Alcohol Review PDF

Alcohol Review Melissa Lugo Review of Learning Objectives Outlined by Dr. Palmer Describe Absorption, Distribution, metabolism and excretion Absorption – Passive Diffusion, Down Concentration Gradient Distribution- Appears in tissues in proportion to water content Metabolism- 90-98% ox...

Alcohol Review Melissa Lugo Review of Learning Objectives Outlined by Dr. Palmer Describe Absorption, Distribution, metabolism and excretion Absorption – Passive Diffusion, Down Concentration Gradient Distribution- Appears in tissues in proportion to water content Metabolism- 90-98% oxidation by the liver Excretion-Small amounts of alcohol are present in the breath and urine Characterize the Pharmacokinetics of Alcohol metabolism Kinetics are zero order because of limited ability of liver to convert NADH-ND+ Two inhibitors of alcohol metabolism and for each describe mechanisms of action and clinical uses FOMEPAZOLE and DISULFIRAM Metabolic Changes associated with Heavy alcohol use? 1Hypoglycemia,Ketonemia, Lactic Acidosis, Hyperuricemia Characterize the CNS Effects of acute alcohol ingestion CNS depressant, Anti-anxiety actions & behavioral disinhibitions, Disturbed balance between excitatory and inhibitory influences Alcohol action on the liver Alcohol consumption affects the liver by initially causing reversible fat deposition in hepatocytes. Prolonged exposure can lead to hepatic steatosis (fatty liver), alcoholic hepatitis with liver inflammation, and eventually cirrhosis, an irreversible condition characterized by fibrosis, liver dysfunction, and impaired circulation, with women being more susceptible than men. Alcohol actions on the GI tract Development of acute and chronic gastritis with a fair frequency of bleeding Alcohol actions on the Hematopoietic system Anemia, Thrombocytopenia secondary to bone marrow depression, immune depression Alcohol actions on the cardiovascular system Cardiomyopathy, Hypertension, hypothermia Describe the phenotypic facial features of individuals with FAS Facial abnormalities PLUA growth deficits and CNS abnormalities Describe the influence of gender on alcohol disposition and pharmacodynamics Women are more vulnerable than men to the adverse effects of alcohol, achieving higher blood alcohol concentrations due to lower gastric ADH and a smaller volume of distribution, and developing alcohol-induced liver disease, hepatitis, and cirrhosis more rapidly and with less alcohol. While alcohol use and dependence are more common in men, women are at greater risk for alcohol-related organ damage and mortality. Characterize alcohol use disorder “Positive Last Use Assessment.” PLUA It is a term used in clinical and therapeutic settings to assess the most recent instance of alcohol consumption in individuals being evaluated or treated for Alcohol Use Disorder (AUD), including the FAS point signifies the critical threshold or stage at which alcohol exposure causes measurable effects on fetal development, leading to symptoms such as growth deficiencies, facial abnormalities, and neurodevelopmental disorders. This term emphasizes the importance of understanding the timing and extent of alcohol exposure’s impact during pregnancy which could lead to Fetal Alcohol Syndrome Alcohol Use Disorder (AUD), previously referred to as alcohol abuse or dependence, is the most common substance use disorder, characterized by behavioral and physical symptoms such as withdrawal, tolerance, and craving. With an average onset age of 21, AUD affects 14% of adults currently and 29% over a lifetime, contributing to a threefold increase in early mortality, while 30% of adults are considered “at-risk” drinkers for exceeding recommended alcohol limits. The class of drugs used to manage alcohol withdrawal? Benzodiazepines Drugs used to prevent relapse in alcohol use disorder? Disulfiram, Naltrexone, Acamprosate Characterize the pharmacodynamic interactions between alcohol and warfarin and alcohol and acetaminophen. Alcohol interacts with warfarin and acetaminophen through CYP2E1 modulation, impacting their pharmacodynamics. Acute alcohol exposure inhibits CYP2E1, enhancing warfarin’s anticoagulant effect, while chronic alcohol use induces CYP2E1, reducing warfarin’s action. For acetaminophen, alcohol’s shared metabolic pathway via CYP2E1 increases the production of the hepatotoxic metabolite NAPQI, with chronic alcohol use exacerbating liver damage severity, while acute alcohol exposure has been postulated (without clinical evidence)