


1. accumulation of acetaldehyde

2. altered cytokine metabolism = nausea, HA, fatigue

3. hypoglycemia

4. dehydration = electrolyte disturbances = thirst, dry mouth, dizziness

5. metabolic acidosis

6. disturbed prostaglanding synthesis

7. sleep deprivation (tremors, anxiety, restlessness)

27

How does Disulfiram work?


It interferes with aldehyde dehydrogenase, so you get excessive acetaldehyde levels when you drink, which makes you feel absolutely terrible

28

Methanol is extremely toxic. What are the early symptoms of methanol toxicity?


blurred vision

29


At what amounts will the patient go blind and at what level will the patint die from methanol?


blindness at 4 ml

severe acidosis, coma, and death at 80-150 ml

30

What likely causes the roxicity of methanol?


the formation of formic acid during metabolism

31

What is the treatment of methanol toxicity?


1. maintain respiration

2. induce emesis if the patient is ocnscious

3. MOST IMPORTANT: therapeutic goal is to reduce the acidosis by treating with bicarobnate until urinary pH is 7.5

4. Hemodialysis will help remove methanol in unconscious patient

5. oddly enough, administer ethanol to compete with the metabolism of methanol

32

What alcohol is in antifreeze?


ethylene glycol

33

What are the symptoms of an accidental ethylene glycol consumptions (usually kids and pets)?

Early: vomiting, depression, ataxia, weakness, flaccid paralysis, convulsions followed by coma

late (for survivors): renal failure, emesis, dehydration, weight loss, weakness, hematuria, anuria, tonic convulsions, coma and death in 1-3 days

34

What's the cause of the renal fialure in ethylene glycol consumption?


a byproduct of the metabolism is calcium oxalate crystals, which can clog of the renal tubules

35

What are the usual causes of death in ethylene glycol consumption?


1. metabolic acidosis

2. cardiovascular dysfunction

3. acute kidney failure

36

What is the treatment for ethylene glycol toxicity?


1. symptomatically deal with the emesis, acidosis and convulsions

2. give ethanol for metabolic competition

3. Fomepizole - will inhibit alcohol dehydrogenase

37

What are the two options for addiction relapse prevention in terms of alcoholism?


disulfiram

naltrezone

38