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79 Cards in this Set
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- Back
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what will cause the anxiolytic, euphoric, and disinhibition effects of etoh
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gaba a enhancement
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w/ etoh there will be a decrease in --- times
and an increase in errors of ---- |
rxn
judgement |
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etoh will change ---- patterns
will --- latency to fall asleep decrease/increase REM |
sleep
decrease decrease REM |
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etoh use can progress to -- and death
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coma
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why etoh not good for long term anticonvulsant
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big rebound effect on seizure threshold, so an increase in seizure sensitivity btw 12-24 hrs after last dose
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etoh will decrease/increase seizure frequency
increase/decrease latency to seizure |
decrease
increase latency not useful against seizure due to short t1/2 |
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why isn't etoh an effective analgesia
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cuz no selective
impairs senses |
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how is etoh emetic
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stimulates ctz
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tx uses of etoh
----- for topical agents antedote for --- poisoning |
solvent: helps drug get thru skin
methanol |
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etoh increases --- release in NAc
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DA: euphoric effects
w/ alcholics involves release of endogenous opiates |
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etoh inhibits ---- ---- receptor fx , so there's anmestic effects. . . this inhibits production of ------
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glutamate NMDA
LTP |
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at high conc there's --- inhbition of cognitive fx
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kainate
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etoh enchances ---- stimulated ----- conductance
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GABA
Chloride |
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what subunits mostly affected by gaba a
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alpha
beta gamma 2L (long) so this will lead to sedation |
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etoh inhibits ---- sensitive Ca channels
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voltage
at 150-300 mg % more severe sedation and coma |
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etoh --- cell membrane
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fluidizes
etoh is a solvent it melts fat of membrances. . . screws up structure at 500 mg% |
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there rapid/slow tolerance to etoh even w/ 1st drink
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rapid
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why w/ etoh there's frequenct wakenings at night
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due to rapid tolerance
becoming less sedated |
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etoh can get into lipids easily and affect the -- -----
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ion channels
possibly K channels . . .most sensitive. . .increase fiiring |
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which is more sensitive to etoh
gamma 2 short or long |
long
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vaso----- of cutaneous vessels leads to ------
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dilation
hypothermia |
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at very high doses of etoh what will happen to the temp
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respet hypothalmic temp setpoint
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> 3 drinks /day is -----
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cardiotoxic
damage to vasculature |
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etoh will increase --- and decrease --- in the blood
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increase HDL
decrease LDL decrease coronary heart disease by about 40% |
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how many drinks to prevent heart disease
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1-2 drinks/day
better w/ flavonoids (red wine). . . enhance the effects |
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etoh will increase ---- acid secretions
still will worsen --- and ---- se |
gastric
ulcers NSAIDS |
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etoh inhibits --- secretion
decreases/increase renal reabsoption of water |
ADH
decreases . . . so dehydration diuresis |
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high doses of etoh will depress -----
this is -- w/ other sedatives |
respiration
synergistic |
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dose of etoh depends on:
---- rate of ---- --- conc |
weight
absorption etoh also, gender, body fat, sleep status |
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first signs of intoxication:
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20mg%
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under 21 illegal
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30mg%
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legally impaired in many states
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50mg%
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dui
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80mg%
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7x more likely to cause an accident
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100mg%
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25x more likely to cause an accident
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150mg%
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death:
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400 mg%
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antedote for etoh
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stomach pump
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t/f
coma always due to etoh |
f
cause be due to head injury, DM |
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90-98% of metabolism of etoh is
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hepatic
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most metabolism of etoh is
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dehydrogenase
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cyp involved in etoh
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cyp2E1
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avg drink has -- g of etoh
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14
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etoh dehydrogenase converts ethanol to ----
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acetaldehyde
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acetaldehyde dehydrogenase converts --- to ---
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acetaldehyde
acetyl coA |
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which has zero order kinetics
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alcohol dehydrogenase
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which has 1st order kinetics
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acetaldehyde dehydrogenase
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when will acetaladehyde begin to build up
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if the person drinks more than zero order
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what will cause flushed face, ha, vomiting, sweating
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acetaldehyde
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why use disulfiram w/ etoh abuse
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it blocks acetaldehyde dehydrogenase
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metanol metabolized to -- ---
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formic acid
and formaldehyde by denaturization |
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what can cause death w/ methanol
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severe acidosis
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what can cause blindness w/ methanol
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specific toxicity for retinal cells
irreversible |
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methanol has specific toxicity for --- cells
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retinal cells
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what's the antedote for methanol
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ethanol
uses 0 order kinetscs so it floods the system so only 7-10g/hr so, it inhibits formaldehyde formation |
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etoh is additive w/
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bdz's
sedatives anethetics antipsychotics tca opiates (increase amnesia and resp depression) |
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etoh will decrease absorption and increase metabolism of ----
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pcn
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etoh promotes ---- induced gastric bleeding
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NSAID
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what other meds will inhibt acet. dehyd
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1st gen oral hypoglycemics
cephalosporins methronidazole - may in some sub-populations |
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initially etoh will compete for ---- so increases many drug levels
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CYP2E1
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chronic use of etoh induces cyp2e1 and what will occur next
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decreases drug levels
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what do you become tolerant to in etoh
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all initial effects except death
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PK changes due to etoh:
increased activity of --- --- increased contribution by induction of ------ |
etoh dehydrogenase (so more than 7-10 g metabolized)
CYP2E1 (from 2 to 10% being metabolized . . . more metabolized) more metabolized so you need more to get the effects |
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TI gets lower/higher w/time
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lower
cuz need more to feel effects |
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PD changes of etoh:
--- receptor up regulation; this will increase --- likelihood decreased ----- recpeotr fx increased membrane ----- |
glutamate
seizure (decrease seizure threshold) gaba rigidity |
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decreased gaba a leads to an alteration in ---- composition
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subunit
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increased membrane rigidity due to change in ----- that make up cells
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phospholipids
so cells don't move around as well |
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3 or more drinks q day for long time is mild/mod/severe dependence
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mild
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abstinence syndrome will lead to --- ---
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delirum tremens
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2-24hrs of abstinence syndrome s/s
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tremors
sleeplessness irritability seizures |
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24-48 hrs of abstinence syndrome
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delirium
fever vivid halluicnations (exacerbated by vitamin deficiency) |
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3 days of abstinence syndrome
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exhaustion
cv collapse |
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5-7 days of abstinence syndrome
tx: |
recovery
15% mortality tx: long acting bdz |
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5 or more drinks q day for a long time is mild/mod/severe
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severe
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protracted withdrawal sydnrome is -- and ---
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severe
persistent changes in mood, etc even after done w/ abstinence syndrome will have cravings, etc. . . etoh has high abuse potential |
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abuse liability:
--- genetic, --- environmental |
50%
50% |
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etoh increases --- and -- release in the mesolimbic areas
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DA
taurine |
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etoh combined abuse worsens esp w/
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esp w/ nicotine
ex: etoh will increase nictotine use and vice versa |
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etoh will have altered endogenouse --- systems
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opioid
ex: naltrexone |
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etanol induced damage to --- ----
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prefrontal condition
decrease inhibitory neurons, so want more etoh. . . further damage |
