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Pharm38

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robbypowell's version from 2016-12-13 00:35

Alcohols

Question Answer
What is the most commonly abused legal substance?ethanol
____% of all fatal traffic accidents are linked to use of ethanol50%
ethanol is associate ____ (fraction) of suicide and rapes, _____% of assaults and ____ to ____% of homicides1/3rd (suicide and rapes); 50% (assaults); 50-65% (homicides)
_____ _____ system is major site of action for ethanolCentral Nervous system
What is the specific receptor targeted by ethanol?TRICK QUESTION; no specific receptor, instead exerts effect through many mechanisms
One of the mechanistic effects of ethanol is to cause in _____ (inc/dec) in membrane fluidity, disorder membrane lipids, and cause abnormal ion channel activity in CNS much like inhalation anestheticsincrease membrane fluidity
One of the mechanistic effects of ethanol is to cause enhancement of inhibitory NT's/GABA at ______ receptors like BenzodiazepinesGABA-a receptors (i thought there wasn't a specific receptor?)
One of the mechanistic effects of ethanol is to reduce the effect of excitatory NT, _______, on ion channelsGlutamate (thereby inhibiting NMDA receptors to glutamate's effects)
One of the mechanistic effects of ethanol is to release endogenous opioids and change levels of _____ and ____ (this is why it is so addictive)Dopamine & Serotonin (5HT)
Chronic use of alcohol may alter sensitivity/structure of ______ receptor, leading to an excitatory toxicity effect upon withdrawal of alcohol (delirium tremens)NMDA receptor
_______ receptor antagonists are given to during alcohol withdrawals to reduce the incidence of seizuresNMDA receptor antagonists (examples: Methadone, Tramadol)
Opioid and Dopamine receptor antagonists, such as ________ inhibit desire for alcohol intake (and remove reward payoff)Naltrexone
What is the toxic metabolite of ethanol?Acetaldehyde
what 3 parts of nervous system make up the reward pathway that is activated by alcohol use?ventral tegmental area (VTA), nucleus accumbens, and prefrontal cortex
one of the effects of EtOh is to increase ________ in blood and urineCatecholamines
EtOh causes _____(inc/dec) coronary blood flow and ______ (inc/dec) myocardial activityIncreased Coronary blood flow; Decreased Myocardial activity
_____ (acute/chronic) intoxication affects liver by reversible decrease in microsomal metabolic enzymesAcute (drugs that you were taking at this tiem would have a PROLONGED effect)
______ (acute/chronic) intoxication affects liver by induction of liver enzyme activity (including P450) → dec duration of co-admin drugsChronic
Chronic alcoholism can create deficiencies in these 2 vitamins by inhibiting their active form activationVit A & D
Chronic alcoholism is associated with depletion/deficiencies of what 2 minerals?Zn & Selenium
EtOh inhibits the release of _______ which causes an increase in urinary outputADH (antidiuretic hormone, aka vasopressin)
Chronic use of alcoholism can cause lasting impotence/sterility and lead to a decrease in _______ (hormone) productionTestosterone
A benefit of minimal alcohol use (1 drink per day) is that it improves what ratio?HDL/LDL (we want more HDL than LDL)
Small alcohol doses ______ (increase/decrease) salivation/gastric secretion; larger doses have the opposite effect and so _____(inc/dec) secretionlow --> increase; high --> decrease
EtOH has gastric irritant effects in solutions > ___% EtOH: increasing mucous secretions, gastric ulcerations & petechial hemorrhage>20%
EtOH use decrease absorption of what 4 nutrients?Glucose, AA (amino acids?), Thiamine, & Vitamin B12
With oral EtOH intake... which is higher... arterial blood alcohol content or venous blood alcohol content?Arterial
Why do breath tests work for testing blood alcohol content?alcohol is partly released by lungs
EtOH is metabolized >____% via non-microsomal and microsomal pathways (which of the two is associated with chronic alcohol users?)>95%; (microsomal pathways mainly used in chronic alcohol users)
EtOH elimination follows _____ order kinetics (NOT based on concentration, eliminated at a CONSTANT rate)Zero Order
_______ inhibits Aldehyde Dehdrogenase (which breaks down Acetaldehyde) causing severe hangover like symptoms whenever patient drinksDisulfuram
What are 3 other drugs that have Disulfiram-like effects on Acetaldehyde breakdown?metronidazole (antibiotic/antiprotozoan), sulfonylurea (oral hypoglycemics), & cephalosporins (some)(antibiotics)
T/F: Short-term ethanol ingestion may cause exaggerated response to anticoagulants and oral hypoglycemic agentsTrue
How does alcohol consumption interact with benzodiazepines?Increase levels (inhibits metabolism, so levels stay HIGH and BZD's super potent)
T/F: it is believed that there may be different Acetaldehyde Dehydrogenase levels in different ethnic groupsTrue (asian flush)
One dental problem associate with chronic alcoholism is prolonged post-op healing, believed to be caused by increased _______-ase activityCollagenase
how does alcoholism affect the potency of N2O and conscious sedation in generalLess Potent (less effective, takes more to get same result)
T/F: Concurrent use of alcohol and NSAID's should be avoidedTrue
T/F: Concurrent use of alcohol and acetaminophen should be avoidedTrue
What oral cancer risk increases with alcoholism?Oral Carcinomas
Abstinence syndromes of alcohol are treated with long acting ______; or an alternative treatment is _______ (alpha A agonist) & ______ (anticonvulsant)long acting BZD's; Clonidine (alpha A agonist) & Carbamazepine (Anticonvulsant)
Tx of Alcoholism that increases Acetaldehyde concentration from alcohol use but MUST be medically supervised bc can also cause unconsciousness, hypotensive shock, and sudden MIDisulfiram (Also inhibits dopamine B-hydroxylase so may exaggerate schizophrenia or depression)
Tx of alcoholism that is a long acting opioid antagonist, better tolerated than disulfiramNaltrexone
tx of alcoholism that is used in alcohol-dependence, not yet understood = may inhibit GABAAcamprosate (i wouldn't bet this is on the test)
Acamprosate is a tx used in alcohol-dependence, not yet understood mechanism... it may inhibit _______GABA
What is the denaturing agent put in EtOH to prevent consumption (when sold for non consumptive purposes)Methanol
Methanol toxicity can cause headache, nausea, extreme abdominal pain and what two more serious effects?Blindness & Coma
What are the metabolites of Methanol?Formaldehyde & Formic Acid (these cause blindness)
4 treatments of Methanol poisoning***Hemodialysis, Peritoneal Dialysis, Bicarb infusion & Ethanol administration (ethanol is more selectively taken up)***
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