Pharmacology of Ethyl Alcohol (Ethanol)
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Questions and Answers

What is the primary route of absorption for ethanol in the body?

  • From the large intestine
  • From the skin
  • From the stomach
  • From the small intestine (correct)

    • Which of the following is a common product that contains ethanol?

  • Saline solution
  • Mouthwash (correct)
  • Liquid analgesic
  • Syrup

    • Which effect of ethanol primarily influences the central nervous system?

  • Stimulating neurotransmitter release
  • CNS depression (correct)
  • Increasing heart rate
  • Enhancing cognitive function

    • What is the major site of ethanol metabolism in the body?

    <p>Liver</p> Signup and view all the answers

    What effect does ethanol have on blood glucose levels?

    <p>Causes hypoglycemia</p> Signup and view all the answers

    What are the possible excretion pathways for unchanged ethanol?

    <p>Urine and breath</p> Signup and view all the answers

    Which condition is classified as an accidental alcohol poisoning scenario?

    <p>Alcohol poisoning in children</p> Signup and view all the answers

    What is one of the physiological effects of ethanol on the peripheral system?

    <p>Vasodilation</p> Signup and view all the answers

    What blood alcohol level is generally considered legally intoxicated?

    <p>100 mg/dL</p> Signup and view all the answers

    What is NOT a characteristic of moderate toxicity from ethanol?

    <p>Severe depression of medullary centers</p> Signup and view all the answers

    At what blood alcohol level does severe toxicity begin?

    <p>0.5%</p> Signup and view all the answers

    Which of the following symptoms is characteristic of mild toxicity?

    <p>Euphoria</p> Signup and view all the answers

    Which method is NOT typically used to investigate ethanol presence?

    <p>Gas chromatography</p> Signup and view all the answers

    What is a significant symptom of severe toxicity related to respiratory function?

    <p>Rapid and shallow respiration</p> Signup and view all the answers

    In a case of ethanol poisoning, what condition might be indicated by blood chemistry?

    <p>Ketoacidosis</p> Signup and view all the answers

    What does the 'McEwen’s sign' refer to in the context of severe ethanol toxicity?

    <p>Constricted pupils that dilate upon skin stimulation</p> Signup and view all the answers

    What is the primary method for eliminating absorbed ethanol from the body?

    <p>Forced alkaline diuresis</p> Signup and view all the answers

    Which of the following treatments can be administered to counteract metabolic acidosis caused by ethanol intoxication?

    <p>Sodium bicarbonate IV</p> Signup and view all the answers

    What characteristic of methanol metabolism leads to its greater toxicity compared to ethanol?

    <p>Slower metabolism and accumulation in the body</p> Signup and view all the answers

    What potential antidote may aid in the metabolism of ethanol by stimulating alcohol dehydrogenase?

    <p>Vitamin B6</p> Signup and view all the answers

    Which statement best characterizes the mechanism of toxicity caused by methanol?

    <p>Inhibition of cytochrome oxidase in the optic nerve</p> Signup and view all the answers

    Which of the following substances is NOT an effective treatment for ethanol intoxication?

    <p>Activated charcoal for gastrointestinal decontamination</p> Signup and view all the answers

    What is the primary risk of methanol exposure to workers and children?

    <p>Accidental consumption of adulterated ethanol</p> Signup and view all the answers

    What is the major route of elimination for methanol in the body?

    <p>Hepatic metabolism primarily</p> Signup and view all the answers

    Which clinical manifestation is most directly associated with severe metabolic acidosis in methanol poisoning?

    <p>Tachypnea</p> Signup and view all the answers

    What is the primary purpose of administering ethanol in methanol poisoning treatment?

    <p>To compete with methanol for alcohol dehydrogenase</p> Signup and view all the answers

    Which of the following is NOT a recommended treatment for methanol poisoning?

    <p>Intravenous activated charcoal</p> Signup and view all the answers

    What critical condition may result from severe metabolic acidosis in methanol poisoning?

    <p>Hyperkalemia</p> Signup and view all the answers

    Which of the following is an indicator for the use of hemodialysis in a patient with methanol poisoning?

    <p>Methanol blood level greater than 20 mg/dL</p> Signup and view all the answers

    What is the effect of formic acid accumulation in patients with methanol poisoning?

    <p>Disorientation and stupor</p> Signup and view all the answers

    Which investigative procedure is crucial for assessing optic nerve affection in methanol poisoning?

