Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

KG - pharmacology 3 > KG - Pharm 3, Exam 1, Alcohol > Flashcards

KG - Pharm 3, Exam 1, Alcohol Flashcards

1
Q

DSM-IV criteria for alcohol abuse?

A

social life of individual impaired for at least 1 month as a result of alcohol

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

DSM-IV criteria for alcoholism?

A
  • occurrence of tolerance and dependence as a result of prolonged alcohol abuse
  • continuous or periodic lack of control over drinking, preoccupation with alcohol, use of alcohol despite adverse consequence, and distortions in thinking (esp denial)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

describe: genetic component to being prone to alcoholism

A
  • marked increase in release of B-endorphins in dopamine reward pathway (activate meso-limbic pathway)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

ALCOHOL: pharmokinetics?

A
  • absorption from stomach, small intestine
  • peak BAC w/in 30-90 min after last drink
  • evenly distributed, crosses BLOOD-BRAIN BARRIER
  • crosses placenta (fetal BAC same as mom)
  • may compete for metabolism/inhibit breakdown of some drugs (Benzos, barbiturates, TCAs)
  • metabolized by multiple enzyme systems (ADH, MEOS, CYP2E1)
  • induces CYP450s
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

ALCOHOL: metabolism

A
  1. metabolized by alcohol dehydrogenase to acetaldehyde
  2. acetaldehyde oxidized by dehydrogenase to acetate
    - oxidation reqs cofactor (NAD+)
  3. NAD+ saturated at low concentration
    - less NAD+ for other enzymes
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

ALCOHOL: what order kinetics?

A

zero order kinetics

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

ALCOHOL: relationship between rate and concentration

A

rate is INDEPENDENT of concentration

- 10 g/hr

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

ALCOHOL: what accumulates and happens due to this accumulation?

A
  • lactate & acetyl-CoA accumulate

- Fatty acid synthesis & lactic acidosis occur due to the accumulation

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

why do women (typically) have greater side effects to alcohol?

A

LEVELS ADH IN GI TRACT LOWER IN WOMEN

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

ALCOHOL: describe - aldehyde dehydrogenase deficiency

A

w/ this deficiency, acetaldehyde accumulates (TOXIC)

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

ALCOHOL: describe - Microsomal-ethanol oxidizing system (MEOS)

A
  • chronic consumption induces MEOS

- more alcohol needed for same effect

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

ALCOHOL: describe - CYP2E1 pathway

A
  • MINOR METABOLIC PATHWAY
  • chronic consumption induces 2E1
  • increases acetaminophen toxicity
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

Which drug inhibits aldehyde dehydrogenase?

A

DISULFIRAM

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Which drug inhibits alcohol dehydrogenase?

A

FOMEPIZOLE

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Alcohol tolerance: Pharmocokinetic

A
  • ETHANOL INDUCES CYP2E1 & MEOS

- chronic users have increased ethanol metabolism

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Alcohol tolerance: Pharmacodynamic

A
  • DOWN REG OF GABA RECEPTORS
  • UP REG OF NMDA RECEPTORS (black outs)
  • withdrawal due to pharmacodynamic tolerance
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

Alcohol tolerance: cross tolerance?

A
  • cross tolerance to Benzos & barbiturates (bc also act on GABA receptors)
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

ALCOHOL: Mechanism of action

A
  • CNS DEPRESSANT
  • BINDS TO GABAa RECEPTOR TO INCREASE Cl- INFLUX AND ENHANCE INHIBITORY GABA TRANSMISSION
  • increase dopamine in mesolimbic pathway
  • inhibits effect of glutamate on NMDA receptor
How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Effects of alcohol: CNS, low concentrations

A
  • DISINHIBITION

- decreased anxiety, mild euphoria, confidence increases, memory/concentration affected, mood swings

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Effects of alcohol: CNS, increased dose

A
  • motor function & judgment impaired, speech slurred, ataxia

- CNS DEPRESSANT & SEDATIVE properties become apparent

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

Effects of alcohol: what causes ANTEROGRADE AMNESIA (blackouts)?

A
  • blockage of NMDA receptors
22
Q

Effects of alcohol: smooth muscle

A
  • ethanol = VASODILATOR (due to acetaldehyde metabolite)
  • HYPOTHERMIA
  • relaxes uterus (used for prevention premature labor)
23
Q

Effects of alcohol: heart

A
  • depression myocardial contractility
24
Q

Effects of alcohol: kidney

A
  • decreases ADH

- DIURETIC EFFECT

25
Q

Describe: acute alcohol toxicity

A
  • emesis, stupor, coma, resp depression, death
  • metabolic & electrolyte disturbances
  • hypothermia (cutaneous vasodilation)
  • decr BP, CO
26
Q

Treatment for acute alcohol toxicity?

A
  • manage resp depression

- prevent emesis

27
Q

why do we get hangovers?

