Ethanol & Alcohol Deterrants

how does ethanol affect the CNS?

-depression

if ethanol is used alongside other CNS depressants, what happens?

-additive CNS depression effects

is ethanol H2O-soluble or lipid-soluble?

-both!

what are the 3 phases of ethanol metabolism?

1: ethanol — (alcohol dehydrogenase) → acetaldehyde

2: acetaldehyde — aldehyde dehydrogenase → acetate

3: acetate → acetyl coenzyme A

how does ethanol cause a hangover?

-accumulation of acetaldehyde

how is ethanol excreted?

-kidneys

-lungs

what is the 1st CNS area affected by ethanol?

-cerebral cortex

which does ethanol affect 1st: motor function or cardiopulmonary function?

-motor function

what are the 3 physiological adverse effects of acute ethanol intoxication?

-vasodilation

-cardiopulmonary depression

-GI irritation & diarrhea

what are the 5 physiological adverse effects of chronic alcohol abuse?

-cardiomyopathy

-hepatotoxicity

-peripheral neuropathy

-dementia

-Wernicke’s & Korsakoff’s (thiamine deficiency)

why does chronic alcohol abuse cause Wernicke-Korsakoff syndrome?

-thiamine deficiency

alcohol withdrawal of ______ hours can lead to delirium tremens

-48-96hr

how is alcohol withdrawal prevented & treated?

-benzodiazepines = oral or IV lorazepam

what benzodiazepine is used for preventing & treating alcohol withdrawal?

-lorazepam

why are benzodiazepines used for managing alcohol withdrawal?

-they have cross tolerance with alcohol

what are the 3 alcohol deterrent agents?

-disulfiram

-naltrexone

-acamprosate

what is disulfiram (Antabuse)?

-alcohol deterrent agent

what is the ROA of disulfiram?

-oral

what is the mechanism of action of disulfiram?

-blocks oxidation of acetaldehyde to acetate which causes an accumulation of acetaldehyde

how is disulfiram an alcohol deterrent?

-causes acetaldehyde accumulation & subsequent hangover/unpleasant Sx when alcohol is consumed

the combination of alcohol with what non-alcohol deterrent medication may cause a disulfiram-like reaction?

-metronidazole

when is disulfiram used?

-management of alcoholics who want to have enforced sobriety

what is naltrexone?

-opioid antagonist that acts as an alcohol deterrent

what are the 2 possible ROAs of naltrexone?

-oral

-IM

how is naltrexone used as an alcohol deterrent?

-blocks opioid effects to prevent the “high” of alcohol ingestion & an alcohol dependence relapse

what are the 4 adverse effects of naltrexone?

-nausea

-h/a

-dizziness

-elevated liver enzymes

when prescribing naltrexone for a patient as an alcohol deterrent, what must be monitored?

-LFTs

what is acamprosate?

-glutamate receptor modulator that is an alcohol deterrent

what is the ROA of acamprosate?

-oral

what is the mechanism of action of acamprosate?

-stimulates GABA neurotransmission & antagonizes excitatory amino acid NTs

what are the 3 uses of acamprosate?

-maintenance of alcohol abstinence

-decrease thoughts of drinking

-help resist drinking urges

what are the 3 adverse effects of acamprosate?

-diarrhea

-nervousness

-fatigue