Pharmacology Of Alcohol

Front 1

cause of death in acute EtOH intox

Back 1

respiratory depression
(typically pt is not a chronic drinker - college freshman rushing a frat)

Front 2

EtOH metabolism

Back 2

lipophilic and hydrophilic
absorbed in stomach and SI
EtOH --> acetyl aldehyde = alcohol dehydrogenase (0th order rxn)
acetyl aldehyde --> acetic acid = aldehyde dehydrogenase (rapid)
can also be processed via P450

Front 3

EtOH pharmacodynamics

Back 3

dissolves in lipid membrane of nerves and disturbs nerve function
binds to and augments GABA activity
decr glutamate activity
induce drug metabolism
dilates blood vessels
irritates gastric mucosa
decr ADH secretion (drinking = clear pee)
antiseptic action

Front 4

EtOH effect on CNS

Back 4

0.02% - sensory impair, coordination impair, decr memory/concentration, faulty judgement, mood changes
0.05%-0.1% - marked mental impairment
>0.4% - death
Chronic effects (thiamine def) - Wernicke's (reversible ataxis, EOM dysfunction, CNS changes), Korsakoff's (irreversible brain damage)

Front 5

EtOh effect on Liver

Back 5

lipid accumulation --> cirrhosis
drug metabolizing enzymes induced then decr w/ liver damage

Front 6

EtOH effects of Stomach

Back 6

acid secretion stimulated
mucosal damage --> bleeding

Front 7

EtOH effects on CV

Back 7

dilates blood vessels
decr CV risk factors w/ small amount
chronic use --> myocardial damage

Front 8

EtOH effects on Kidney, Fetus, Pancreas, Boudouir

Back 8

Kidney - diuresis s/p incr ADH
Fetus - FAS (CNS impair, facial abnormalities, small) *must be chronic use throughout pregnancy
Pancreas - irritates (IFYA), can cause pancreatitis
Boudouir - not good: desires w/o physical capability

Front 9

EtOH - Rx interactions

Back 9

incr or decr action of some drugs
w/ NSAIDs --> mucosal ulceration
w/ acetimenophen --> toxic metabolite (liver damage)

Front 10

Alcoholism Tx

Back 10

Give thiamine
Disulfiram (blocks aldehyde dehydrogenase)
Fomepazole - Tx MeOH or Ethylene glycol ingestion