Pharmacology of Alcohols Quiz

• Alcohol absorption in the body occurs rapidly in the duodenum
• Blood alcohol concentration (BAC) depends on several factors: volume, concentration, rate of drinking, food, gastric emptying, and hepatic first pass
• Women have a slower alcohol metabolism than men due to less alcohol dehydrogenase and a lower proportion of total body water
• Ethanol is a sedative-hypnotic agent primarily affecting the Reticular Activating System in the CNS
• Metabolism of ethanol involves potentiating GABA receptors and inhibiting Glutamate/NMDA receptor neurotransmission, inducing release of endogenous opiates
• Large doses of ethanol can cause myocardial and vasomotor centre depression, leading to a fall in blood pressure
• Chronic alcoholism can cause hypertension, arrhythmias, and oxidative stress in the liver, leading to cellular necrosis
• Synergistic interactions occur with antidepressants, antihistamics, hypnotics, opioids, disulfiram, chlorpropamide, metronidazole, cefoperazone, insulin, and sulfonylureas
• Methanol, a toxic alcohol, is well absorbed from the GI tract and causes severe poisoning and blindness with blood levels above 50 mg/dl
• Methanol metabolism results in the formation of toxic metabolites, formaldehyde, and formic acid
• Methanol poisoning treatment includes keeping in a quiet, dark room, gastric lavage with sodium bicarbonate, combat acidosis, and hemodialysis
• Fomepizole is a specific inhibitor of alcohol dehydrogenase used to treat alcohol poisoning.

Additionally, ethanol has local actions as an astringent and antiseptic agent, and it acts as a stimulant on the gastrointestinal tract at low concentrations and an inhibitor at high concentrations. Chronic alcoholism can lead to weakness and myopathy in skeletal muscle, impotence and infertility in the kidney, endocrine effects such as hyperglycaemia and hypoglycaemia, and can be a cause of peptic ulcers, epilepsy, severe liver diseases, unstable personalities, and fetal alcohol syndrome.

Acute alcoholic intoxication symptoms include hypotension, hypoglycaemia, collapse, respiratory depression, coma, and death, and treatment includes ABCD approach, gastric lavage, correction of hypoglycaemia and electrolyte imbalance, insulin and fructose drip, and recovery can be hastened by haemodialysis and thiamine to prevent Wernicke-Korsakoff syndrome.

Chronic alcoholism leads to tolerance and dependence, and symptoms of withdrawal include anxiety, sweating, tremor, impairment of sleep, confusion, hallucinations, delirium tremens, convulsions, and collapse. Treatment includes benzodiazepines, long-acting opioid antagonists, NMDA antagonists, and aldehyde dehydrogenase inhibitors like disulfiram, which causes distressing symptoms when consumed with alcohol.

Acamprosate, a medication used to treat alcohol withdrawal symptoms, is thought to reduce glutamate surges that excite NMDARs, and may act as a neuro-protectant and protect neurons from damage caused by alcohol withdrawal. Acamprosate has also been used in external applications as an antiseptic and antiperspirant.

Alcoholic sponges can be used to reduce body temperature in fever, and alcohol can be used internally as an appetite stimulant, carminative, and to treat intractable neuralgias, severe cancer pain, and methanol poisoning.

Chronic alcoholism can lead to weakness, myopathy, impotence, and infertility in the skeletal muscle, kidney, and endocrine system, respectively. Alcohol consumption is contraindicated for pregnant women due to the risk of fetal alcohol syndrome.

Alcohol can interact synergistically with various medications, including antidepressants, antihistamics, hypnotics, opioids, disulfiram, chlorpropamide, metronidazole, and cefoperazone. It can enhance the hypoglycaemic effect of insulin and sulfonylureas and increase the risk of gastric bleeding when taken with aspirin. Chronic alcoholism can also lead to peptic ulcers, epilepsy, severe liver diseases, unstable personalities, and pregnancy complications.

Alcohol has various clinical uses, including external applications as an antiseptic and antiperspirant, internal use as an appetite stimulant, carminative, and to treat intractable neuralgias, severe cancer pain, and methanol poisoning. Methanol poisoning treatment includes keeping in a quiet, dark room, gastric lavage with sodium bicarbonate, combat acidosis, and hemodialysis using a specific inhibitor of alcohol dehydrogenase.

Benzodiazepines, long-acting opioid antagonists, NMDA antagonists, and aldehyde dehydrogenase inhibitors are commonly used in the treatment of chronic alcoholism to manage withdrawal symptoms and prevent relapse. Disulfiram is used as an aversion technique to treat chronic alcoholics, and it causes distressing symptoms when consumed with alcohol, making it an effective deterrent for individuals trying to abstain from alcohol.

Chronic alcoholism can lead to tolerance, dependence, and withdrawal symptoms, including anxiety, sweating, tremor, impairment of sleep, confusion, hallucinations, delirium tremens, convulsions, and collapse. Withdrawal symptoms can be managed with a combination of medications and supportive care, including benzodiazepines, long-acting opioid antagonists, and aldehyde dehydrogenase inhibitors.

Acute alcoholic intoxication is a medical emergency and requires immediate attention. Symptoms include hypotension, hypoglycaemia, collapse, respiratory depression, coma, and death. Treatment includes the ABCD approach, gastric lavage, correction of hypoglycaemia and electrolyte imbalance, insulin and fructose drip, and recovery can be hastened by haemodialysis and thiamine to prevent Wernicke-Korsakoff syndrome.

Chronic alcoholism can lead to various health complications, including toxicity from alcohol and its metabolites, cardiovascular disease, liver damage, pancreatitis, gastrointestinal bleeding, and neurological damage. Chronic alcoholism can also lead to a wide range of social and psychological problems, including family conflicts, financial difficulties, and employment issues.

Alcoholism can also lead to various comorbidities, such as depression, anxiety, and other mental health conditions. Treatment for alcoholism typically involves a combination of medication, counseling, and support from family and friends.

Alcohol consumption is also associated with an increased risk of various cancers, including breast, colon, liver, and throat cancer. Alcohol can also interact with other medications, including antibiotics, antidepressants, and antihypertensives, leading to adverse effects.

In summary, alcohol has various pharmacological actions on the body, including its absorption and distribution, local actions on the CNS, CVS, GIT, and liver. Alcohol consumption can lead to both acute and chronic health complications, including withdrawal symptoms, liver damage, and various cancers. Treatment for alcoholism typically involves a combination of medication, counseling, and support from family and friends. Alcohol can also interact with other medications, leading to adverse effects. It is essential to be aware of the potential risks and benefits of alcohol consumption and to seek medical attention if symptoms of acute or chronic alcoholism are present.