Term
| Adverse Effects of Alcohol |
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Definition
CNS: Peripheral Neuropathy
Wernicke-Ataxia, Ophthalmoplegia
Korsakoffs-Learning, Memory Problems
CV: Vasodialation-Hypothermia
Vasoconstriction-Heart/Brain
HPTN, Dialated Cardiomyopathy
GI: Gastrin->Acid->Peptic Ulcer Disease
Liver: Increased NADH->Fatty Liver/Cirrhosis
Acetomenophen Toxicity
Renal: ADH decrease
Sex: Premenopausal-Decrease Estrogen
Postmenopausal-Increased Estrogen(cancer)
Men-Decrease Test, Increased Estrogen
Teratogenic: Decreased IQ, Microcephaly, Facial Abnormalities |
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Term
| What are the enzymes that metabolize ethanol, which is inducable, which is blocked by disulfiram, and which is blocked by Fomepizol? |
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Definition
Alcohol Dehydrogenase: Blocked by Fomepizole
Aldehyde Dehydrogenase: Blocked by disulfiram
CYP2E1: Inducible in heavy drinkers |
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Term
| What are the treatments for alcohol withdrawal |
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Definition
Benzodiazepines: lorazepam or oxazepam should be used if liver is damaged
Haloperidol: Prevent hallucinations
Beta-Block/Clonidine: Prevent Adrenergic |
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Term
| How does alcohol use cause liver steatosis |
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Definition
NADH decreases Beta-Oxitdation
Hypoglycemia increases Keto-fatty Acids |
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Term
| What drugs inhibit Aldehyde Dehydrogenase |
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Definition
Cyclophosphamide
Oral Hypoglycemics
Metronidazole
Disulfiram |
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Term
| What population shows more expression of the inactive form of aldehyde dehydrogenase |
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Definition
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Term
| What are the causes of metabolic acidosis in alcohol use? |
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Definition
A)Lactic Acid production to maintain NAD/NADH ratio
B)NADH reduces Gluconeogenesis causing hypoglycemia and a rise in Keto-Fatty acids
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Term
| What are the mechanisms of Alcohol |
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Definition
Potentiate GABAa
Block NMDA->increase Dopamine(Accumbens)
5HT-3 increases Inhibition
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Term
| How is Pharmacodynamic and Pharmacokinetic tolerance to alcohol generated |
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Definition
Pharmacokinetic: CYP2E1 Induction
Pharmacodynamic: GABAa, NMDA-Glutamate Ca receptor increase |
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Term
| What is the mechanism of Acetomenophen toxicity in alcoholics |
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Definition
CYP2E1 induction generates more NAPQI
Glutathione Depletion allows more damage |
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Term
| What are the signs and treatment of Methanol toxicity |
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Definition
Sign: Visual Disturbances
Treatment: Fomepizol or Ethanol |
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Term
| What is the pathophysiology of ethylene glycol poisoning and how is it treated |
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Definition
Path: Metabolic Acidosis
Renal Insufficiency from Oxalate production
Treatment: Fomepizol or Ethanol |
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Term
| How is gout precipitated by alcohol |
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Definition
| Lactic acid shows compete with urate for excretion transporter in the kidney |
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Term
| What are the drugs used treat alcoholism and what is their mechanism of action |
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Definition
Disulfiram: Block Aldehyde Dehydrogenase
Naltrexone: Block alcohol reinforcement
Acamprosate: Block NMDA
Rimonobant: CB1 Agonist |
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