Imported: Neuro Test 2: Schriefer_Alcohol

Front 1

Given the blood levels of ethanol of .15%, .4%, and .6%, describe the manifestations of intoxication

Front 2

Describe the mechanisms by which ethanol produces its effects. (sedative/ataxia/blackout)

Back 2

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

Front 3

Describe the primary effects of ethanol on CNS

how do you get hypothermia ?

Back 3

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.

Front 4

Describe the primary effects of ethanol on respiratory and CV system

Back 4

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

Front 5

Describe the primary effects of ethanol on the GI (stomach, intestine, and pancreas)

Back 5

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

Front 6

Describe the primary effects of ethanol on the liver

Back 6

Chronic ingestion → induction of hepatic microsomal enzyme system and other enzyme systems.
Chronic excessive use fatty → infiltration, hepatitis, and hepatic cirrhosis.
Biochemical changes

Front 7

what important endocrine effect does ethanol have?

**

Back 7

decreases ADH release

Front 8

leading cause of teratogenesis

Back 8

booze

Front 9

Describe the metabolism and elimination kinetics of ethanol

what enzyme does this?

Back 9

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

Front 10

how does drinking cause hypoglycemia

Back 10

NAD is used to metabolize etoh and you dont have any left for gluconeogenesis

Front 11

Wernicke-Korsakoff Syndrome

Back 11

memory loss and psychosis due to vitamin loss and booze

Front 12

moa of Disulfuram? use?

Back 12

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

Front 13

Naltrexone, an opiod antagonist has what other use?

Back 13

Opioid antagonist which blocks the rewarding effects of alcohol. Limitation is possibility of liver damage at high dose

Front 14

what kind of drug is acamprostate?

Back 14

An anti-craving drug approved by FDA August, 2004. Used to maintain abstinence in former drinkers.

Front 15

2 metabolites of methanol? things they cause

Back 15

formic acid (metabolic acidosis-death)

formaldehyde (damage retinal cells-->blindness)

Front 16

tx for methanol?

Back 16

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

Front 17

Oxidation to glycoaldehyde and oxalate may cause serious metabolic acidosis (anion gap) and renal damage (oxalate crystals)....

Back 17

Ethylene Glycol

Solvent, antifreeze. Sweet taste attracts children and animals

Front 18

What is the Tx for acute alcohol intoxication?

Back 18

Symptomatic support

Front 19

Describe methanol metabolism

-Order?

-Enzyme?

Back 19

Methanol is largely oxidized in the body by ADH to formic acid and formaldehyde

Metabolism zero order but slower than ethanol metabolism

Ethanol competes with methanol for alcohol dehydrogenase thereby decreasing the rate of methanol oxidation.

Front 20

What is the tx for methanol toxicity

Back 20

**Ethanol**
-competes with ethanol for Alcohol Dehydrogenase

**Fomepizol**
an inhibitor of alcohol
dehydrogenase which decreases metabolism of methanol to toxic metabolites

Front 21

How does alcohol consumption cause hypoglycemia?

Back 21

Alcohol Dehydrogenas needs NAD to break down alcohol.

Limited amounts of NAD decreases gluconeogenesis, resulting in hypoglycemia

Front 22

How does alcohol cause HYPOthermia?

Back 22

-Hypothalamus Depression

-Alcohol causes peripheral vasodilation causing slight ↓ BP and heat loss.

Front 23

Describe the metabolic consequences of ethanol metabolism.

Back 23

Alcohol causes end organ damage via ethanol metabolites.

-Liver Damage
-Brain Damage
-Immune system depression
-Spontaneous abortion
-Testicular Atrophy
-Anovulation and Early menopause
-Arrythmia, Cardiomyopathy

Front 24

Vitamin Supplement to treat effects of chronic alcoholism?

Back 24

Vitamin B replenishment

Front 25

What is the Fetal Alcohol Effect?

Back 25

As little as one drink per week during pregnancy increases aggressive behavior or learning problems in the child

Front 26

Drug to Promote Abstinence:

-"anti-craving" drug

- Blocks NMDA receptors, calcium channels, and activates GABA-A receptors

Back 26

Acamprostate