Pharm, Alcohol part II Flashcards Preview

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Flashcards in Pharm, Alcohol part II Deck (26):
1

alcohol and cancer

chronic alcohol use increases risk for cancer of mouth, pharynx, larynx esophagus and liver
maybe breast

2

chronic alcohol consumption increases what enzyme

CYP450s

3

DDI with ethanol

may inhibit drug metabolis: phenothizines, TCA, sedative-hypnotics
additive CNS depression to CNS depressants
inhibit ALDH and cause disulfiram like reaction: metronidazole, cefotetan, trimethoprim

4

management acute alcohol intoxication

prevent severe respiratory depression and aspiration of vomitus
glucose to Tx metabolic alterations
thiamine to protect wernicke korsakoff
K if severe vomiting and renal function okay

5

moderate alcohol withdrawal syndrome

tremor, anxiety, insomina

6

major pharm objective in alcohol withdrawal syndrome

prevent seizures, delirium, arrhythmias and include electrolyte rebalancing and thiamine therapy

7

Drug therapy for detox alcohol

long acting sedativ hypnotic and tapering
like benzos: chlordiazepoxide, clorazepate, diazepam

8

pros and cons to benzos for drug therapy of withrawal

pro: less frequent dosing, built in tapering effect
con: active metabolites may accumulate

9

short acting benzos used in withdrawal

lorazepam and oxazepam

10

Primary Tx for alcohol dependence

psychosocial therapy

11

MOA naltrexone

mu opioid R antagonist

12

CI naltrexone

acute hepatitis or liver failure
do not use with disulfiram
if on opioids too, must be opioid free before initiating therapy because precipitates acute withdrawal syndrome

13

MOA acamprosate

weak NMDA R antagonist and GABA a R agonist
reduces shor tand long term relapse rates

14

use caution in what patients with acamprosate

kidney disease

15

adverse effect acamprosate

nausea comiting, diarrhea, rash

16

MOA disulfiram

irreversibly inhibits ALDH causing extreme discomfort in patients drinking alcohol

17

disulfiram length of action

up to 14 days after dose

18

CI disuldiram

since hepatotoxic , careful
inhibits metabolism phenytoin, anticoagulants, isoniazid
should not be administered with anything with alcohol like mouthwash

19

never administer disulfiram to

patient in state of intoxication

20

new Tx under trial

topiramate and ondansetron

21

common Sx methanol poisoning

blurred vision

22

Tx methanol poisoning

respiratory support
suppression of metabolism by ADH
hemodialysis to enhance methanol removal
alkalinization to counteract acidosis

23

what is used to Tx methanol poisoning

ethanol IV because higher affinity for ADH
fomepizole which inhibits ADH

24

ethylene glycol

antifreeze

25

metabolites of ethylene glycol

toxic aldehydes and oxalate

26

Tx ethylene glycol poisoning

hemodialysis
ethanol infusions
fomepizole