L18: Ethyl Alcohol Flashcards

(36 cards)

1
Q

How can benzos be helpful when one is no longer drinking excess ETOH?

A
  1. Decrease chance of seizure activity
  2. Reduce withdrawl side effects
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2
Q

True or False: Diazepam and Cholordiazepoxide are benzos

A

True

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3
Q

Which drug class does Naltrexone, Acamprosate, and Fomepizole belong to?
A. Anti-Convulsants
B. Benzos
C. Treats alcoholism

A

C. Treats alcoholism

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4
Q

Fomepizole is useful for ____ poisoning

A

methanol

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5
Q

Why is ETOH able to readily cross BBB?

A

It is both Lipophilic and Hydrophilic

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6
Q

Where is ETOH absorbed? Which enzymes are involved in normal vs excess levels of ETOH?

A

Stomach and Small Intestine*
- High ETOH: CYP2E1 and Catalase
- Normally: Alcohol Dehydrogenase

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7
Q

_____ blocks aldehyde dehydrogenase

_____ blocks alcohol dehydrogenase

A. Dilsulfram; Fomepizole
B. Fomepizole; Dilsulfram

A

A. Dilsulfram; Fomepizole

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8
Q

Alcohol is ____ order kinetics while Caffeine is ___ order
A. First; Second
B. Zero; First
C. Zero; Third
D. First; Third

A

B. Zero; First

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9
Q

Both ETOH and Benzodiazepines can bind to the _____ receptor, leading to increases in Cl- ion flow

A

GABA

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10
Q

True or False: ETOH increases responsiveness of NMDA receptors to glutamate, resulting in increased neuronal firing

A

False - ETOH INHIBITS responsiveness of NMDA receptors to glutamate, resulting in DECREASE neuronal firing

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11
Q

_____ is a structural analog of glutamate used in maintaining alcohol abstinence
A. Naltrexone
B. Acamprosate
C. Fomepizole

_____, an opioid antagonist, may reduce ETOH cravings

A

B. Acamprosate (glutamate analog)

A. Naltrexone (reduce cravings)

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12
Q

True or False: Hypo-glutamatergic state contributes to ETOH withdrawl

A

True

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13
Q

True or False: In addition to acting on GABA-R, ethanol can activate opioid receptors as well–making it more addictive, as it can trigged endogenous opioid release and trigger dopamine response–and cannabinoid-R

A

True

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14
Q

True or False: Chronic ETOH use augments serotonergic activity

A

True

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15
Q

Chronic ETOH use stimulates formation of endogenous cannabinoid transmitter ___, which leads to downregulation of cannabinoid receptors and disinhibition of nucleus accumbens

A

anadamide

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16
Q

True or False: When one ceases drinking, it results in hypoactive endocannabinoid reaction, which stimulates cravings for ETOH

A

False - HYPERACTIVE

17
Q

True or False: Alcohol myopia causes a focus on present without thinking about consequences, plays large role in crime

18
Q

What are the three types of ETOH tolerance?

A

1) Metabolic: liver increases metabolizing enzymes
2) Tissue/Functional: Neurons adapt to drug – behavior only
3) Associative: Environmental

19
Q

With Korsakoff’s Syndrome, it is important to treat aggressively with ___ to prevent permanent damage

20
Q

What causes brain damage in Korsakoff’s Syndrome?

A

Mammillary Body damage

21
Q

Which disease is characterized by permanent anterograde amnesia where one has no new learning or membrane, but still has normal IQ?
A. Korsakoff’s Syndrome
B. Fetal Alcohol Syndrome
C. Alcohol Withdrawal Syndrome
D. Alcoholism

A

A. Korsakoff’s Syndrome

22
Q

True or False: Patients with Korsakoff’s Syndrome may confabulate

23
Q

Which of the following disorders is associated with: CNS dysfunction, reduced brain size and growth rate, and behavioral abnormalities?
A. Korsakoff’s Syndrome
B. Fetal Alcohol Syndrome
C. Alcohol Withdrawal Syndrome
D. Alcoholism

A

B. Fetal Alcohol Syndrome

24
Q

True or False: Signs and symptoms of ETOH withdrawal that manifest earliest are: anxiety, insomnia, tremor, palpitations, nausea, and anorexia as well as (in severe syndromes) hallucinations and seizures.

Delirium tremens typically develops 48–72 hours after alcohol
discontinuation. The earliest symptoms (anxiety, insomnia, etc.) can persist, in a milder form, for several months after alcohol discontinuation

25
Diazepam and Chlordiazepoxide can be used to treat/prevent... A. Alcohol withdrawal B. Prevention of withdrawal-induced seizures C. Seizure disorders
A/C
26
Why is it important for one to not be drinking when taking either Diazepam or Chlordiazepoxide? Can tolerance or dependence develop?
Additive effect Yes!
27
Which drugs inactivate Na+ channels, which prevent withdrawal-induced seizures, and induces hepatic metabolism (therefore: many DDI)? A. Carbamazepine/Valproic acid B. Gabapentin/ Oxcarbazepine
A. Carbamazepine/Valproic acid
28
Which drugs prevent withdrawal-induced seizures via: decreasing glutamate release and/or inactivation of Na+ channels? A. Carbamazepine/Valproic acid B. Gabapentin/ Oxcarbazepine
B. Gabapentin/ Oxcarbazepine
29
Which has LESS hepatic induction and interactions than carbamazepine?
Oxcarbazepine
30
True or False: SJS is a AE associated with Carbamazepine/Valproic acid
True
31
____irreversibly inhibits aldehyde dehydrogenase causing increased serum acetaldehyde A. Disulfiram B. Naltrexone C. Acamprosate ______ competes for opiate receptors and displaces opioid drugs A. Disulfiram B. Naltrexone C. Acamprosate ______ is thought to interact with NMDA receptors and calcium channels and is used to maintain abstinence in alcohol-dependent patients A. Disulfiram B. Naltrexone C. Acamprosate
A. Disulfiram B. Naltrexone C. Acamprosate
32
True or False: Cocaine dependence inhibits dopamine beta- hydroxylase causing an accumulation of dopamine
True
33
____ is a competitive inhibitor of alcohol dehydrogenase that treats methanol/ethylene glycol poisoning -- should be used w/caution in patients with hepatic/renal dysfunction
Fomepizole
34
____ blocks conversion of acetaldehyde to acetate to treat chronic alcoholism. However, it should NEVER be administered to a patient if/when they are in a state of alcohol intoxication A. Fomepizole B. Disulfiram C. Acamprosate D. Naltrexone
B. Disulfiram
35
____is thought to interact with neuronal NMDA receptors/Ca channel to maintain maintain abstinence in alcohol- dependent patients; it is NOT metabolized -- it is excreted unchanged from the kidneys A. Fomepizole B. Disulfiram C. Acamprosate D. Naltrexone
C. Acamprosate
36
_____i s used to treat opioid use and alcohol use disorders is subject to significant first pass metabolism
Naltrexone