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29 Cards in this Set
- Front
- Back
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Pharmacologic Effects & Mechanisms of Ethanol
on CNS |
Dose related non-specific depressant
Effects: Disinhibition, Sedation, Ataxia Mechanism: Activation of GABA Inhibition of Glutamate (NMDA-Receptors) |
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Pharmacologic Effects & Mechanisms of Ethanol
on GI |
Effects: Irritation of GI
Mechanism: Stimulates Gastric Secretion Decreases Lower Esophageal Sphincter tone (worsens/preciptates reflux) |
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Pharmacologic Effects & Mechanisms of Ethanol
on Renal |
Effect:
Diuresis Mechanism: Decreased release of ADH |
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Pharmacologic Effects of Ethanol
on Cardiovascular system |
Cutaneous vasodilation = Flushing
Elevation of HDL = cardioprotective in moderate amounts. Reduced cardiac contractility |
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Ethanol
Absorption & Distribution |
Rapid absorption from GI tract
Distributes throughout total body water Cross BBB well Peak blood level 30-60 min. |
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Rate of Ethanol metabolism
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at usual doses, linear.
7-10 g/hr ~ 1 drink/hr |
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Metabolism of Ethanol.
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1.
a) Usual Dose = Alcohol Dehydrogenase b) High Doses = AD & Mitochondrial Ethanol Oxidizing System & Cytochrome P450. 2. Aldehyde Dehydrogenase. |
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Alcohol Dehydrogenase
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converts Ethanol to Acetaldehyde + NADH
present in liver and stomach (weaker effect in female stomach) |
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Aldehyde Dehydrogenase
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Oxidizes Acetaldehyde to Acetate.
Lower activity in Asian. |
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Acute Ethanol Toxicity
- manifestation - setting |
Leading cause of drug overdose deaths. Especially in instances of drinking as much as you can as fast as you can.
Respiratory Depression |
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Chronic Ethanol Toxicity
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Hepatic: Fatty infiltration, cirrhosis, portal HTN, ascites.
CNS: Wernicke's Encephalopathy, Korsakoff syndrome. Cardiovascular - Cardiomyopathy (fatty infiltration), HTN, increased risk of supraventricular arrhythmia & stroke GI: gastritis, pancreatitis Depressed Immune function. |
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What is the effect of chronic ethanol toxicity on the liver?
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Fatty Liver disease (infiltration)
Cirrhosis portal HTN Ascites |
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What is the effect of chronic ethanol toxicity on CNS?
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Wernicke-Korsakoff Syndrome (memory loss, confabulation)
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Wernicke- Korsakoff Syndrome
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Manifestation of Thiamine (B1) deficiency in the CNS. (beriberi & Ch alcohol tox)
Wernicke = confusion, nystagmus, unequal pupil size, ataxia, sluggish pupillary reflex, coma Korsakoff = confabulation, hallucinations, anterograde & retrograde amnesia |
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Fetal Alcohol Syndrome
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Syndrome secondary to alcohol consumption during fetal development.
early CNS dysfunction midfacial structural abnorm. stunting of growth. |
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Alcoholic Withdrawl Syndrome
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Agitation, Insomnia, Tremor,
Delirium Tremens Convulsions Hyperthermia Cardiac arrythmias |
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Treatment of Alcoholism
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Withdrawal with the use of a sedative, especially Diazepam
Supportive & Psychological Tx Disulfiram Naltrexone Acamprostate |
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Disulfiram
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(antabuse)
Inhibits Aldehyde dehydrogenase. = accumulation of acetaldehyde with alcohol consumption. = Nausea, faintness, hypotension & weakness. |
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Naltrexone
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(ReVia)
Opiate Antagonist. - reduces craving, reward and incidence of relapse. |
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Acamprosate
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(Campral)
Decreases glutamate transmission. Reduces Relapse rate. |
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Ethanol Topical Use
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70% concentration = effective antiseptic / disinfectant
MoA: protein denaturant. |
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Uses of Methanol
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Fuel, Solvent, Denaturant.
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Metabolism & Manifestations of Methanol ingestion
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Methanol Toxicity
metabolized = formaldehyde & formate Blindness. Acidosis w/ anion gap. |
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Treatment of Methanol Ingestion
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Supportive treatment: respiratory & bicarb.
Dialysis Ethanol or Fomepizole = Inhibit alcohol dehydrogenase. |
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Fomepizole
- Mechanism of action - Uses |
Inhibits alcohol dehydrogenase
(metabolite production) Used in treatment of: - methanol - ethylene glycol |
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Why would you treat Methanol Ingestion with Ethanol?
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Ethanol will out compete methanol for alcohol dehydrogenase, thereby inhibiting the metabolism of methanol to formaldehyde and formate.
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Ethylene Glycol
- Use - Toxicity |
Antifreeze.
Excitation followed by depression, acidosis & renal damage via oxalate crystals |
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Treatment of Ethylene Glycol Toxicity
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Supportive therapies
Dialysis Ethanol or Fomepizole |
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Manifestations of Isopropyl Alcohol Toxicity
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CNS depression
Acidosis Renal Damage |
