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29 Cards in this Set

  • Front
  • Back
Name three types of alcohol
Ethanol; Methanol; Ethylene Glycol
What is ethanol’s mechanism of action
Ethanol is a CNS depressant that works through GABA receptors to enhance GABA-mediated synaptic transmission
What is ethanol metabolized to
Which enzymes are responsible for the first steps in the metabolism of ethanol
Alcohol dehydrogenase—a NAD-dependent enzyme that metabolizes alcohol at a fixed rate of approximately 7 to 10 g/hr. This enzyme must follow zero-order kinetics because of a limited supply of the NAD cofactor. The enzyme is found primarily in the liver and GI tract; Microsomal ethanol oxidizing system (MEOS)—Found mainly in the liver, this enzyme increases in activity with chronic ethanol exposure. This increase may account for the tolerance that develops with regular ethanol use
What is acetaldehyde further metabolized into
Acetaldehyde is converted to acetic acid by aldehyde dehydrogenase
Are there therapeutic indications for ethanol use
Yes: Methanol overdose; Ethylene glycol overdose—Ethanol is used in this circumstance because it preferentially binds to alcohol dehydrogenase, and therefore prevents the formation of toxic metabolites from either methanol or ethylene glycol; Recent research indicates that one alcoholic drink (red wine) a day may reduce the risk of coronary artery disease
What are the acute effects of ethanol intoxications
Euphoria; Disinhibition; Slurred speech; Reduced visual acuity; Ataxia; Relaxation of vascular and uterine smooth muscle; Blood levels of alcohol greater than 300 mg/dL can lead to loss of consciousness and decreased myocardial action; Blood levels of alcohol greater than 400 mg/dL can be fatal
What are the chronic CNS effects of alcoholism
A deficiency of thiamine associated with chronic alcohol use can lead to Wernicke-Korsakoff syndrome. This disease is characterized by ophthalmoplegia, ataxia, and confusion
What are the chronic peripheral effects of alcoholism
Decreased liver function—Hepatitis and cirrhosis may develop; GI irritation, inflammation, and bleeding; Gynecomastia and testicular atrophy in men du to the cirrhotic liver’s inability to metabolize estrogen; Hypertension; Dilated cardiomyopathy; Although alcohol is not considered to be a direct carcinogen, alcohol consumption can lead to an increased risk of GI cancer
Why is it unsafe for pregnant women to drink alcohol
Ethanol use during pregnancy may lead to fetal alcohol syndrome, which includes mental retardation, growth deficiencies, microenephaly, and malformations of the face and head
What are the DTs of alcoholism
Delirium tremens—tremor, anxiety, tachycardia, delusions, and agitation. These symptoms are experienced by chronic alcohol users who are suddenly deprived of ethanol
What is disulfiram used for
Disulfiram, and aldehyde dehydrogenase inhibitor, is used adjunctively in some alcohol treatment programs. Patients who drink while taking disulfiram will experience nausea, hypotension, and vomiting. These adverse symptoms encourage avoidance of ethanol
Which drugs are well known to cause a disulfiram-type reaction when used in conjunction with alcohol
Metronidazole, the cephalosporins, and procarbazine
What is marijuana
Marijuana has as its active component delta-9 THC, which is derived from the flowering tops of the hemp plant
What are marijuana’s effects on the CNS
Sedation; Euphoria; Decreased psychomotor activity; Impaired judgement, memory, and time sense
What peripheral physiologic effects does marijuana have
Increased heart rate and blood pressure; Injected (red) conjunctiva; Dry mouth; Bronchodilation; Increased appetite
Does marijuana have any clinical indications
Yes. Dronabinol is a pharmaceutical preparation of delta-9 THC that is used to treat anorexia related to terminal conditions and as an antiemetic in chemotherapy
What are the physiologic effects of marijuana
Analgesia; Increased appetite; impairment of short-term memory; antiemetic; altered perception of time and space; change in motor and postural control
What is the active psychotropic component of marijuana
What are the sign/symptoms of marijuana withdrawal
Restlessness; irritability; agitation; insomnia; nausea
What is LSD
Lysergic acid diethylamide
How does LSD work
It interacts with 5-HT receptors in the midbrain
What are the physiologic actions of LSD on the CNS
Visual hallucinations and flashbacks; Arousal; Excitation; Disturbed perception; Disturbed mood; Panic
What are the peripheral physiologic effects of LSD
Mydriasis; Tachycardia; Flushing, lacrimation, salivation; Increased blood pressure
What drug can block the hallucinatory effects of LSD
What is PCP
Phencyclidine, or “angel dust,” is a dissociative anesthetic (causing analgesia and catatonia without loss of consciousness) that block N-methyl, D-aspartic acid (NMDA) receptors (i.e. glutamate receptors). It is also a ketamine analogue
What is PCP’s mechanism of action
It blocks serotonin uptake
What are the central physiologic actions of PCP
PCP causes a schizophrenia-like psychosis involving distortion of time, space, and body image. Extremely high doses can cause seizures and coma
What are the peripheral physiologic effects of PCP
Increased blood pressure and heart rate; Limb numbness; Ataxia; Hypersalivation; Nystagmus