Card Set Information
Pharmacology Toxicology Alcohol
Pharm Exam 5: Toxicology II: Alcohol
60 proof is equal to what percent alcohol?
What is the rate-limiting step of fermentation of ethanol? What drug inhibits it?
Ethanol to acetaldehyde by ADH (in liver and stomach)
Inhibited by pyrazoles
What does disulfiram do?
Inhibits aldehyde dehydrogenase so acetaldehyde cant be broken down to acetate. Treatment of alcoholism.
4 pharmacological treatments of alcoholism?
Disulfuram, pyrazoles, naltrexone, antidepressants
(70% have reduction in drinking)
4 symptoms of alcoholism
Craving, loss of control, physical dependence, tolerance
How much is 1 unit of alcohol in ml and g? What is the legal limit BAC in mg/dl?
1 unit = 10 ml or 8 g EtOH
Legal BAC= 80 mg / dl (.08)
Where is most alcohol absorbed?
Sm intestine (duodenum) and stomach
4 elimination routes of ethanol?
Liver, kidney, lungs, sweat glands
Effects on CNS?
Depressant- facilitates GABA, may inhibit NMDA glutamate receptors
*resp depression occurs bc depression of brainstem resp drive (primary cause of acute alcohol lethality!)
: memory loss and cerebellar atrophy, peripheral neuropathy
Cardiovascular, renal, sexual, GI effects?
Vasodilation (hypothermia), increase HDL/decrease LDL, coagulation defects when used long-term
Increase urine flow
Gonadal toxin, frontal lobe disinhibitor, decreases testosterone w chronic abuse
Low doses stimulate appetite while high doses depress appetite (7 cal/g), ulcers and diarrhea
Effect of alcohol on liver
Stimulation cytochrome P450, production of ROS
Fatty liver-> fibrosis-> cirrhosis (due to altered lipid metab and NADH accumulation)
AST and GGTP will be elevated
Portal hypertension (GI bleeding) and salt/ water retention
Triglycerides increase after damage
T or F: acute alcohol poisoning causes mainly CNS symptoms but also hyperglycemia
F: does cause mainly CNS symptoms but also HYPOGLYCEMIA (and alcoholic ketoacidosis)
Other chronic effects of alcohol abuse=
Diabetes (damaged pancreas)
Gout (increased uric acid)
Megaloblastic anemia (decreased folate)
Also decrease in magnesium and phosphate
What drugs have additive effects w alcohol?
CNS depressants, some antihypertensives, oral anticoagulants, hypoglycemic agents
Aspirin and acetaminophen with alcohol?
Drugs with reduced uptake w alcohol?
Penicillin and diazepam (long term only)
Signs of fetal alcohol syndrome
Dental problems of alcoholics
Which other type of alcohol has a therapeutic use? what is it used for?
Isopropanol is used as rubbing alcohol and is a dental disinfectant. (2nd most commonly ingested alcohol)
Kinetics of isopropanol
Rapid complete uptake from GI
Metabolized to acetone
Elimination in kidneys and lung
Toxicity and treatment of 70% isopropanol poisoning
Toxic dose adult
: 2-4ml/ kg
: 3 swallows
Monitor, cardiac and resp support, intravenous fluid for hypotension, hemodialysis
Methanol sources and kinetics
Volatile, odor, antifreeze and paints
Absorbed from GI in 30-90 min (also skin and lung absorption)
Hepatic metabolism to formaldehyde and formic acid
Toxicity and treatment 40% methanol poisoning
Toxic adult dose
: 10 ml= blindness
CNS depression (Headache, cerebral edema), ocular toxicity, GI mucosal irritation, blood acidosis (causes lethality)
Treat with cardiac and resp support, hemodialysis, EtOH as antidote, correct acidosis and hypoglycemia
Ethylene glycol sources and kinetics
Colorless, non volatile, sweet taste (poor mans alcohol. But lets be real- how expensive is hawkeye vodka??)
In antifreeze coolants etc
Rapidly absorbed in the GI, renal filtration
Low ADH affinity
Metabolized to glycoaldehyde, glycolic acid, oxalic acid
Ethylene glycol poisoning symptoms and treatment?
CNS depression (exhilaration, nausea, acidosis, convulsions, coma), renal tox/ failure, cardiopulmonary symptoms ( tachycardia, HTN, failure)
Treat with hemodialysis, correct acidosis, fliud/electrolyte imbalance, resp depression, serum calcium, EtOH as antidote or 4-methylprazole