Question 1

The pharmacologic action(s) of disulfiram is/are:&#10;A) Increased acetate concentration&#10;B) Catabolism of acetaldehyde is increased&#10;C) Acetaldehyde dehydrogenase is inhibited&#10;D) Decreases central nervous system effects of alcohol&#10;E) Alcohol is rapidly converted to glucose

Accepted Answer

Aldehyde dehydrogenase is a major enzyme involved in the metabolism of ethanol. Inhibition of this enzyme leads to accumulation of acetaldehyde and its adverse effects.

Question 2

The pharmacologic basis for using acamprosate in an alcoholic is:&#10;A) It blocks the disinhibition of alcohol&#10;B) It has GABA agonist activity&#10;C) It is a glutamate NMDA receptor antagonist&#10;D) It enhances the rapid breakdown of ethanol.&#10;E) It blocks opiate receptors

Accepted Answer

Acamprosate is an antagonist at glutamate NMDA receptors and modulates the ability of glutamate to activate the metabotropic type 5 glutamate receptor. Acamprosate is thought to restore balance by inhibiting the excitatory component.

Question 3

The blood alcohol concentration (BAC) for a given intake of alcohol (assuming a starting level of zero):&#10;A) Tends to be higher in chronic alcoholics&#10;B) Can be initially higher in women due to a lower first pass clearance&#10;C) Is relatively consistent whether it was determined on whole blood, plasma, or serum.&#10;D) Is not affected by end-stage renal disease&#10;E) Is not clinically significant at 0.15%

Accepted Answer

BAC will be lower in a chronic alcoholic due to metabolic enzyme induction. Women have a lower first pass effect for alcohol which leads to a higher BAC. BAC varies with the hematocrit, so the method of BAC extraction is important. Though not the primary route of elimination, the kidneys do play a role.

Deck 32: Ethanol, Other Alcohols, and Drugs for Alcohol Dependence