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40 Cards in this Set
- Front
- Back
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What are the three classified alcohols?
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1. ethanol
2. methanol 3. ethylene glycol |
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What are the enzymes that metabolize alcohol?
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1. alcohol dehydrogenase (ADH)
2. aldehyde dehydrogenase |
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What is the toxic metabolite of each class of alcohol?
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1. ethanol is its own
2. methanol --> formic acid 3. ethylene glycol --> oxalic acid |
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Aldehyde dehydrogenase converts acetaldehyde to...?
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acetate
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What are the effects of long term use of ethanol on metabolism?
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Tolerance. ADH becomes saturated and limited to metabolize ethanol.
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MOA of ethanol?
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- facilitates action of GABA at GABA(A) receptors
- inhibits the ability of glutamate to activate NMDA receptors |
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Acute effects of alcohol?
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sedation
loss of inhibition impaired judgement slurred speech and ataxia (possible embarrassment) |
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Chronic effects of ethanol mentally?
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- tolerance and dependence
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Ethanol:
Chronic effects on liver? |
Liver:
- reduced gluconeogenesis--> hypoglycemia - fatty liver, hepatitis, cirrhosis and liver failure |
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Ethanol:
Chronic effects on GIT? |
- inflammation, scarring and bleeding of the gut wall
- increased risk of pancreatitis |
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Ethanol:
Chronic effects on CNS? |
- peripheral neuropathies
- thiamine deficiency --> Wernicke-Korsakoff syndrome |
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What are the symptoms of Wernicke-korsakoff?
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paralysis of the external eye muscles, ataxia, and a confused state
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Wernicke Korsakoff is associated with a deficiency of which vitamin?
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thiamine (B1)
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What is the treatment for wernicke korsakoff?
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thiamine therapy
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What is a complication of Wernicke korsakoff?
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Korsakoff psychosis- chronic disabling memory disorder
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What are the endocrine effects of alcohol?
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- inhibits release of ADH
- gynecomastia, testicular atrophy |
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What are the cardiovascular effects of alcohol?
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- increased incidence of HTN, anemia & dilated cardiomyopathy
- ingestion of moderate quantities raises serum levels of HDL |
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Pregnant women drinking alcohol increase the risk of their child of developing...?
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Fetal alcohol syndrome
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What are the symptoms on FAS?
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1. intrauterine growth retardation
2. microcephaly 3. poor motor coordination 4. underdevelopment of midfacial region (appearing as a flattened face) 5. minor joint anomalies 6. ADHD in later part of childhood |
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Rx. for xs CNS depression in alcohol withdrawal?
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-supportive care
-IV dextrose - thiamine to prevent wernicke-korsakoff |
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Symptoms of alcohol withdrawal?
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insomnia, tremor, anxiety, life threatening seizures, delirium
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Rx. for alcohol withdrawal induced insomnia and anxiety?
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lorazepam, diazepam
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Rx. for alcohol withdrawal?
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- thiamine
- restoration of fluid electrolyte balance |
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How is the intensity of the withdrawal effects of alcohol reduced?
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- clonidine or propranolol
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Rx. alcoholism?
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disulfram- aldehyde dehydrogenase inhibitor
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What is the effect of alcohol consumption for a patient on disulfiram?
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- accumulation of acetaldehyde
- nausea, headache, flushing & hypotension. |
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Rx. for alcohol de-addiction:
opioid antagonist? |
Naltrexone
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Name an NMDA antagonist used to treat alcohol de-addiction?
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acamprosate
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Antiemetic used for alcohol de-addiction?
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ondansetron
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Antiepileptic drug used for alcohol addiction?
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topiramate
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What are other drugs with disulfiram like effects?
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metronidazole, cephalosporin, sulfonylurea hypoglycemic drugs, chloral hydrate
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Where do you find methanol?
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windshield cleaners and "canned heat"
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Symptoms of formic acid
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severe acidosis and retinal damage/blindness
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What is the toxic metabolite of methanol?
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formic acid
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What are the adverse effects of formic acid?
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severe acidosis and retinal damage/blindness
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Rx. of methanol poisoning?
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-gastric lavage
-hemodialysis done at high alcohol levels 1. IV ethanol to saturate ADH 2. fomepizole inhibits the remaining ADH 3. bicarbonate for the metabolic acidosis |
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How is ethylene glycol used?
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Heat exchangers, in antifreeze formulations, and as industrial solvents
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What draws children and animals to ethylene glycol?
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the sweet taste
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What are the signs of alcohol toxicity?
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- excitation followed by CNS depression
- after a delay of 4-12 hrs. --> severe metabolic acidosis - delayed renal insufficiency following the deposition of oxalate in renal tubules |
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Rx. of ethylene glycol poisoning?
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-ethanol
- fomepizole - supportive measures --> sodium bicardonate |
