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40 Cards in this Set
- Front
- Back
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What are the therapeutic uses of alcohol?
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Disinfectant (70%)
Alcohol rub down to reduce fever Massaging lotion and astringent Stimulate appetite Nerve block Treat methanol or ethylene glycol poisoning |
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Where is alcohol absorbed?
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20% in the stomach
80% in the small intestine |
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What concentration of alcohol allows for maximum gastric absorption? Why?
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~20%, more than that is inhibitory due to decreased peristalsis
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What is the ratio of ethanol in alveolar air to blood alcohol?
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1/2100
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What forms the basis of BAC?
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1/2100 ratio of ethanol in alveolar air to blood alcohol content.
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What percent of alcohol is metabolized in the liver? What happens to the rest?
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90-98%
The rest (2-10%) is excreted uncharged by the kidney or exhaled. |
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What is the first metabolite of alcohol? What enzyme is involved?
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ADH makes ethanol into acetaldehyde
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What is the second metabolite of alcohol? What enzyme is involved?
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ALDH makes acetaldehyde into acetate
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What cofactor is necessary to metabolize alcohol?
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NAD
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When does alcohol metabolism become zero order?
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When you run out of NAD
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What is the average rate of alcohol metabolism?
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15mL/hr
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How much alcohol is in one serving?
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~18mL
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When will the p450 system start to metabolize alcohol?
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With chronic use
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What is the mechanism of alcohol?
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1. disorganizes neuronal membranes
2. Inhibits Na conductance 3. High concentrations inhibit active transports 4. Stimulates GABA transmission 5. Inhibits glutamate at NMDA 6. Enhances GIRK |
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What is the effect of alcohol on neuronal lipid bilayer?
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Expands the bilayer
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What is the effect of alcohol used as a sleep aid?
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Effective with rapid induction
Causes shallow sleep, multiple awakenings, REM rebound with nightmares, next day drowsy |
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At what BAC will sleep progress to coma? Respiratory depression and peripheral collapse?
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Coma = 0.25
Respiratory depression/collapse = >0.50 |
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What is causes Wernicke's encephalopathy? What are the symptoms?
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Chronic alcohol used with CNS depression
Confusion Nystagmus Ataxia |
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How is Wernicke's encephalopathy treated?
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Thiamine
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What is a significant neurological risk of chronic alcohol use? Why?
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Korsakoff's psychosis because its irreversible. Caused by a lack of thiamine
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Why does chronic alcohol use cause fatty liver?
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Increase in NADH/NAD ratio stimulates triglyceride formation and inhibits the Kreb cycle.
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Why do alcoholics have metabolic acidosis?
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Increase in lactate levels due to inhibition of Kreb cycle.
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Why are alcoholics uremic?
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Because they have elevated lactate and lactate competes for renal tubular elimination of uric acid.
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What is the effect of alcohol on antidiuretic hormone and oxytocin?
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inhibits the release of both
Alcohol make you pee a lot. |
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Why should alcohol not be combined with tolbutamide, metronidazole, and cephalosporin?
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Because they block ALDH
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Alcohol causes cross tolerance to which drug classes?
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General anesthetics
Barbiturates Benzos |
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What drugs are used to manage alcohol withdrawal? Which types are preferred? Why?
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Short acting benzos so they dont have to be activated in a liver that is already fucked.
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What is "Holiday Heart"?
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Arrhythmias due to binge drinking
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What is disulfiram? What is the effect?
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Blocks ALDH. When alcohol is consumed, it causes flushing and N/V.
To control abuse. |
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What is naltrexone? Why is it used with alcoholics?
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opioid antagonist that can change the effect of alcohol. Can reduce cravings.
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What is a necessary condition prior to initiating naltrexone?
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stabilize pt post acute withdrawal
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What is acamprosate? Why is it used with alcoholics?
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inhibits glutaminergic states in alcoholic withdrawal, used to maintain abstinence and avoid withdrawal symptoms
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Why is ondansetron used with alcoholics?
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5HT3 receptor antagonist used to decrease consumption
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What are the metabolic products of methanol?
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formaldehyde and formic acid
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What are the effects of formic acid on the body?
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Causes deadly acidosis and accumulates in the optic nerve causing blindness
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What is fomepizole? What is it used for?
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A potent competitive inhibitor of ADH use in methanol poisoning
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What are the treatments for methanol poisoning?
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1. Fomepizole
2. Ethanol IV 3. Hemodialysis |
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What are the metabolic products of ethylene glycol?
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glycolic acid and oxalic acid
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Why is ethylene glycol toxic?
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Causes acidosis
Oxalic acid is renal toxic |
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Why is isopropyl alcohol bad bad joo joo?
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Metabolite is acetone causing severe intoxication.
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