A
  • buildup of acetaldehyde
  • dehydration
  • beg of withdrawal
28
Q

TREATMENT: seizures due to acute alcohol toxicity

A

treat w/ benzos or anticonvulsants

  • LORAZEPAM (Ativan) = benzo
  • PHENYTOIN (Dilantin) = anticonvulsant
29
Q

Effects chronic abuse: Liver/GI tract

A
  • GASTRITIS, PANCREATITIS
  • LIVER DISEASE (most common)
  • FATTY LIVER –> FIBROSIS –> CIRRHOSIS
  • metal of alcohol lowers concentration of glutathione, results in oxidative stress/tissue damage
  • ALCOHOLIC HEPATITIS
  • LIVER CANCER (usu 10 yrs post-consumption)
30
Q

Effects chronic abuse: malnutrition

A
  • deficiencies in FOLATE, THIAMINE
31
Q

Effects chronic abuse: CNS

A
  • WERNICKE-KORSAKOFF SYNDROME = paralysis eye muscles, ataxia, confusion, coma, death (THIAMINE DEF)
  • KORSAKOFF’S PSYCHOSIS = chronic memory loss
  • PERIPHERAL NEUROPATHY
32
Q

Effects chronic abuse: cardiovascular

A
  • CARDIOMYOPATHY = due to direct effects acetaldehyde
  • ARRHYTHMIAS = binges can cause incr in bp
  • HTN
  • incr risk stroke, heart dz
33
Q

Effects chronic abuse: carcinogenicity

A
  • incr car. of tobacco
34
Q

Effects chronic abuse: blood

A
  • mild anemia
35
Q

Effects chronic abuse: sexual dysfunction

A
  • testicular atrophy
  • impotence
  • gynecomastia
36
Q

Effects chronic abuse: immune

A
  • resp infections
37
Q

Effects chronic abuse: teratogenicity

A

fetal alcohol syndrome
- microcephaly, mental retardation, poor coordination, flattened face, joint abnormalities, heart defects, impaired immune system

38
Q

Effects chronic abuse: muscles

A
  • skeletal muscle atrophy
39
Q

Effects chronic abuse: temp

A
  • hypothermia
40
Q

Alcoholism: best way to treat?

A
  • combo pharmacologic + psychosocial (AA) treatments
41
Q

NALTREXONE: moa

A
  • OPIOID RECEPTOR ANTAGONIST
  • BLOCKS ABILITY OF ALCOHOL TO STIMULATE REWARD PATHWAY
  • reduces craving (decreases rate of relapse
42
Q

NALTREXONE: adverse effects/contraindications

A
  • large doses may cause liver damage

- do not use in pts w/ liver failure

43
Q

ACAMPROSATE: moa

A
  • STRUCTURAL ANALOGUE OF GABA
  • balance between GABA and glutamate disturbed
  • RESTORES NORMAL BALANCE OF GABA & GLUTAMATE
  • increases abstinence & decreases likelihood of relapse
  • EXCRETED BY KIDNEY - NO LIVER TOXICITY
44
Q

DISULFIRAM: moa

A
  • INHIBITS ALDEHYDE DEHYDROGENASE
  • ACETYLDEHYDE BUILDS UP - causes flushing, nausea, confusion
  • long duration of action
  • EFFECTS CAN BE SEVERE - vomiting, sweating, chest pain, vertigo, blurred vision, shock
  • dangerous, NOT recommended
45
Q

ANTIDEPRESSANTS: when to use?

A

many alcoholics have level of depression - help depression, may reduce craving to drink

46
Q

describe: mild alcohol withdrawal

A
  • anxiety, irritability, insomnia, nausea, tachycardia
47
Q

describe: severe alcohol withdrawal

A
  • hallucinations, DTs, seizures, arrhythmias, hypotension
48
Q

treatment: alcohol withdrawal?

A
  • restore electrolyte imbalances
  • hydration
  • DIAZEPAM (Valium) = to PREVENT seizures & DTs, tapers symptoms
  • LORAZEPAM (Ativan) = to treat seizures
  • PHENYTOIN (Dilantin) = secondary drug to treat seizures
49
Q

describe: methanol poisoning

A
  • VISUAL DISTURBANCES (like being in a snowstorm)
  • smell formaldehyde on breath
  • METABOLIZED BY ALCOHOL DEHYDROGENASE TO TOXIC ALDEHYDES AND OXALATES
  • transient CNS excitation, then depression, then severe METABOLIC ACIDOSIS
  • bradycardia, coma, seizures, cessation of respiration
50
Q

Treatment: methanol poisoning

A
  • support respiration
  • lavage
  • alkalization for acidosis
  • dialysis
  • FOMEPIZOLE = ALCOHOL DEHYDROGENASE INHIBITOR
  • -> CAN ALSO USE ETHANOL

KG - pharmacology 3 (11 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions