Pharm, Alcohol part I Flashcards Preview

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Flashcards in Pharm, Alcohol part I Deck (52):
1

Drugs for Tx of acute alcohol withdrawal

diazepam
lorazepam
oxazepam
thiamine

2

drugs for prevention alcohol abuse

acamprosate
disulfiram
naltrexone

3

what drugs are used for Tx acute methanol or ethylene glycol poisoning

ethanol
fomepizole

4

defintion alcohol abuse

use of alcohol in dangerous situtation like drinking.driving or combination with other meds

5

alcohol dependence

alcohol abuse plus physical dependence on alcohol like tolerance to alcohol and signs and Sx upon withdrawal

6

peak blood levels alcohol

30 min after ingestion if empty stomach

7

typical 70 kg adult can metabolize

7-10 g alcohol per hour

8

what is required to convert ethanol to acetaldehyde

NAD+

9

aspirin interaction with ADH

inhibits gastric ADH and increase ethanol bioavailability

10

MOA fomepizole

inhibits ADH and used in Tx of acute methanol or ethylene glycol poisoning

11

what is produced when acetaldehyde converted to acetic acid

NADH

12

what drug inhibits ALDH

disulfiram

13

what population has low activity level mitochondrial ALDH

asian

14

if have low activity level mitochondrial ALDH what happens when drink alcohol

facial flushing
light headedness
palpitations
nausea
general hangover

15

how to cytochrome P450s metabolize ehtanol

use NADPH as cofactor in metabolism of ethanol to acetaldehyde

16

chronic alcohol consumption induces microsomal ethanol oxidizing system and results in what

activation of toxins, free radicals and hydrogen peroxide

17

alcohol effects on glutamate

inhibits ability of glutamate to activate and open NMDA R
leads to inc depression of CNS
memory loss can occur as a result (blackout)

18

Alcohol effects on GABA

enhances GABA on GABA a R and leads to increased depression of CNS

19

depression of myocardial contractility observed when drinking what amount

people who acutely drink moderate amounts
BAC >100

20

alcohol effects on smooth muscle

vasodilation and smooth muscle relaxation
can cause hypothermia in severe overdose
cause uterine mm relaxation

21

chronic alcohol use and esophagus

esophageal dysfunciton, barretts, traumatic rupture
mallory weiss tears
cancer
at high BAD dec peristalsis and de LES tone

22

Tx for alcohol effects on esophagus

PPI and stop drinking

23

chronic alcohol and sotmach

distrupte mucosal barrier leading to acute and chronic gastritis
clinical Sx of acute epigastric pain

24

Tx gastritis from alcohol

antacids, histamine H2 R blockers

25

chronic alcohol and intestines

chronic diarrhea from malabsorption
reversible damage can result in weight loss and vitamine deficiencies

26

what vitamin deficiencies occur in chronic alcoholism

vit B like thiamine, retinoids and carotenoids
lower serum and brain levels of Mg

27

chronic alcohol and pancreas

most common cause acute and chronic pancreatitis in US
direct effect on pancreatic acinar cells and epithelial permeability
promotes Ca carbonate stone formation

28

chronic alcohol and liver

leading cause of liver cirrhosis and need for transplantation

29

primary effects of alcohol

progressive fatty infiltration
hepatitis
cirrhosis

30

accumulation fat in liver leads to

inhibition TCA cycle and oxidation of fat
excess NADH produced

31

Sx alcohol withdrawal

delirium, hallucinations, fever and tachycardia

32

Expression of ion channels in chronic alcoholism

NMDA R and vCaCh upregulated
GABAa down regulated

33

neurotoxicity seen with chronic alcohol abuse

symmetric peripheral nerve injury with distal parathesias of hands and feet
gait disturbance and ataxia
dementia and demyelinating

34

Wernicke Korsakoff syndrome

paralysis of external eye mm, ataxia and confused state that can progress to coma and death
assoc with thiamine def

35

korsakoffs psychosis

chronic disabling memory disorder

36

CV effects alcohol

cardiomyopathy HF
arrhythmias
HTN
CHD
stroke

37

cardiomyopathy and alcohol

dilated with ventricular hypertrophy and fibrosis

38

alcohol induces what changes in heart cells

membrane disruption,
depressed function mitochondria and SR
intracell accumulation phospholipids and fatty acids
up regulation vCaCh

39

arrhtyhmias and alcohol

atrial and ventricular

40

ethanol raises serum levels of what in heart

cardioprotective HDL cholesterol that inhibits process involved in atherosclerosis

41

increased incidence of hemorrhagic and ischemic stroke if drink what

>40-60g alcohol/day

42

what causes mild anemia in chronic drinkers

alcohol related folic acid deficiency
or Fe deficiency from GI bleed

43

What hormones get messed up in chronic alcoholism

unbalance steroid hormones that cause gynecomastia and testicular atrophy
K alterations and hypoglycemia and ketosis

44

what occurs to immune system in chronic alcohol use

inhibited in lung (predispose to infection- pneumonia )
hyperactive in liver and pancreas

45

skel mm effects alcohol

dec mm strength and increased activity CK in plasma

46

body temp in chronic alcohol

increased cutaneous and gastric blood flow, sweating may occur while internal body temp falls

47

diuresis with chronic alcohol

alcohol inhibits release of vasopression from posterior piruitary gland

48

what causes hyponatremia in alcohol withdrawal

vasopressin release
dilutional hyponatremia

49

sexual function with alcohol use

disinhibiting effects
increased libido but can lead to deterioration of sexual function

50

Fetal Alcohol Syndrome

chronic alcohol abuse during pregnancy can have teratogenic effects
alcohol is a leading cause of mental retardation and congenital malformation

51

signs FAS

intrauterine growth retardation
microcephaly
poor coordination
underdevelopment of midfacial region
minor joint abnormalities

52

ethanol elimination in fetus

fetal liver has no or little ADH so rely on mother's liver for elimination