Pharm, Alcohol part I

Question 1

Drugs for Tx of acute alcohol withdrawal

Answer 1

diazepam
lorazepam
oxazepam
thiamine

Question 2

drugs for prevention alcohol abuse

Answer 2

acamprosate
disulfiram
naltrexone

Question 3

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

Answer 3

ethanol

fomepizole

Question 4

defintion alcohol abuse

Answer 4

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

Question 5

alcohol dependence

Answer 5

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

Question 6

peak blood levels alcohol

Answer 6

30 min after ingestion if empty stomach

Question 7

typical 70 kg adult can metabolize

Answer 7

7-10 g alcohol per hour

Question 8

what is required to convert ethanol to acetaldehyde

Answer 8

NAD+

Question 9

aspirin interaction with ADH

Answer 9

inhibits gastric ADH and increase ethanol bioavailability

Question 10

MOA fomepizole

Answer 10

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

Question 11

what is produced when acetaldehyde converted to acetic acid

Answer 11

NADH

Question 12

what drug inhibits ALDH

Answer 12

disulfiram

Question 13

what population has low activity level mitochondrial ALDH

Answer 13

asian

Question 14

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

Answer 14

facial flushing
light headedness
palpitations
nausea
general hangover

Question 15

how to cytochrome P450s metabolize ehtanol

Answer 15

use NADPH as cofactor in metabolism of ethanol to acetaldehyde

Question 16

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

Answer 16

activation of toxins, free radicals and hydrogen peroxide

Question 17

alcohol effects on glutamate

Answer 17

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

Question 18

Alcohol effects on GABA

Answer 18

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

Question 19

depression of myocardial contractility observed when drinking what amount

Answer 19

people who acutely drink moderate amounts

BAC >100

Question 20

alcohol effects on smooth muscle

Answer 20

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

Question 21

chronic alcohol use and esophagus

Answer 21

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

Question 22

Tx for alcohol effects on esophagus

Answer 22

PPI and stop drinking

Question 23

chronic alcohol and sotmach

Answer 23

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

Question 24

Tx gastritis from alcohol

Answer 24

antacids, histamine H2 R blockers

Question 25

chronic alcohol and intestines

Answer 25

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

Question 26

what vitamin deficiencies occur in chronic alcoholism

Answer 26

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

Question 27

chronic alcohol and pancreas

Answer 27

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

Question 28

chronic alcohol and liver

Answer 28

leading cause of liver cirrhosis and need for transplantation

Question 29

primary effects of alcohol

Answer 29

progressive fatty infiltration hepatitis cirrhosis

Question 30

accumulation fat in liver leads to

Answer 30

inhibition TCA cycle and oxidation of fat | excess NADH produced

Question 31

Sx alcohol withdrawal

Answer 31

delirium, hallucinations, fever and tachycardia

Question 32

Expression of ion channels in chronic alcoholism

Answer 32

NMDA R and vCaCh upregulated | GABAa down regulated

Question 33

neurotoxicity seen with chronic alcohol abuse

Answer 33

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

Question 34

Wernicke Korsakoff syndrome

Answer 34

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

Question 35

korsakoffs psychosis

Answer 35

chronic disabling memory disorder

Question 36

CV effects alcohol

Answer 36

``` cardiomyopathy HF arrhythmias HTN CHD stroke ```

Question 37

cardiomyopathy and alcohol

Answer 37

dilated with ventricular hypertrophy and fibrosis

Question 38

alcohol induces what changes in heart cells

Answer 38

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

Question 39

arrhtyhmias and alcohol

Answer 39

atrial and ventricular

Question 40

ethanol raises serum levels of what in heart

Answer 40

cardioprotective HDL cholesterol that inhibits process involved in atherosclerosis

Question 41

increased incidence of hemorrhagic and ischemic stroke if drink what

Answer 41

>40-60g alcohol/day

Question 42

what causes mild anemia in chronic drinkers

Answer 42

alcohol related folic acid deficiency | or Fe deficiency from GI bleed

Question 43

What hormones get messed up in chronic alcoholism

Answer 43

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

Question 44

what occurs to immune system in chronic alcohol use

Answer 44

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

Question 45

skel mm effects alcohol

Answer 45

dec mm strength and increased activity CK in plasma

Question 46

body temp in chronic alcohol

Answer 46

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

Question 47

diuresis with chronic alcohol

Answer 47

alcohol inhibits release of vasopression from posterior piruitary gland

Question 48

what causes hyponatremia in alcohol withdrawal

Answer 48

vasopressin release | dilutional hyponatremia

Question 49

sexual function with alcohol use

Answer 49

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

Question 50

Fetal Alcohol Syndrome

Answer 50

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

Question 51

signs FAS

Answer 51

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

Question 52

ethanol elimination in fetus

Answer 52

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