    <p>Fundus examination</p> Signup and view all the answers

    What is the primary clinical risk associated with central asphyxia in methanol poisoning?

    <p>Reduction in cardiac output</p> Signup and view all the answers

    Study Notes

    Ethyl Alcohol (Ethanol)

    • One of the oldest drugs, found in beers, wines, and distilled spirits
    • A clear, colorless liquid with a slight pleasant odor
    • Source: Fermentation of sugar
    • Uses: Beverages (e.g., wine, whiskey), over-the-counter products (mouthwash, aftershave lotion, hairspray, cough/cold remedies), solvent

    Pharmacokinetics of Ethanol

    • Absorption: Primarily from the small intestine (80%), with some from the stomach and large intestine (20%)
    • Distribution: Distributed to all tissues and body fluids, proportionally to their water content; crosses the blood-brain barrier and placenta.
    • Metabolism: 90-98% is removed through enzymatic oxidation, primarily in the liver, and to a lesser extent in the kidneys.
    • Excretion: 2-10% excreted unchanged through urine, breath; small amounts in sweat, tears, bile, gastric juice, and other secretions.

    Poisoning Conditions

    • Accidental: Addicts, children, workers
    • Homicidal: Facilitating rape or robbery (used with other drugs)
    • Suicidal: Rare

    Mechanism of Action

    • CNS Depression: Ethanol's primary effect is inhibiting neuronal membranes (possibly through Na-K-ATP inhibition). This effect is proportional to blood concentration.
    • Peripheral Vasodilation: Causes a false sensation of heat (central thermal auto-regulation is inhibited).
    • Metabolic Effects: Significant decrease in the NAD/NADH ratio in the liver leads to:
      • Hypoglycemia (inhibition of gluconeogenesis)
      • Accumulation of fat in the liver (reduced glycerol metabolism)
      • Accumulation of lactic acid and ketoacids (metabolic acidosis)

    Toxic Dose

    • A blood level of 100 mg/dL of pure ethanol is considered legally intoxicated.
    • Levels causing deep coma or respiratory depression vary widely based on individual tolerance. Chronic alcoholics may tolerate much higher levels.

    Clinical Presentation (Based on Blood Ethanol Levels)

    • Mild Toxicity (Excitation):
      • Blood alcohol level: 0.05-0.15%
      • Inhibition of centers controlling judgment and behavior
      • Euphoria, talkativeness, behavioral changes.
    • Moderate Toxicity (Incoordination):
      • Blood alcohol level: 0.15-0.3%
      • Motor incoordination (staggering gait, tremors, slurred speech, decreased motor skills)
      • Hiccoughs, diplopia (double vision), vomiting, flushed skin
    • Severe Toxicity (Seizures & Coma): Blood alcohol level > 0.5%
      • Severe central nervous system (CNS) depression
      • Seizures
      • Shock (decreased temperature, blood pressure, pulse, rapid shallow breathing)
      • Alcoholic breath odor, pupils may constrict then dilate (McEwen sign)
      • Coma with respiratory depression
      • Possible cause of death: central asphyxia

    Investigations

    • Rapid Tests: Finger-to-nose, walking in a straight line, buttoning/unbuttoning
    • Chemical Analysis: Breath tests (used by law enforcement), urine, blood tests (for blood alcohol content)

    Treatment

    • Supportive Measures: Maintain airway, provide oxygen, support breathing and circulation
    • GIT Decontamination: Gastric lavage with sodium bicarbonate. Activated charcoal is not effective for ethanol.
    • Elimination: Forced alkaline diuresis, hemodialysis (effective due to alcohol's low molecular weight)

    Antidotes

    • No specific antidote; Vit B₁ accelerates metabolism, but only through stimulating alcohol dehydrogenase enzyme.

    Symptomatic Treatment (for any issues seen)

    • Metabolic Acidosis: Sodium bicarbonate
    • Hypoglycemia: 10-50% dextrose IV
    • Hypothermia: Warming the patient
    • Shock: Fluid expansion and dobutamine
    • Convulsions: Diazepam

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    Description

    Explore the complex properties of ethyl alcohol, including its history, pharmacokinetics, and potential poisoning conditions. This quiz covers its absorption, distribution, metabolism, and excretion in the human body. Test your knowledge and understanding of this important substance in both medical and recreational contexts.

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