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2011-05-02 22:14:23
Pharmacology Toxicology Alcohol

Pharm Exam 5: Toxicology II: Alcohol
Show Answers:

  1. 60 proof is equal to what percent alcohol?
  2. 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
  3. What does disulfiram do?
    Inhibits aldehyde dehydrogenase so acetaldehyde cant be broken down to acetate. Treatment of alcoholism.
  4. 4 pharmacological treatments of alcoholism?
    • Disulfuram, pyrazoles, naltrexone, antidepressants
    • (70% have reduction in drinking)
  5. 4 symptoms of alcoholism
    Craving, loss of control, physical dependence, tolerance
  6. 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)
  7. Where is most alcohol absorbed?
    Sm intestine (duodenum) and stomach
  8. 4 elimination routes of ethanol?
    Liver, kidney, lungs, sweat glands
  9. 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!)
    • Long term: memory loss and cerebellar atrophy, peripheral neuropathy
  10. 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
  11. 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
  12. 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)
  13. Other chronic effects of alcohol abuse=
    • Diabetes (damaged pancreas)
    • Gout (increased uric acid)
    • Megaloblastic anemia (decreased folate)
    • Also decrease in magnesium and phosphate
  14. What drugs have additive effects w alcohol?
    CNS depressants, some antihypertensives, oral anticoagulants, hypoglycemic agents
  15. Aspirin and acetaminophen with alcohol?
    • Aspirin-gastric beeding
    • Acetominophen- toxicity
  16. Drugs with reduced uptake w alcohol?
    Penicillin and diazepam (long term only)
  17. Signs of fetal alcohol syndrome
    • Low IQ
    • Small heads
    • Poor coordination
    • Hyperactivity
    • Flat face
    • Thin lips
    • Philtrum missing
  18. Dental problems of alcoholics
    • Poor OH
    • decreased salivation
    • Malnourishment
    • Oral cancer
  19. 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)
  20. Kinetics of isopropanol
    • Rapid complete uptake from GI
    • Metabolized to acetone
    • Elimination in kidneys and lung
  21. Toxicity and treatment of 70% isopropanol poisoning
    • Toxic dose adult: 2-4ml/ kg
    • Child: 3 swallows
    • Monitor, cardiac and resp support, intravenous fluid for hypotension, hemodialysis
  22. 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
  23. 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
  24. 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
  25. 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