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18 Cards in this Set

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Given the blood levels of ethanol of .15%, .4%, and .6%, describe the manifestations of intoxication
Describe the mechanisms by which ethanol produces its effects. (sedative/ataxia/blackout)
An action on the GABA receptor – increases GABA – mediated inhibition. This action may mediate sedative and ataxia effects.

May also inhibit NMDA receptors causing blackouts
Describe the primary effects of ethanol on CNS

how do you get hypothermia ?
Alcohol causes a dose-related depression of all areas of the CNS. Depression of hypothalamus results in hypothermia

Acute intoxication can be lethal due to depression of medullary respiratory and CV centers
Stimulation observed after one or two drinks is a result of depression of inhibitory control mechanism of the reticular activating system.

Chronic use can lead to irreversible neurological damage.
Describe the primary effects of ethanol on respiratory and CV system
Respiratory system:
At about 0.40% - depression of respiratory center results in death

Cardiovascular system:
Moderate amount – peripheral vasodilation causing slight ↓ BP and heat loss. Regular moderate consumption decreases risk of heart disease (↑ HDL, ↓ platelet aggregation).
High dose – myocardial depression
Chronic change – alcoholic cardiomyopathy
Describe the primary effects of ethanol on the GI (stomach, intestine, and pancreas)
Stomach – at low doses, alcohol stimulates salivary and gastric acid secretion. High concentrations of alcohol (>20%) may inhibit gastric acid secretion and peptic activity.

Intestine – chronic ingestion will lead to ↓ absorption of folic acid, thiamine, niacin, other vitamins, constipation, or diarrhea.

Pancreas – chronic ingestion may lead to pancreatitis
Describe the primary effects of ethanol on the liver
Chronic ingestion → induction of hepatic microsomal enzyme system and other enzyme systems.
Chronic excessive use fatty → infiltration, hepatitis, and hepatic cirrhosis.
Biochemical changes
what important endocrine effect does ethanol have?

**
decreases ADH release
leading cause of teratogenesis
booze
Describe the metabolism and elimination kinetics of ethanol

what enzyme does this?
90-98% of ethanol ingested is completely oxidized in the body. The rest is excreted via the urine and expired air.

At BAC > 0.01% the metabolism of ethanol follows zero-order kinetics

alcohol dehydrogenase
how does drinking cause hypoglycemia
NAD is used to metabolize etoh and you dont have any left for gluconeogenesis
Wernicke-Korsakoff Syndrome
memory loss and psychosis due to vitamin loss and booze
moa of Disulfuram? use?
Inhibition of aldehyde dehydrogenase leads to increase blood levels of acetaldehyde following ingestion of alcohol

causes a person to get really sick and deter them from drinking

can also be used against cocaine
Naltrexone, an opiod antagonist has what other use?
Opioid antagonist which blocks the rewarding effects of alcohol. Limitation is possibility of liver damage at high dose
what kind of drug is acamprostate?
An anti-craving drug approved by FDA August, 2004. Used to maintain abstinence in former drinkers.
Describe the potential drug interactions between ethanol and CNS depressants, oral hypoglycemics, anticoagulants, salicylates, acetaminophen, anticonvulsants, and antimicrobial agents
CNS depressants: potentiate effect

hypoglycemia: Alcohol causes potentiation of hypoglycemic effect. May also see disulfiram-like effect, particularly with chlorpropamide and tolbutamide


anticoagulants: Half-life of warfarin decreased by chronic use of alcohol; however, anticoagulant effect may be enhanced in the presence of liver disease. Occasional moderate doses of ethanol unlikely to interfere with warfarin therapy in patients with normal liver function

salicylates: Increase risk of gastric hemorrhage (aspirin)

acetaminophen: potentiate breakdown to toxic metabolite-->liver damage

anticonvulsants: Half-life decreased with chronic ingestion of large doses of alcohol due to induction of microsomal enzymes. Alcohol withdrawal associates with seizures

antimicrobial agents: disulfram like rxns
2 metabolites of methanol? things they cause
formic acid (metabolic acidosis-death)

formaldehyde (damage retinal cells-->blindness)
tx for methanol?
Hemodialysis, support respiration
NaHCO3 administration to correct for metabolic acidosis
Delay methanol metabolism with ethanol or Fomepizol (Antizol) - an inhibitor of alcohol dehydrogenase which decreases metabolism of methanol to toxic metabolites
Oxidation to glycoaldehyde and oxalate may cause serious metabolic acidosis (anion gap) and renal damage (oxalate crystals)....
Ethylene Glycol

Solvent, antifreeze. Sweet taste attracts children and animals