Pharm of Ethanol [3] Flashcards Preview

Neuro 4 > Pharm of Ethanol [3] > Flashcards

Flashcards in Pharm of Ethanol [3] Deck (15):
1

How does fat affect blood alcohol level (BAC)?

Fat contains less water (less alcohol distribution, more alcohol accumulation)
- women have greater body fat % than men
- given same dose of ethanol, women will have higher BAC

2

Major metabolic route of elimination of Ethanol

Minor metabolic route of elimination of Ethanol?

zero-order kinetics
Ethanol → alcohol dehydrogenase → acetaldehyde

First-order kinetics
Ethanol → mixed fxn oxidase (P450) → acetaldehyde

Both take place in the liver (90-98%)

3

inhibitor of aldehyde dehydrogenase

disulfiram (antabuse)

- increase acetaldehyde: nausea, vomiting, respiratory/cardio collapse, convulsions
- protection against alcoholism

4

what compound builds up in asians?

Acetaldehyde
- due to increased activity of alcohol dehydrogenase
- or due to high Km (low affinity) of aldehyde dehydrogenase (cant break down acetaldehyde → acetic acid)

5

How are these levels affected with hepatic metabolism of ethanol and what can that lead to?
NADH
Blood lactate
MG2+ excretion
Acetyl CoA
Uric acid excretion

↑ NADH → hypoglycemia (↓gluconeogenesis from Krebs)
↑ Blood lactate → acidosis
↑ MG2+ excretion → convulsions
↑ Acetyl CoA → fatty liver (↑ fat synth + ↓ fat breakdown)
↓ Uric acid excretion →

6

DWAI
DUI

DWAI: impaired driving ability (0.05-0.08)
DUI: (0.08-0.2)

7

How does Ethanol affect sleep?

suppression of stage IV REM (best sleep)
but then you rebound with withdrawal (nightmares)
- similar to barbiturates

8

Alcohol intoxication at lethal doses most closely resembles intoxication with which class of abused drug?

barbiturates (pentobarbital)
- great CNS depression, low safety margin
- sleep effects
- anticonvulsant initially (then ppt seizures)

9

Are BDZ or barbs gen used to suppress -OH withdrawal?

BDZ (cross dependence) - sedative hypnotics
GAs
(a2 adrenergic agonists - clonidine)

10

name that disease/psychosis
-confusion
-diplopia
-nystagmus
-ataxia
-periph neuropathy

wernicke's disease
(eth toxicity, malnutrition)

11

name that disease/psychosis
- disorientation
- amnesia
- confabulations

Korsakoff's psychosis
(eth toxicity, malnutrition)

12

Signs with early/acute Eth withdrawal (minor)
what about late (major withdrawal)?

Tremor
Anxiety
Agitation
Insomnia
Restlessness (NOT somnolence)

Disorientation
Confusion
Disordered sensory perception

13

DDI for Ethanol

faster CYP2E1 metabolism
- reduced drug effect
- Potentiate acetaminophen toxicity

14

How are BDZ and a2 adrenergic agonists good against alcohol withdrawal syndromes?

BDZ: action at GABA PREVENTS emergence of CNS HYPEREXCITABILITY following withdrawal of alcohol

a2 agonist (clonidine) effective for autonomic hyperactivity

15

Which drugs reduce alcohol consumption?

Disulfiram - alcohol sensitizing drug
Naltrexone - opioid antagonist (block u reinforcement)
- turns wine into water
Acamprosate - NMDA R blocker (↓ craving)