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19 Cards in this Set
- Front
- Back
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Which symptoms of alcohol consumption are caused by ethanol itself, and which symptoms are caused by acetaldehyde? |
The "positive" symptoms, like euphoria and decreased inhibiton are caused by ethanol The "negative" symptoms, like headache and nausea, are caused by acetaldehyde |
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How does alcohol modulate GABA receptors, and which other drugs have similar action?
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Ethanol binds to an allosteric binding site on the GABA-A receptor, which increases the receptor's affinity for GABA. This fascilitates inflow of chloride, which hyperpolarizes the cells. This allosteric binding site is not the same site as barbiturates, Z-drugs and benzos bind to. |
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Which changes occur in the liver due to alcohol consumption? |
The NADH/NAD+ ratio increases, inducing a state of pseudohypoxia. To reverse this ratio, pyruvate is converted into lactate. This depletes substrates for gluconeogenesis. Also, fats accumulate in the liver. |
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How are the pharmacokinetics of alcohol? |
Alcohol is rapidly absorbed, much by gastric mucosa. It has substantial first-pass metabolism. It follows zero-order kinetics of biotransformation, because NAD+, the cofactor of ADH, is quickly depleted. |
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Which three enzymes can metabolize ethanol in the liver? |
CYP2E1, alcohol dehydrogenase and catalase. |
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Which enzyme metabolizes acetaldehyde in the liver? |
Acetaldehyde dehydrogenase |
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How are the pharmacokinetics different between western and asian populations? |
Asians often have rapid ADH but slow ALDH metabolism. This causes them to experience lower amounts of the "positive" effects of ethanol and more of the "negative" effects of acetaldehyde. |
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What is the mechanism of acquired alcohol tolerance? |
A downregulation of GABA-A receptors and upregulation of Ca2+ channels and NMDA receptors |
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What are the physical symptoms of alcohol withdrawal? |
- Sleep disruption - Hallucination - Sympathetic activation - Tremors - Seizures - Delirium tremens |
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What is delirium tremens? |
Delirium tremens is a state that occurs approximately three days after alcohol withdrawal and lasts for around three more days. It is characterised by hallucinations, fever, delirium, seizures and possibly death. |
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What are the psychological symptoms of alcohol withdrawal? |
- Anxiety - Stress - Dysphoria |
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What is the treatment for alcohol withdrawal? |
Benzodiazepines like diazepam |
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Which drugs can promote alcohol cessation? |
Disulfiram, naltrexone, acamprosate |
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What is the mechanism of action and indication of disulfiram? |
Disulfiram is an aldehyde dehydrogenase inhibitor. It's given to people who are trying to avoid alcohol. If these people consume alcohol, most of the consumed ethanol will remain in the body as acetaldehyde. This causes acetaldehyde syndrome, characterised by vomiting, tachycardia and hypotension |
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What is the mechanism of action and indication of naltrexone? |
Naltrexone is an opioid receptor antagonist. It decreases the euphoric effect caused by drinking. |
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What is the mechanism of action and indication of acomprosate? |
Acomprosate is an NMDA receptor antagonist. It reduces the craving for alcohol. |
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What is the treatment of methanol poisoning? |
- Gastric lavage - Sodium bicarbonate infusion - Fomepizole (ADH inhibitor) or ethanol - Folic acid |
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What is the treatment of ethylene glycol poisoning? |
- Gastric lavage - Sodium bicarbonate infusion - Fomepizole (ADH inhibitor) or ethanol |
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What is often the first symptom of methanol poisoning? |
Visual abnormalities, blindness |
